Research On Anatomy And Three-dimensional Visualization Of Mid-cheek Groove Area

Objective: To clarify the location and characteristics and relations of the anatomical structure of mid-cheek groove area through dissecting the mid-cheek groove area of fresh cadaver head. To research the tissue structure of the mid-cheek groove area by serial tissue section and to set up the 3d visualization model. To provide anatomical basis for treatment of mid-cheek groove deformity through the foregoing research.Methods : 1Anatomical study was performed on 4 sides of 2 fresh cadaver head specimens(1 male,1 female,between 45-70 years old)of mid-cheek groove area, for observing the location and characteristics and relations of the anatomical structure, to measurement related structures by vernier caliper and recording them through the text and image. 2Tissue of mid-cheek groove of a side of fresh cadaver head specimens with an approximate size of 40.17×11.20×13.17 mm were embedded in paraffin and cut serially in sagittal plane with the thickness of 10μm.The means of screening sections was to retain one piece in every eight pieces, and finally, the total number of the collected sections was 450. After that, one-tenth of the prepared sections(45 pieces) were extracted in equal interval, which were used to perform Masson stain. The others(405 pieces) were stained with HE. The sections with HE stain were photographed by HD digital camera, then the two-dimensional images were registrated by Adobe Photoshop CS6 software. Image segmentation and reconstructing three-dimensional model of the mid-cheek fold were both operated on the computer with 3D-DOCTOR 4.0 software.Results: 1.Results of the anatomy:1The skin of mid-cheek groove area was thicker. Subcutaneous fat between the skin and orbital part of the orbicularis oculi muscle. The cephalic of the malar fat pad was located at the junction of the palpebral portions of the orbicularis oculi muscle and the orbital portions of the orbicularis oculi muscle, the medial to the nasolabial sulcus, the low bound to the corner. 2The zygomatic ligament was true osteocutaneous ligament in the mid-cheek groove area. It at zygomatic front surface, as a bundle of bundle of fibrous connective tissue,through orbital part of the orbicularis oculi muscle, end at skin of mid-cheek area. 3The orbicularis oculi fat pad was under the orbicularis oculi, and connected with deep periosteum. 2.Results of the histologic study and 3D visual research:1 The anatomic level on the mid-cheek area includes: skin,orbicularis oculi,suborbicularis oculi fat,periosteum;2Has the fiber structure from periosteal surface through the muscle stopped at skin in mid-cheek area. 3Three-dimensional visible model displayed the position and relationship of anatomical structure, contained skin, subcutaneous fat,orbicularis oculi muscle,ligament,suborbicular oculi fat,periosteum, and the model can be observed in all directions, the model can be enlarged or shrinked optionally.Conclusion:1 The zygomatic ligament is existed in the mid-cheek groove area.It commences at zygomatic bone through orbital part of the orbicularis oculi muscle,stoped at skin of mid-cheek groove. Discontinuous fiber bundle arrangement along the zygomatic bone periosteum, through the orbicularis oculi muscle to the skin, medial to the zygomatic minor muscle, outward to the zygomatic arch. There are fibers in orbicularis oculi muscle in the tissue section of the mid-cheek groove area, and the fibers is according with the characteristics of the ligament. Zygomatic ligament is the key factor that the mid-cheek appear. 2Three-dimensional visible model of mid-cheek groove area can obtain through serial tissue section on personal computer, and this is a practical way for observe stereoscopic anatomical structure.