Takami Hisako, Hayashi Takafumi, Sato Noboru, Ohshima Hayato
Division of Anatomy, Department of Regenerative and Transplant Medicine.
Division of Oral and Maxillofacial Radiology, Department of Tissue Regeneration and Reconstruction.
J Craniofac Surg. 2022 Oct 1;33(7):2258-2266. doi: 10.1097/SCS.0000000000008700. Epub 2022 Aug 2.
The layered structures of facial muscles and their topographical relationship with facial fasciae are still not fully understood. This study aimed to clarify the layered structures of facial muscles and fasciae in the temporal-malar-mandible-neck region. Thirty-four human cadavers were examined during gross anatomy courses at Niigata University (2017-2020). The face was composed of 3-layered (deep, middle, and superficial) fasciae and 4-layered facial muscles (first superficial, second superficial, third, and fourth muscle layers) according to the attachment of muscles and their topographical relationship with the fasciae. The deep fascia covered the temporal and masseter muscles. The parotid gland and facial nerves were enveloped in the middle fascia. The superficial fascia was continuous with the second superficial muscle layer. The connection between fourth and superficial muscles was at the malar and buccal areas, where the platysma blended with the masseter and the plural muscles blended with the buccinator. Our findings suggest that cooperation between the 4-layered structure of the facial muscles surrounding the apertures of the eyes and mouth and the superficial fascia enables humans to produce complex facial expressions. Furthermore, the spread of inflammation in the face may be owing to the layered facial muscles and fasciae, as these layered structures separate tissues into multiple compartments.
面部肌肉的分层结构及其与面部筋膜的局部解剖关系仍未完全明确。本研究旨在阐明颞-颧-下颌-颈部区域面部肌肉和筋膜的分层结构。在新潟大学（2017 - 2020年）的大体解剖课程中对34具人类尸体进行了检查。根据肌肉附着情况及其与筋膜的局部解剖关系，面部由三层（深层、中层和浅层）筋膜和四层面部肌肉（第一浅层、第二浅层、第三和第四肌层）组成。深层筋膜覆盖颞肌和咬肌。腮腺和面神经被包裹在中层筋膜内。浅层筋膜与第二浅层肌层相连。第四肌层与浅层肌层在颧部和颊部相连，此处颈阔肌与咬肌融合，多块肌肉与颊肌融合。我们的研究结果表明，围绕眼口孔的四层面部肌肉结构与浅层筋膜之间的协作使人类能够产生复杂的面部表情。此外，面部炎症的扩散可能归因于分层的面部肌肉和筋膜，因为这些分层结构将组织分隔成多个腔隙。
