The Anatomical Study Of Prevention Of The Zygomatic Branches Of The Facial Nerve In Facial Rhytidectomy

Objective: The more people think highly of appearance, the more plastic operation are attended. Especially in overseas, the plastic operation is welcomed by people, but, in these years, plastic operation comes into China. Plastic operation which includs many subjects is developing rapidly. Its subject system is forming gradually, but, this subject requests anatomy. The face is exposed, and can express emotion well. So, the skin of face easily appears wrinkle and aging. When the make-up can't mask the wrinkle and the aged skin, somebody will ask help from plastic operation to recover the youth. Thus, eliminating wrinkle preserves more apprehension, and become one of the most usual plastic operations. In the eliminating winkle operation, people easily injury cranial nerve and cause different degrees of facial palsy. So we study and research the position of rami zygomatici nervi facialis, the number of branches, SMAS system, and how to prevent injurying rami zygomatici nervi facialis, for providing the anatomic data for clinic operation.Method: 20 adult corpse skull essay, 16 of them are male, 4 of them are female. Age: 18-60. average age 40s. They are all die of infection and tumor, the super face skin tissue is not breakaged and injuryed. The artery of essay is filled with emul within red colorant. The venous system is filled with emul within blue colorant. We fix the skull essay on the headframe. The skin cut is brow temple preauricula arc-type cut. During the whole procession, we decoherence skin and adipose,then reveal arteria temporalis superficialis and arteria transversa facie. Keep eyebrow, anguls oculi lateralis and ala auris. Decoherence external acoustic foramen part tissue, dissect egion temporalis, egion zygomatica, egion zygomatica and infraorbital region one by one. Dissect the rami zygomatici nervi facialis to musculus dormitator inferior part lateral margin, the super of greater zygomatic muscle and greater zygomatic muscle.Observe the SMAS system.On the base of bone marker,ascertain acoustic pore,osseous,externa anterior border point,the crossing of cheek bone TF hom-frontal process of zygomatic bone and processus temporalis,bone angulus oculi lateralis as measure marker.Ascertain articular tubercle cusp of processus zygomaticus ossis temporalis and articular tubercle posterior extremity ansa capitis superior border point as ansa capitis superior border marker.Results:1.ansa capitis length:from porus acousticus to porus acousticus processus temporalis is (54.6±4.2)mm.The distance from porus acousticus anterior border to cheek bone TFhom is (51.0±6.7) mm.The level distance from porus acousticus anterior border to rticular tubercle is(17.8±1.7) mm.The level distance from antilobium to angulus oculi lateralis is(75.5±9.3)mm.The slope distance from eyebrow extip to cheek boneTF is(35.8±4.0)mm.The slope distance from articular tubercle to porus acousticus sup-point is(7.4±1.7)mm.The slope distance from articular tubercle cheek boneTF is(15.4±2.0)mm.2.Rami zygomatici nervi facialis branches from external salivary gland:two branches type is 27 sides(67%),three branches type is 10 sides(25%).Poly branches type is 3 sides(8%). According to the different level,divide into ramus superficialis and deep branch. 3.Rami zygomatici nervi facialis lines on jugomaxillary muscle super,fascia parotidea masseterica cover on it, lamina superficialis is SMAS,adipose layer,and skin.4.SMAS lines on the deep of adipose layer to latissimus colli.SMAS strentch to fascia temporalis superficialis through ansa capitis,to aponeurosis of occipitofron talis muscle through fascia temporalis superficialis,to frontal belly.Back to attollens aurem,auricularis posterior,auricularis posterior.The SMAS of quanliao buccal region ahead to musculus dormitator;musculus orbicularis oculi,distortor oris muscle. 5.Arteria transversa faciei nourish rami zygomatici nervi facialis, monobranch type is 36 sides(90%),dibranch type is 4 sides (10%).Arteria transversa faciei which line between ansa capitis Stensen's duct is 38 sides (95%),under SD is 2 sides(5%). The external diameter of arteria transversa faciei is(1.8±0.28)mm.Conclusion:1.With the method of zygomatic branch of facial nerve localization which can be found by body surface symbol and bone symbol,we can presentate the pathway of rami temporales nervi facialis and determine the parts where can be damaged on rami temporales nervi facialis.2.We have described branches of zygomatic branch of facial nerve which divided to the superfacial and the deep rami.And there is inosculans between the two rami.3.We have identified the reference between zygomatic branch of facial nerve and anadesma,which can be used in clinic operation to avoid of damaging zygomatic branch of facial nerve.4.We have done elaborative anatomy to the constitution of SMAS.We identified the reference between SMAS and the muscle anroud SMAS.Before SMAS there is fascia temporal is superficialis and musculus dormitator,after SMAS there is latissimus colli.These constitution upon compose fibroid capsule.This identification can be used in clinic rhytidectomy to avoid zygomatic branch of facial nerve.5.We should do these to avoid of damaging zygomatic branch of facial nerve:(1)Do abruptio subcutaneouly as far as possible and avoid the path of zygomatic branch.(2)Deresis and eleminate wrinkle under the greater zygomatic muscle at its 2/3 part.(3)Deresis and eleminate wrinkle under the Subperiosteum can avoid of damaging zygomatic branch of facial nerve. 6.We have observed the pathway,the branches and muscle under whose charge of arteria transversa faciei.We also have comprehend the blood supply of zygomatic branch of facial nerve which can help clinic operation.