Sandulescu T, Blaurock-Sandulescu T, Buechner H, Naumova E A, Arnold W H
Department of Biological and Material Sciences in Dentistry, School of Dentistry, Faculty of Health, Witten/Herdecke University, Germany.
JPRAS Open. 2018 Jan 31;16:6-19. doi: 10.1016/j.jpra.2018.01.001. eCollection 2018 Jun.
The aim of this study was to reveal the histomorphological connections among the suborbicularis oculi fat (SOOF), the orbicularis oculi muscle (OOM), the superficial musculoaponeurotic system (SMAS), the infraorbital fat and the skin. Full graft tissue blocks of the infraorbital region with the skin, SMAS, OOM and SOOF were collected post mortem from one female and two male formalin-fixed body donors. Serial histological sections were made, stained and digitized. Digitalization and three-dimensional (3D) reconstruction of the histological meshwork were performed. SOOF was revealed as a fibro-adipose tissue underlying the OOM, which was strictly separated from the intraorbital fat pad by the orbital septum. SOOF, OOM and SMAS were connected by fibrous septa derived from the SOOF, traversing the OOM with division into multiple muscular bundles, continuing above the muscular plane by forming the SMAS and ending with skin insertion. In the infraorbital region, two different types of SMAS bordering the infraorbital fold have been recognized. Muscle cells have been demonstrated in the SMAS fibrous septa of both SMAS types. Together with the OOM, the SMAS and the skin, SOOF forms an anatomical functional unit. Muscular contraction of the OOM could be transferred by the SMAS to the skin level, producing periorbital mimic expression. The 3D reconstruction facilitates the comprehension of the morphological structure, its connections and space correlations in the infraorbital area. The morphological and topographical peculiarities of the infraorbital structures make it possible to conclude that surgical interventions in this area need to be elaborated and individualized.
本研究的目的是揭示眼轮匝肌下脂肪（SOOF）、眼轮匝肌（OOM）、表浅肌肉腱膜系统（SMAS）、眶下脂肪和皮肤之间的组织形态学联系。从一名女性和两名男性福尔马林固定尸体供体身上死后采集带有皮肤、SMAS、OOM和SOOF的眶下区域全层移植组织块。制作连续组织学切片，进行染色并数字化。对组织学网络进行数字化和三维（3D）重建。结果显示，SOOF是位于OOM下方的纤维脂肪组织，它通过眶隔与眶内脂肪垫严格分隔。SOOF、OOM和SMAS通过源自SOOF的纤维间隔相连，这些间隔穿过OOM并分成多个肌束，在肌平面上方继续延伸，形成SMAS，并以插入皮肤告终。在眶下区域，已识别出两种与眶下皱襞相邻的不同类型的SMAS。在两种类型的SMAS的纤维间隔中均已证实有肌细胞。SOOF与OOM、SMAS和皮肤一起形成一个解剖功能单元。OOM的肌肉收缩可通过SMAS传递至皮肤层面，产生眶周表情。3D重建有助于理解眶下区域的形态结构、其连接和空间相关性。眶下结构的形态和地形特点使得可以得出结论，该区域的手术干预需要精心设计并个体化。
