Catholic Institute for Applied Anatomy, College of Medicine, The Catholic University of Korea.
From the Department of Anatomy.
Plast Reconstr Surg. 2023 Aug 1;152(2):237e-247e. doi: 10.1097/PRS.0000000000010210. Epub 2023 Jul 27.
Sensory nerve tension and gliding-layer mobility in the brow may be significant factors affecting postoperative brow level in an endoscopic brow lift, yet they have rarely been studied.
To investigate the effects of sensory nerve tension and gliding-layer mobility, the following measurements were performed alongside the endoscopic brow lift in 50 fresh cadaveric hemifaces: amount of brow elevation, critical lifting amount (as sensory nerves became tense), laxity of sensory nerve courses, and mobility of brow-gliding layers. The sensory nerve situations in the subperiosteal and subgaleal dissections were also observed.
Supraorbital nerve tension limited the cephalic advancement of the forehead flap. The mean elevation of the brow was 5.8 ± 1 mm (range, 3.5 to 8.6 mm). The mean critical lifting amount was 5.3 ± 1.1 mm (range, 4.0 to 7.3 mm). The mean amount of laxity in the supraorbital nerve (the permissible amount of lift) was 4.1 ± 0.9 mm (range, 2.5 to 5.5 mm). The galeal fat pad was responsible for 60% of brow mobility. The sensory nerve was more protected by a subgaleal dissection in the brow and inferior forehead and by a subperiosteal dissection in the middle and upper forehead.
Cephalic movement of the forehead flap is limited by supraorbital nerve tension. The permitted lifting amount varies from 2.5 to 5.5 mm. Gliding-layer mobility in the brow offsets the postoperative amount of cephalic advancement of the forehead flap. Consideration of supraorbital nerve tension and gliding-layer mobility is recommended to obtain an optimal brow level in endoscopic brow lifts.
在内窥镜眉提升术中，眉部的感觉神经张力和滑行层活动性可能是影响术后眉部水平的重要因素，但这些因素很少被研究过。
为了研究感觉神经张力和滑行层活动性的影响，我们在 50 例新鲜尸半侧头颅旁进行了内窥镜眉提升术，同时进行了以下测量：眉部抬高量、临界提升量（感觉神经紧张时）、感觉神经走行松弛度和眉滑行层活动性。还观察了骨膜下和帽状腱膜下解剖中感觉神经的情况。
眶上神经张力限制了额部皮瓣的向前推进。眉部的平均抬高量为 5.8 ± 1mm（范围为 3.5 至 8.6mm）。平均临界提升量为 5.3 ± 1.1mm（范围为 4.0 至 7.3mm）。眶上神经的松弛度平均值（允许的提升量）为 4.1 ± 0.9mm（范围为 2.5 至 5.5mm）。帽状腱膜脂肪垫负责眉部 60%的活动性。在眉部和额下部，骨膜下解剖比帽状腱膜下解剖更能保护感觉神经；在中、上部额部，骨膜下解剖比帽状腱膜下解剖更能保护感觉神经。
额部皮瓣的向前运动受眶上神经张力的限制。允许的提升量在 2.5 至 5.5mm 之间。眉部滑行层的活动性抵消了额部皮瓣术后的向前推进量。考虑眶上神经张力和滑行层活动性有助于在内窥镜眉提升术中获得最佳的眉部水平。
