Gosain A K, Yousif N J, Madiedo G, Larson D L, Matloub H S, Sanger J R
Department of Plastic and Reconstructive Surgery, Medical College of Wisconsin, Milwaukee.
Plast Reconstr Surg. 1993 Dec;92(7):1254-63; discussion 1264-5.
There has been considerable disagreement in descriptions of the SMAS. Fresh cadaver dissection, combining anatomic dissection done with the aid of the operating microscope and histologic cross section of facial tissues, was performed in 24 facial halves. Histologic preparation was made on tissue macrosections, each 10 cm in length. Consistent findings include the following: (1) Although the SMAS is closely applied to the superficial surface of the parotid gland, a thin but distinct parotid fascia can be identified between parotid gland and SMAS. (2) The SMAS terminates superiorly within 1 cm below the zygomatic arch, and is not continuous with the temporoparietal fascia. (3) The SMAS in the cheek lies in continuity with the orbicularis oculi muscle of the lower eyelid. (4) Considerable variability exists in the histologic appearance of the SMAS in different facial regions within a single cadaver, as well as in a given facial region between cadavers. Because of its variability, histologic identification of the SMAS should be made in continuity with known reference structures, such as the platysma.
关于SMAS（颈阔肌-耳前肌-颞肌筋膜）的描述存在很大分歧。我们对24个半侧面部进行了新鲜尸体解剖，解剖过程借助手术显微镜，并对面部组织进行了组织学横断面分析。组织学标本取自长度为10厘米的组织大块。一致的发现如下：（1）尽管SMAS紧密附着于腮腺浅面，但在腮腺与SMAS之间可识别出一层薄但清晰的腮腺筋膜。（2）SMAS在颧弓下方1厘米内向上终止，且不与颞顶筋膜连续。（3）颊部的SMAS与下睑眼轮匝肌相连。（4）在同一具尸体的不同面部区域以及不同尸体的同一面部区域，SMAS的组织学外观存在相当大的差异。由于其变异性，SMAS的组织学识别应与已知的参考结构（如颈阔肌）连续进行。
