Department of Plastic Surgery, Inha University School of Medicine, Incheon, South Korea.
Department of Anatomy, Dalian Medical University, Dalina, China.
J Craniofac Surg. 2021;32(2):759-761. doi: 10.1097/SCS.0000000000007065.
In this paper, the authors attempted to determine the extent of the superficial fascia of the cheek using P45 sheet plastination.Three head and neck specimens were sliced in horizontal (46 slices), coronal (30 slices), and sagittal (29 slices) sections using P45 sheet plastination (special polyester resin corrosion-resistant method designed to preserve biological sectional specimens in situ). Through slicing, bleaching, dehydration, casting, forced impregnation, curing, cutting, and sanding the molds, P45 plastination sheets provided good light transmission, allowing the internal structures within the sheet to reveal clearly in their intact form.P45 sheet plastination revealed that the superficial fascia in the cheek area is generally composed of 3 layers: a superficial fatty layer, a membranous layer, and a deep fatty layer. Anteriorly, the membranous layer of superficial fascia (MSF) extended to the posterior border of the zygomaticus major muscle, enveloping this muscle, and then to the lateral border of the orbicularis oculi muscle. Posteriorly, the MSF extended to the anterior border of the parotid gland, and then was continuous with the parotid fascia. Superiorly, the MSF extended to the line from the tragus to the alar base. Inferiorly, the MSF extended to the line from the mandibular angle to the mouth corner. Below this line, the SMAS continued to the upper border of the platysma muscle.Our results using P45 plastination concorded well with Mitz's original drawing. We suggest that the results of the present study may be helpful for practicing surgeons to apply in subcutaneous dissection or sub-SMAS dissection in facelift procedures.
本文作者试图通过 P45 塑化片来确定颊部浅筋膜的范围。使用 P45 塑化片对 3 个头颈部标本进行水平(46 片)、冠状(30 片)和矢状(29 片)切片。P45 塑化片(专门设计的耐腐蚀聚酯树脂,用于原位保存生物切片标本)采用特殊聚酯树脂耐腐蚀方法,在原位保存生物切片标本。通过切片、漂白、脱水、浇铸、强制浸渍、固化、切割和砂纸打磨模具,P45 塑化片提供了良好的透光性,使薄片内部结构得以完整清晰地呈现。P45 塑化片显示,颊区浅筋膜一般由 3 层组成:浅层脂肪层、膜层和深层脂肪层。浅层筋膜的膜层(MSF)向前延伸至颧大肌的后缘,包裹着这块肌肉,然后延伸至眼轮匝肌的外侧缘。向后,MSF 延伸至腮腺前缘,然后与腮腺筋膜连续。向上,MSF 延伸至从耳屏到鼻翼基部的连线。向下,MSF 延伸至从下颌角到口角的连线。在此线以下,SMAS 继续延伸至颈阔肌的上缘。我们使用 P45 塑化片的结果与 Mitz 的原始绘图一致。我们建议,本研究的结果可能有助于临床医生在面部提升手术中进行皮下或皮下 SMAS 解剖。