Relationship of the lobular branch of the great auricular nerve to the tympanoparotid fascia: Spatial anatomy for salvage during face and neck lift


Autoři: Anna Jeon aff001;  Heejun Ahn aff001;  Chang Min Seo aff001;  Je-Hun Lee aff002;  Woo Seob Kim aff003;  Joo Heon Lee aff004;  Seung-Ho Han aff001
Působiště autorů: Department of Anatomy, College of Medicine, Chung-Ang University, Seoul, Republic of Korea aff001;  Anatomy Laboratory, College of Sports Science, Korea National Sport University, Seoul, Republic of Korea aff002;  Department of Plastic Surgery, College of Medicine, Chung-Ang University, Seoul, Republic of Korea aff003;  Area88 Plastic Surgery Clinic, Seoul, Republic of Korea aff004
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0222324

Souhrn

To enable selection of a safer suspension site to use in face and neck lifting procedures, the spatial relationship between the tympanoparotid fascia and the great auricular nerve should be clarified. In this study, we aimed to elucidate the position of the tympanoparotid fascia and the pathway of the lobular branch of the great auricular nerve traversing the tympanoparotid fascia. Twenty hemifaces from non-preserved bequeathed Korean cadavers (5 males, 7 females; mean age, 77.0 years) were dissected to determine the great auricular nerve distribution close to the tympanoparotid fascia of clinical significance for face and neck lift procedures. We observed the tympanoparotid fascia in all specimens (20 hemifaces). The tympanoparotid fascia was located anteriorly between the tragus and intertragic notch. Regarding the spatial relationship between the tympanoparotid fascia and the great auricular nerve, we found the sensory nerve entering the tympanoparotid fascia in all specimens (100%), and the depth from the skin was approximately 4.5 mm; in 65% of the specimens, the lobular branch was found to run close to the tympanoparotid fascia before going into the earlobe. Provided with relatively safer surface mapping to access the tympanoparotid fascia free of the lobular branch of the great auricular nerve, surgeons may better protect the lobular branch by anchoring the SMAS-platysma flap and thread to the deeper superior and anterior portions of the expected tympanoparotid fascia.

Klíčová slova:

Face – Neuroanatomy – Sensory perception – Skin anatomy – Surgeons – Trauma surgery – Traumatic injury – Facial nerve


Zdroje

1. Loré JM. An Atlas of Head and Neck Surgery. 2nd ed: Saunders; 1973.

2. Labbe D, Franco RG, Nicolas J. Platysma suspension and platysmaplasty during neck lift: anatomical study and analysis of 30 cases. Plast Reconstr Surg. 2006;117: 10.

3. Fogli AL. Skin and platysma muscle anchoring. Aesthetic Plast Surg. 2008;32: 531–541. doi: 10.1007/s00266-007-9111-9 18305986

4. Hwang K, Nam YS, Kim DJ, Han SH. Anatomy of tympanoparotid fascia relating to neck lift. J Craniofac Surg. 2008;19: 648–651. doi: 10.1097/SCS.0b013e31816ae267 18520378

5. O’Brien JX, Rozen WM, Whitaker IS, Ashton MW. Lore's fascia and the platysma-auricular ligament are distinct structures. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2012;65: e245.

6. Kang MS, Kim SH, Nam SM, Park ES. Evaluation of elastic lift for neck rejuvenation. Archives of Aesthetic Plastic Surgery. 2016;22: 68–73.

7. Peuker ET, Filler TJ. The nerve supply of the human auricle. Clinical Anatomy. 2002;15: 35–37. doi: 10.1002/ca.1089 11835542

8. Yang H, Kim H, Hu K. Anatomic and histological study of great auricular nerve and its clinical implication. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2015;68: 230–236.

9. Rohrich RJ, Taylor NS, Ahmad J, Lu A, Pessa JE. Great auricular nerve injury, the "subauricular band" phenomenon, and the periauricular adipose compartments. Plast Reconstr Surg. 2011;127: 835–843. doi: 10.1097/PRS.0b013e318200aa5a 21285786

10. Sharma VS, Stephens RE, Wright BW, Surek CC. What Is the Lobular Branch of the Great Auricular Nerve? Anatomical Description and Significance in Rhytidectomy. Plast Reconstr Surg. 2017;139: 378e.

11. Guerrero-Santos J. The role of the platysma muscle in rhytidoplasty. Clin Plast Surg. 1978;5: 29–49. 346294

12. Stuzin JM, Baker TJ, Baker TM. Refinements in face lifting: enhanced facial contour using vicryl mesh incorporated into SMAS fixation. Plast Reconstr Surg. 2000;105: 290–301. doi: 10.1097/00006534-200001000-00046 10627000

13. Stuzin JM. Discussion: modified deep plane rhytidectomy with a lateral approach to the neck: an alternative to submental incision and dissection. Plast Reconstr Surg. 2011;127: 371–373. doi: 10.1097/PRS.0b013e3181f957da 21200232

14. Bae J, Youn K, Hu K, Lee J, Tansatit T, Kim H. Clinical implications of the extension of platysmal fibers on the middle and lower face. Plast Reconstr Surg. 2016;138: 365–371. doi: 10.1097/PRS.0000000000002346 27064219

15. McKinney P, Katrana DJ. Prevention of injury to the great auricular nerve during rhytidectomy. Plast Reconstr Surg. 1980;66: 675–679. doi: 10.1097/00006534-198011000-00001 7433552

16. McKinney P, Gottlieb J. The relationship of the great auricular nerve to the superficial musculoaponeurotic system. Ann Plast Surg. 1985;14: 310–314. doi: 10.1097/00000637-198504000-00003 3994276

17. Izquierdo R, Parry SW, Boydell CL, Almand J. The great auricular nerve revisited: pertinent anatomy for SMAS-platysma rhytidectomy. Ann Plast Surg. 1991;27: 44–48. doi: 10.1097/00000637-199107000-00007 1872553


Článek vyšel v časopise

PLOS One


2019 Číslo 10

Nejčtenější v tomto čísle

Tomuto tématu se dále věnují…


Kurzy

Zvyšte si kvalifikaci online z pohodlí domova

Léčba bolesti v ordinaci praktického lékaře
nový kurz
Autoři: MUDr. PhDr. Zdeňka Nováková, Ph.D.

Revmatoidní artritida: včas a k cíli
Autoři: MUDr. Heřman Mann

Jistoty a nástrahy antikoagulační léčby aneb kardiolog - neurolog - farmakolog - nefrolog - právník diskutují
Autoři: doc. MUDr. Štěpán Havránek, Ph.D., prof. MUDr. Roman Herzig, Ph.D., doc. MUDr. Karel Urbánek, Ph.D., prim. MUDr. Jan Vachek, MUDr. et Mgr. Jolana Těšínová, Ph.D.

Léčba akutní pooperační bolesti
Autoři: doc. MUDr. Jiří Málek, CSc.

Nové antipsychotikum kariprazin v léčbě schizofrenie
Autoři: prof. MUDr. Cyril Höschl, DrSc., FRCPsych.

Všechny kurzy
Kurzy Doporučená témata Časopisy
Přihlášení
Zapomenuté heslo

Nemáte účet?  Registrujte se

Zapomenuté heslo

Zadejte e-mailovou adresu se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.

Přihlášení

Nemáte účet?  Registrujte se