应用尸体解剖模拟面部SMAS分离提紧术的效果探讨  

Efficacy investigation of cadaver head anatomy in the simulation of facial SMAS separation and tightening

作　　者：杨柠泽 王洁晴[2] 韩晴 孙妍娜 姜晓丽 谷红波 王志军 YANG Ning-ze;WANG Jie-qing;HAN Qing;SUN Yan-na;JIANG Xiao-li;GU Hong-bo;WANG Zhi-jun(Angel Beauty Medical Cosmetic Hospital of Fuxin,Fuxin 123000,China)

机构地区：[1]阜新安琪美医疗美容医院,辽宁阜新123000 [2]大连大学附属新华医院,辽宁大连116000 [3]大连瑞和医疗美容门诊,辽宁大连116000 [4]华颜风然医学研究院,北京100044

出　　处：《中国美容整形外科杂志》2020年第9期524-527,530,共5页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的通过模拟SMAS分离提紧术,测量SMAS不同位点的移动距离,探讨其手术效果。方法选取10具(20侧成人新鲜尸头标本,应用手术器械模拟SMAS分离提紧术的方法进行皮下广泛剥离,剥离范围向内侧至鼻唇沟,内下方至口下颌沟,向下至耳垂下5.0 cm,向后延申至发际线。在耳屏前垂直切开SMAS层,并在颧弓下0.5 cm处平行颧弓水平切开SMAS,垂直和水平向分离最大范围为7.0 cm×6.0 cm,在SMAS上选择9个点,在保存SMAS层完整的情况下用最大50 N的力将其分别沿颧弓水平与垂直方向向上、向外提拉,分别记录9个标记点的水平与垂直位置的变化数据,每个数据测量3次,取其平均值。通过三角函数方法计算各点在水平与垂直方向上的最大位移所需要的提拉力和角度。结果⑴SMAS分离的范围越大,对前端A、B、C点的作用越强,其移动位置越大。离断颧弓韧带、颧颊部韧带等固定结构,有利于对SMAS的提升。⑵SMAS上不同位置的点移动距离不同,水平移动的距离无规律性。⑶SMAS上的点越靠近耳侧,在垂直方向上的移动距离越大,即A">A'>A,B">B'>B,C">C'>C。⑷SMAS上的点越靠近足侧,在垂直方向上的移动距离越大,即A>B>C,A'>B'>C',A">B">C"。ABC线的提拉角度平均为30°,A'B'C'线的提拉角度平均为51°,A"B"C"线的提拉角度平均为70°。结论面颊部各区SMAS层组织结构不同,受力后各部位位移不同,SMAS分离范围越大提升效果越好,不同点在垂直与水平方向上的最大位移所需要拉力的角度不同。Objective Toexplore the surgical efficacyand tomeasure the displacement distance ofdifferent points on SMASin the simulation of facial SMAS separation and tightening. Methods Ten adult fresh cadaverous head specimens(20 sides) were selected. Surgical instruments were used to simulate the SMAS separation and tightening to perform extensive subcutaneous dissection. The dissection range was from medial side to nasolabial groove, inferomedial side to labiomandibular groove, downward to 5.0 cm under the earlobe and then backward extended to the hairline. The SMAS layer was cut vertically in front of the tragus, and the SMAS was cut at the position of 0.5 cm under the zygomatic arch which parallel to the zygomatic arch. The maximum range of vertical and horizontal separation was 7.0 cm × 6.0 cm. Nine points were selected on the SMAS. In the condition of SMAS layer was intact, the maximum force of 50 N was used to pull upward and outward along the horizontal and vertical direction of zygomatic arch. The data of horizontal and vertical position change of 9 points were recorded separately. Each data was measured 3 times and the average was taken. The pulling force and angle required for the maximum displacement of each point in the horizontal and vertical direction was calculated by the trigonometric function method. Results(1) The larger the range of SMAS separation, the stronger the effect on point A, B and C and the farther the displacement. The fixation structures such as isolated zygomatic ligament and and buccal ligament were beneficial to the enhancement of SMAS.(2) The displacement distance of points at different locations of SMAS was different. The distance of horizontal movement was irregular.(3) The points on SMAS closer to the ear, the farther the displacement distance in the vertical direction, that is A">A'>A, B">B'>B and C">C'>C.(4) The points on SMAS closer to the foot, the farther the displacement distance in the vertical direction, that is A>B>C, A'>B'>C' and A">B">C". The average pulling angle of ABC l

关 键 词：表浅肌肉腱膜系统 应用解剖 提升术 分离提紧术 

分 类 号：R62[医药卫生—整形外科]