RT Book, Section
A1 Aslam, Arif
A1 Aasi, Sumaira Z.
A2 Kang, Sewon
A2 Amagai, Masayuki
A2 Bruckner, Anna L.
A2 Enk, Alexander H.
A2 Margolis, David J.
A2 McMichael, Amy J.
A2 Orringer, Jeffrey S.
SR Print(0)
ID 1161346440
T1 Cutaneous Surgical Anatomy
T2 Fitzpatrick's Dermatology, 9e
YR 2019
FD 2019
PB McGraw-Hill Education
PP New York, NY
SN 9780071837798
LK accessmedicine.mhmedical.com/content.aspx?aid=1161346440
RD 2024/04/19
AB AT-A-GLANCEThe  superficial  musculoaponeurotic  system  (SMAS)  is  a  fibromuscular  layer  connecting  the  facial  muscles.  Incisions  and  undermining  within  the  subcutaneous  fat  above  SMAS  will  not  result  in  damage  to  motor  nerves.When  planning  reconstruction,  the  surgeon  should  consider  cosmetic  units,  junctional  lines,  and  resting  skin  tension  lines  to  optimize  the  final  aesthetic  result.The  three  branches  of  the  trigeminal  nerve  (cranial  nerve  V)  provide  sensory  innervation  to  the  face.The  three  main  danger  zones  are  areas  where  the  temporal  and  marginal  mandibular  branches  of  the  facial  nerve  and  spinal  accessory  nerve  lie  superficial  and  can  be  easily  injured.  Damage  to  the  temporal  branch  of  the  facial  nerve  may  result  in  an  ipsilateral  eyebrow  ptosis  and  obscuring  of  the  superolateral  visual  field.  The  marginal  mandibular  branch  of  the  facial  nerve  is  vulnerable  to  damage  along  the  inferior  edge  of  the  body  of  the  mandible.  Damage  to  the  marginal  mandibular  branch  of  the  facial  nerve  results  in  an  asymmetrical  smile.  The  spinal  accessory  nerve  lies  in  the  posterior  triangle  of  the  neck  and  may  be  identified  by  Erb’s  point.The  rich  vascular  supply  to  the  face  from  both  the  external  and  internal  carotid  ensures  the  reliable  healing  potential  and  viability  of  flaps  and  grafts  in  head  and  neck  surgery.