Three-dimensional reconstruction of the suborbicularis oculi fat and the infraorbital soft tissue

T Sandulescu,T Blaurock-Sandulescu,H Buechner,E.A Naumova,W.H Arnold

doi:10.1016/j.jpra.2018.01.001

T Sandulescu, T Blaurock-Sandulescu + Show 3 more

Open Access

https://doi.org/10.1016/j.jpra.2018.01.001

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Journal: JPRAS Open	Publication Date: Jan 31, 2018
Citations: 11	License type: cc-by

Affiliation: Witten/Herdecke University

Abstract

The aim of this study was to reveal the histomorphological connections among the suborbicularis oculi fat (SOOF), the orbicularis oculi muscle (OOM), the superficial musculoaponeurotic system (SMAS), the infraorbital fat and the skin.Full graft tissue blocks of the infraorbital region with the skin, SMAS, OOM and SOOF were collected post mortem from one female and two male formalin-fixed body donors. Serial histological sections were made, stained and digitized. Digitalization and three-dimensional (3D) reconstruction of the histological meshwork were performed.SOOF was revealed as a fibro-adipose tissue underlying the OOM, which was strictly separated from the intraorbital fat pad by the orbital septum. SOOF, OOM and SMAS were connected by fibrous septa derived from the SOOF, traversing the OOM with division into multiple muscular bundles, continuing above the muscular plane by forming the SMAS and ending with skin insertion. In the infraorbital region, two different types of SMAS bordering the infraorbital fold have been recognized. Muscle cells have been demonstrated in the SMAS fibrous septa of both SMAS types.Together with the OOM, the SMAS and the skin, SOOF forms an anatomical functional unit. Muscular contraction of the OOM could be transferred by the SMAS to the skin level, producing periorbital mimic expression. The 3D reconstruction facilitates the comprehension of the morphological structure, its connections and space correlations in the infraorbital area. The morphological and topographical peculiarities of the infraorbital structures make it possible to conclude that surgical interventions in this area need to be elaborated and individualized.

Highlights

The suborbicularis oculi fat (SOOF) was defined as a fat pad lying supraperiosteally beneath the orbicularis oculi muscle (OOM) and below the lateral half of the infraorbital rim above the zygoma.[1]
The histological analysis of the tissue blocks removed from the tissue located at the inferolateral side of the orbit demonstrated the existence of superficial musculoaponeurotic system (SMAS) and SOOF tissue with different morphologies between the specimens (Figure 2)
SOOF SOOF was identified as a fat pad underlying the OOM

Summary

Introduction

The suborbicularis oculi fat (SOOF) was defined as a fat pad lying supraperiosteally beneath the orbicularis oculi muscle (OOM) and below the lateral half of the infraorbital rim above the zygoma.[1]. The lack of a clear definition of the SMAS structure allowed the authors to conclude that SMAS inserts in the orbicularis oculi muscle (OOM) connection to the facial bone.[3,4] Recent investigations described the SMAS as a three-dimensional meshwork connecting the mimic musculature to the skin with communicating fibro-muscular compartments enveloping fat pads.[5]

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