Anatomical and Functional Consideration of the Trigemino-Facial Nervous Communication and Facial Expresssion Muscles / 체질인류학회지

The aim of the study is to examine the distribution and communications of the trigeminal nerve (TN) and facial nerve (FN) and considerate their relationship with the anatomy and function of the facial expression muscles (FEMs) by means of the literature study. The TN emerged on the face via various structures of the skull, and received sensation of the skin and muscles on the face. The FN supplied the motor components to the FEMs, as ramifying five branches after running through the stylohyoid foramen. The TN and FN constituted "nervous communication between heterogeneous cranial nerves" on the ocular (supraorbital nerve and temporal branch), zygomatic (zygomatic nerve and temporal/zygomatic branch), infraorbital (infraorbital nerve and zygomatic branch), retromandibular (auriculotemporal nerve and FN trunk), buccal (buccal nerve and buccal/zygomatic branch) and mental areas (mental nerve and buccal/marginal mandibular branch). The exquisite movement of the FEM which was controlled by the facial motor nucleus would be referred by the proprioception from the TN. The motor components from the FN could be delivered to the FEM via the TN as recruiting the heterogeneous nervous communications. The sensation from the FN also could be conveyed to the TN via the communication.

Motor Innervation and Nerve Pathway of Glabellar Expression Muscles

We studied the motor innervation and the nerve pathway of glabellar expression muscles and a kind of glabellar skin wrinkles. Electric stimulation and surface tracing of the temporal and zygomatic branches of the facial nerve was performed using an electric nerve stimulator on both sides of 14 healthy volunteers. Micro- dissection of four cadaveric heads were also performed to confirm the results of nerve stimulation test. The corrugator supercilii muscle is innervated by the temporal branch of the facial nerve. The depressor supercilii muscle, the medial head of the orbicularis oculi muscle, and the procerus muscle are innervated by the zygomatic branch. The temporal branch to the corrugator supercilii muscles travels in a curvilinear pattern superior to the upper margin of the eyebrow. The zygomatic branch to the glabellar expression muscles travels in a curvilinear pattern inferior to the inferior orbital rim in the proximal portion and in a cobwebby pattern medial to the medial orbital rim in the distal portion. In cadaveric study, the zygomatic nerve branches off in the inferomedial orbital portion, and its fine branches enter into the procerus muscle, the depressor supercilii muscle, and the orbicularis oculi muscle. The surface pathway of the motor nerve to the glabellar expression muscles is described. We think that the zygomatic and temporal branches both should be blocked simultaneously to improve glabellar skin wrinkles completely.

A Clinical Study of Facial Wrinkles Affected by Facial Expression Muscles Treated with Botulinum Toxin(Botox(R)) / 대한피부과학회지

BACKGROUND: Botulinum toxin type A is being widely used for the treatment of facial wrinkles affected by facial expression muscles. Due to the sudden and exponential surge in popularity of its use for facial wrinkles, there are scanty reports of facial wrinkles treated with botulinum toxin type A especially in Asians. OBJECTIVE: This study was performed to investigate the clinical features of facial wrinkles affected by facial expression muscles and the effects of botulinum toxin A on the treatment of wrinkles. METHODS: Medical records of 61 patients with facial wrinkles treated with botulinum toxin type A were reviewed. Demographic profiles of the patients, the age of onset of facial wrinkle, the distributions of facial wrinkles, treatment dose of botulinum toxin type A, side effects, and follow up data were analyzed. RESULTS: Female patients were predominant(93.4%) than male patients(6.6%). The mean age of the patients was 41.3 years. Crow's feet were the most frequently treated site of facial wrinkles. Average number of treated sites were 2.38. Side effect profiles were similar as previous reports in Cauca sians. The number of patients who took the regular retreatment was less than expected. CONCLUSION: The clinical profiles of wrinkle patients in Koreans treated with botulinum toxin A were assessed. We think it is one of the effective treatment modalities for antiwrinkling.