RESUMO
SUMMARY: To clarify the path of the temporal branch of facial nerve (TB) crossing the zygomatic arch (ZA). Eighteen fresh adult heads specimens were carefully dissected in the zygomatic region, with the location of TB as well as its number documented. The hierarchical relationship between the temporal branch and the soft tissue in this region was observed on 64 P45 plastinated slices. 1. TB crosses the ZA as type I (21.8 %), type II (50.0 %,), and type III (28.1 %) twigs. 2. At the level of the superior edge of the ZA, the average distance between the anterior trunk of TB and the anterior part of the auricle is 36.36±6.56 mm, for the posterior trunk is 25.59±5.29 mm. At the level of the inferior edge of the ZA, the average distance between the anterior trunk of TB and the anterior part of the auricle is 25.77±6.19 mm, for the posterior trunk is 19.16±4.71 mm. 3. The average length of ZA is 62.06±5.36 mm. TB crosses the inferior edge of the ZA at an average of 14.67±6.45 mm. TB crosses the superior edge of the ZA at an average of 9.08±4.54 mm. 4. At the level of the ZA, TB passes on the surface of the pericranium while below the SMAS. The TB obliquely crosses the middle 1/3 part of the superior margin of the ZA and the junction of the middle 1/3 part and the posterior 1/3 part of the inferior margin of the ZA below the SMAS while beyond the periosteum. It is suggested that this area should be avoided in clinical operation to avoid the injury of TB.
El objetivo de estudio fue esclarecer el trayecto del ramo temporal del nervio facial (RT) que cruza el arco cigomático (AC). Se disecaron la región cigomática de 18 especímenes de cabezas sin fijar de individuos adultas y se documentó la ubicación del RT y su número de ramos. La relación jerárquica entre el ramo temporal y el tejido blando en esta región se observó en 64 cortes plastinados o P45. 1º El RT cruza el AC como tipo I (21,8 %), tipo II (50,0 %) y tipo III (28,1 %). 2º A nivel del margen superior del AC, la distancia promedio entre el tronco anterior de RT y la parte anterior de la aurícula fue de 36,36±6,56 mm, para el tronco posterior fue de 25,59±5,29 mm. A nivel del margen inferior del AC, la distancia promedio entre el tronco anterior del RT y la parte anterior de la aurícula era de 25,77±6,19 mm, para el tronco posterior era de 19,16±4,71 mm. 3º La longitud media de RT fue de 62,06±5,36 mm. EL RT cruzaba el margen inferior del AC a una distancia media de 14,67±6,45 mm. El RT cruzaba el margen superior del AC a una distancia media de 9,08±4,54 mm. 4º Anivel del AC, el RT pasaba por la superficie del pericráneo mientras se encuentra por debajo del SMAS. El RT cruza oblicuamente el tercio medio del margen superior del AC y la unión del tercio medio y el tercio posterior del margen inferior del AC por debajo del SMAS, más allá del periostio. Se sugiere que esta área debe evitarse en la operación clínica para evitar la lesión de la RT.
Assuntos
Humanos , Adulto , Zigoma/inervação , Nervo Facial/anatomia & histologia , PlastinaçãoRESUMO
BACKGROUND: To study the anatomical characteristics of retro-orbicularis oculi fat (ROOF) in the upper eyelid and to investigate its relevance in upper eyelid surgery. METHODS: Thirty-eight Chinese hemifacial cadaver specimens were used. Several sagittal plane section planes were recorded from the medial canthus to the lateral canthus of the eyelid after P45 sheet plastination. ROOF and the associated orbital septum connective tissues in the 38 hemifaces were studied. According to the anatomic results, the lowest point of the junction of the orbital septum and the ROOF (SRJ) was raised for surgical dissection. We improved the intraoperative management of patients who underwent upper eyelid surgery in the plastic surgery department of the First Affiliated Hospital of Dalian Medical University in 2019. Patients were evaluated by observation and self-assessment. RESULTS: ROOF is fascia adipose tissue. In the upper portion of upper eyelid, ROOF fibers were observed to be extremely dense and continuous with the fascia on the surfaces of orbicularis oculi muscle, the periosteum of the orbital margin, and the orbital septum. In the middle portion, positional relationships were identified between the lowest point of the SRJ and the lowest point of the junction of the orbital septum and the levator palpebrae superioris (SAJ). Lifting the SRJ significantly increased the upper eyelid reflex distance in all 57 patients. CONCLUSIONS: ROOF is an important factor in upper eyelid surgery. Lifting the SRJ effectively improves the retraction force of the levator palpebrae superioris muscle (LPS).
