Landfald Ingrid C, Olewnik Łukasz
Department of Clinical Anatomy, Mazovian Academy in Plock, 2, 09-402 Plock, Poland.
J Clin Med. 2025 Jun 10;14(12):4110. doi: 10.3390/jcm14124110.
The zygomatic major and zygomatic minor muscles play a central role in facial expression, particularly in generating the smile, one of the most essential forms of human nonverbal communication. While their function is widely recognized, the anatomical variability in these muscles remains underexplored in both clinical and surgical settings. This review provides a comprehensive, interdisciplinary analysis of the zygomaticus musculature, integrating classical anatomical insights with recent advances in imaging, developmental biology, and artificial intelligence-based analysis. By examining data from cadaveric dissection, MRI, ultrasonography, and 3D photogrammetry, we identify key morphological differences with potential clinical relevance. A novel five-type morphological classification is proposed, based on differences in the number of muscle bellies (i.e., belly number), accessory structures, insertion patterns, and population-based variation. This classification aims to offer a more functionally relevant and clinically applicable framework for use in facial surgery, aesthetic procedures, and forensic reconstruction. By moving beyond the simplistic binary categorizations that have historically defined zygomaticus morphology, this review highlights the need for a personalized approach to facial anatomy, tailored to individual morphological variation. The proposed framework may assist in refining surgical planning, improving outcomes in facial reanimation, and enhancing diagnostic accuracy in both radiological assessment and preoperative planning. By moving beyond traditional binary categorizations, this review highlights the need for a personalized approach to facial anatomy, tailored to individual morphological variations. The proposed framework may assist in refining surgical planning, improving outcomes in facial reanimation, and advancing diagnostic precision in facial imaging. A total of 75 peer-reviewed articles were selected based on a targeted search in PubMed, Scopus, and Web of Science (1995-2024).
颧大肌和颧小肌在面部表情中起着核心作用，尤其是在产生微笑方面，而微笑是人类非语言交流的最基本形式之一。虽然它们的功能已广为人知，但在临床和外科手术环境中，这些肌肉的解剖变异性仍未得到充分探索。本综述对面部颧肌进行了全面的跨学科分析，将经典解剖学见解与成像、发育生物学和基于人工智能的分析的最新进展相结合。通过检查尸体解剖、MRI、超声检查和三维摄影测量的数据，我们确定了具有潜在临床相关性的关键形态学差异。基于肌腹数量（即腹数）、附属结构、插入模式和基于人群的变异的差异，提出了一种新颖的五型形态学分类。该分类旨在为面部手术、美容手术和法医重建提供一个更具功能相关性和临床适用性的框架。通过超越历史上定义颧肌形态的简单二元分类，本综述强调了对面部解剖学采取个性化方法的必要性，该方法应根据个体形态变异进行调整。所提出的框架可能有助于完善手术规划、改善面部复健效果，并提高放射学评估和术前规划中的诊断准确性。通过超越传统的二元分类，本综述强调了对面部解剖学采取个性化方法的必要性，该方法应根据个体形态变异进行调整。所提出的框架可能有助于完善手术规划、改善面部复健效果，并提高面部成像的诊断精度。基于在PubMed、Scopus和Web of Science（1995 - 2024年）中的定向搜索，共筛选出75篇经同行评审的文章。
