Cucu Ramona Paula, Hînganu Marius Valeriu, Costan Victor-Vlad, Lozneanu Ludmila, Boişteanu Otilia, Tamaş Camelia, Negru Dragoş, Hînganu Delia
Grigore T. Popa" University of Medicine and Pharmacy, Iaşi, Romania.
Department of MorphoFunctional Sciences I, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania.
Ann Anat. 2024 Apr;253:152221. doi: 10.1016/j.aanat.2024.152221. Epub 2024 Feb 1.
The superficial cervicofacial musculoaponeurotic system (SMAS) is a complex network formed by mimic muscles and conjunctive tissue of the superficial fascia of the face.This study aimed to introduce new anatomofunctional data on the importance of the trans-SMAS distribution pattern of the skin microperfusion of the face and to underline the role of SMAS in maintaining the homeostasis of the vascular network that crosses it. Considering the fibrous and muscular matrix of the SMAS, using COLIII and MyoH2 antibodies, together with endothelial immunohistochemistry(IHC)intercellular adhesion molecule 2 marker, we determined the correlation of these structures and their interaction.
This study included 33donors of SMAS tissues, which have been stained withregular hematoxylin and eosin (HE), and three different IHC markers have been used (collagen III, muscular tissue, and blood vessels). The samples were collected from parotid, masseteric, jugal, and zygomatic regions. Magnetic resonance angiography was used to identify the main vascular sources of the midlateral regions of the face of another 47 patients.
Significant differences in topographic arrangement, density, and relations of the microsopic vasculature were observed between each of the four regions. Major differences were identified between the role of SMAS in each of these regions, from the parotid capsule to masseteric fascia, transition mobile part, and attaching manners in the zygomatic subunit.
Blood vessel topography must be related with the surrounding conjunctive and muscular tissue, especially regarding facial SMAS. Intrinsic relations between these three components of the SMAS and nervous fibers can provide us important hints on the functionality of the whole system.
面颈部表浅肌肉腱膜系统（SMAS）是由面部表情肌和表浅筋膜的结缔组织构成的复杂网络。本研究旨在介绍关于面部皮肤微灌注经SMAS分布模式重要性的新解剖功能数据，并强调SMAS在维持穿过它的血管网络稳态中的作用。考虑到SMAS的纤维和肌肉基质，使用III型胶原蛋白（COLIII）和肌球蛋白重链2（MyoH2）抗体，以及内皮免疫组织化学（IHC）细胞间黏附分子2标记物，我们确定了这些结构之间的相关性及其相互作用。
本研究纳入了33例SMAS组织供体，组织用常规苏木精和伊红（HE）染色，并使用了三种不同的IHC标记物（III型胶原蛋白、肌肉组织和血管）。样本取自腮腺、咬肌、颊部和颧部区域。使用磁共振血管造影术确定另外47例患者面部中外侧区域的主要血管来源。
在四个区域中的每个区域，微观脉管系统的地形排列、密度和关系均观察到显著差异。从腮腺包膜到咬肌筋膜、过渡活动部分以及颧部亚单位的附着方式，在这些区域中SMAS的作用存在重大差异。
血管地形必须与周围的结缔组织和肌肉组织相关，尤其是关于面部SMAS。SMAS的这三个组成部分与神经纤维之间的内在关系可为我们提供关于整个系统功能的重要线索。
