The fascial planes of the temporal region related to the frontal branch of the facial nerve.

摘要

We read with great interest two recent articles regarding the anatomical study of the course of the frontal branch of the facial nerve: (1) the article by Agarwal et al. entitled "The Course of the Frontal Branch of the Facial Nerve in Relation to Fascial Planes: An Anatomic Study" (Plast Reconstr Surg. 2010;125:532-537); and (2) the study by Trussler et al. entitled "The Frontal Branch of the Facial Nerve across the Zygo-matic Arch: Anatomical Relevance of the High-SMAS Technique" (Plast Reconstr Surg. 2010;125:1221-1229). In the first article, Agarwal et al. describe the frontal branch of the facial nerve as it crosses the zygomatic arch within the innominate fascia, which is located deep to the superficial musculoaponeurotic system (SMAS) and superficial temporal fascia. They beautifully show the hemiface dissection in a layer-by-layer fashion and illustrate histologic evaluation of the relationship between the nerve and the fascial planes above and below the zygomatic arch. Their facial dissection demonstrates that the frontal branch travels within the innominate fascia as it crosses the zygomatic arch into the temporal region. In the second article, Trussler et al. defined the depth and fascial boundaries of the frontal branch of the facial nerve over the zygomatic arch using histologic evaluation. They demonstrated that the frontal branch coursed under a separate fascial plane, the parotid-temporal fascia, which is deep to the SMAS in its course to the zygomatic arch and remained within this deep fascia over the arch. They concluded that the frontal branch of the facial nerve was protected by a deep layer of fascia, termed the parotid-temporal fascia, which is separate from the SMAS as it travels over the zvaromatic arch.