Department of Operative Surgery and Topographic Anatomy, First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia.
Moscow Engineering Physics Institute, National Research Nuclear University MEPhI, 115409 Moscow, Russia.
Medicina (Kaunas). 2024 Apr 23;60(5):681. doi: 10.3390/medicina60050681.
Our study aimed to clarify the anatomical features of the zygomatic, upper masseteric, lower masseteric and mandibular ligaments and their possible contribution to age-related gravitational ptosis. The study was carried out by the method of layered dissection of fresh cadavers. In several observations, the zygomatic ligament is represented by the fibers originating from the zygomaticus major muscle fibers. It is a true ligament with the fibers inserted directly into the skin. The upper and lower masseteric ligaments originate from the parotideomasseteric fascia and weave into the thickness of the SMAS. The mandibular ligament consists of two connective tissue laminae originating from the parotideomasseteric fascia at the lower edge of the mandible and from the inner surface of this fascia, along the anterior edge of the masseter muscle, skirting the facial vein sheath and the facial artery, traveling toward the platysma and the depressor anguli oris muscle, and merging with their fibers. The zygomatic ligament should be considered an osteo-musculocutaneous ligament, emphasizing the role of the associated zygomaticus major muscle in the mechanism of aging. The upper and lower masseteric and mandibular ligaments are false fascio-SMAS ligaments rather than osteo-cutaneous ones, playing the barrier role and fixing the superficial fascia and the platysma muscle.
我们的研究旨在阐明颧骨、上颌咬肌、下颌咬肌和下颌韧带的解剖特征及其在与年龄相关的重力性下垂中的可能作用。该研究采用新鲜尸体分层解剖的方法进行。在一些观察中，颧骨韧带由发自颧大肌纤维的纤维组成。它是一种真正的韧带，纤维直接插入皮肤。上颌和下颌咬肌韧带起源于腮腺咬肌筋膜，并编织到 SMAS 的厚度中。下颌韧带由两条起源于下颌下缘的腮腺咬肌筋膜和发自该筋膜内表面的结缔组织层组成，沿着咬肌的前缘，绕过面静脉鞘和面动脉，向颈阔肌和降口角肌行进，并与它们的纤维融合。颧骨韧带应被视为一种骨-肌-皮韧带，强调相关的颧大肌在衰老机制中的作用。上颌、下颌咬肌和下颌韧带是假的筋膜-SMAS 韧带，而不是骨-皮韧带，它们起到屏障作用，固定浅筋膜和颈阔肌。
