The Clinic Anatomy Study Of The Plastic And Reconstruction Of The Zygomatic Position

Object:o provide anatomic basis for the reconstruction of the zygomatic region , the special topic research of zygomatic region was taken.(2)To study the operation mimesis of the zygomatic plastic.(3)To research the technique and anatomic key points of the zygomatic reduction and the zygomatic reconstaiction with bone flaps of the calvarial bone, clavicle, rib, iliac.Methods:?0 sides of 15 antisepsis adult head specimens and 18 sides of 9 fresh adult head specimens were studied.(2)18 sides of 10 blood vessel cast head specimens were observed.(3)2 adult cadavers were anatomized.(4)The related anatomic materials were reviewed. ㏕he 3DCMFCAS was applied.Results:㎝alar is the prominent part and appearance feature of face, consists of a rhombic bone body and 4 processuses.(2)M. zygomatic major origins from the boundary point between zygomatic body and arch, M. masseter origins from the margo inferior of the zygomatic arch and the medial aspect of zygomatic bone; except the two muscles, there are no muscles attaching to zygomatic bone, which is "dissociated".(3)The deep temporal fascia origins from the attachment edge of M. temporal and divides into two lamellas(the deep and superficial lamellas), which attach to the lateral and medial sides of the zygomatic arch respectively. There is a fat pad between the two lamellas. V. temporalis media travels in the upside of the fat pad. The secure operation pathway is passing through the-3-interspace between the deep and superficial lamellas to the superior edge of the zygomatic arch.(4)R. temporales and R. zygomatici come out of the parotid gland at the margo inferior of the zygomatic arch(segregated and bundled by the parotid fascia), run forward and up, ramify gradually in the lamella under the SMAS, and go into the depth of muscle and innervate it.(?3DCMFCAS can be used to simulate the zygomatic reduction, the sclerous tissues can be cut and displaced, but the change of the appearance and the soft tissue of face cannot be predicted. 3DCMFCAS cannot be used to simulate the zygomatic cutting reduction and the zygomatic augmentation. 3DCMFCAS cannot be used to link with a meticulous machine to reproduce a model or form an implant.㏕here have rich blood supply in zygomatic bone. The nutrient artery goes into the zygomatic bone from the posterior margo medialis, becomes the zygomaticofaciale artery out of the zygomaticofaciale foramen. The periosteum arteries origin from the A. transversa faciei, the A. temporalis superficialis, the A. infraoribitalis, the A. facialis, the A. maxillaris and so on.㏕he distance between the processus coronoideus and the malar is 12.3 + 3.6m and the thickness of malar in this point is 9.8?.3mm; The distance between the processus coronoideus and the malar arch is 5.2+ 1.2mm and the thickness of malar arch in this point is 3.3 ?.4mm<>㏕he calvarial bone, clavicle, rib and iliac have a radian and are suited to the zygomatic reconstruction. The expanded forehead flap with scapular bone, the expanded cervix flap with clavicle, the eleventh or twelfth rib flap with the arteriae thoracodorsalis pedicle and the iliac flap with double pedicles are designed by the characteristic of the anatomy and blood supply. Those flaps are suited for the zygomatic reconstruction with different advantages and disadvantages.Conclusion:㏕he tissue structure of the zygomatic region and the shape of the zygomatic bone were observed. The relation between zygomatic bone and muscle, the relation between zygomatic bone and the deep and superficial temporal fascia, the relation between zygomatic bone and the face nerve, the blood supply of zygomatic bone, the relation between zygomatic bone and the coronoid process were researched.(2)3DCMFCAS can be used for simulating the operations, discussing and making an operation plan preoperation, teaching, and so on; but it has a lot of disadvantages, should be developed.(3)Anatomic key points of the zygomatic operation were summarized. To decrease the dam...