Anatomy of tympanoparotid fascia relating to neck lift.

The aim of this study is to elucidate anatomical detail of the tympanoparotid fascia (TPF), deployed anteroinferiorly to the tragus, in relation to neck lift and platysmaplasty. Forty-one hemifaces of 25 Korean adult cadavers (age range: 43-101 years, 19 males and 6 females) were used for the study. Thirty-seven were dissected. Twenty-one were used for tension measurement and 4 for the histologic study. Tympanoparotid fascia was found in almost 36 hemifaces (100%). It was white-colored dense connective layer anteroinferior to tragus. The whitish fascia was a dense connective tissue layer deployed anteroinferiorly to the tragus. Two thirds of TRF originated from the tympanomastoid fissure and one third from the auricular cartilage and interfused with the parotid fascia, covering the parotid gland in front of the tragus. Tympanoparotid fascia was tetragonal in shape. The anterior side (15.1+/-5.4 mm) was longer than the posterior side (10.4+/-4.4 mm). It was 11.3+/-3.9 cm in upper width and 9.5+/-3.8 cm in lower, respectively. It was located 43.0+/-7.7 mm inferior to the otobasion superioris (obs) and 6.0+/-5.5 mm superior to the otobasion inferioris (obi). The anterior side was at 9.5 to 11.3 mm anterior to the auricle (obs-obi) and the posterior side at obs-obi line of the auricle. The tensile strength of the 5 mm width of TPF was 38.4+/-18.2 N. It is significantly stronger (P=0.00) than the central portion of the parotid fascia (22.7+/-12.2 N). Tympanoparotid fascia strength (38.4 N) is enough to pull and hold the platysma as much as sternocleidomastoid muscle fascia (44.5 N) does. Such an anatomical component of TPF is useful in performing platysmaplasty or platysma suspension.