An Anatomical and Analytical Study of the Modiolus: Enlightening Its Relevance to Plastic Surgery

Al-Hoqail, Rola Abdullah; Meguid, Eiman Abdel

doi:10.1007/s00266-008-9187-x

Cited by 21 publications

(16 citation statements)

References 10 publications

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“…10 A special region of the facial musculature is the "modiolus," the corner of the mouth where muscles unite and insert. 11 Fascia are often absent, and there is high inter-and intraindividual variability in location, morphology, and number of fibers within a muscle. The risorius and zygomaticus minor muscles are absent in some people.…”

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confidence: 99%

Quantitative facial muscle ultrasound: Feasibility and reproducibility

et al. 2013

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mentioning

confidence: 99%

Quantitative facial muscle ultrasound: Feasibility and reproducibility

et al. 2013

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“…In general, nine muscles attach to modiolus: Buccinator, risorius, orbicularis oris, depressor anguli oris, depressor labii inferioris, zygomaticus major, platysma pars modiolaris, levator anguli oris and mentalis. Most of these muscles have dermal terminations [4]. Patients with a prominent nasolabial fold, which is considered one of the principle landmarks of lower face aging, have weak trophic modioli [2,5].…”

Section: Introductionmentioning

confidence: 99%

“…Patients with a prominent nasolabial fold, which is considered one of the principle landmarks of lower face aging, have weak trophic modioli [2,5]. In the literature, there are microscopic studies examining its histo-morphological structure [2,5], and macroscopic cadaveric studies indicating the relationship of modiolus with the vessels and neighboring expression muscles [4]. Location of the modiolus was also studied in living individuals by palpation [6].…”

Section: Introductionmentioning

confidence: 99%

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Anatomical and radiological evaluation of modiolus anguli oris in facial anatomy

Çalişkan¹,

Çelebioğlu²,

Akkaşoğlu³

et al. 2019

Journal of Surgery and Medicine

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Aim: Modiolus is a dense, mobile fibromuscular structure lateral to the mouth corner. It is of great importance in aesthetic and reconstructive surgery. The aim of this study was to enlighten the structural changes in modiolus with demographic variables such as age and gender in living individuals. Methods: This retrospective cohort study was conducted on MR images of healthy individuals. Age and sex-related changes in modiolus level and volume were retrospectively analyzed in 64 patients [37M; 27F; mean age 48.2(16.3)] who underwent head and neck magnetic resonance imaging. ROC analysis was performed to determine the cut off values for age of modiolus. Correlation analysis (Pearson and point biserial correlation) was used to determine whether there was a significant correlation between age and volume. Significance of the differences between the volumes of right and left modiolus of the same individual were evaluated by dependent t tests. Results: The mean volume of the modiolus was calculated as 0.51(0.26) mm 3. The volumes of right and left modioli decreased by aging. Ninety-one percent of the patients with modioli located inferior to horizontal line were over 49 years old. Right and left modioli relocated inferior to horizontal line with age. Modiolus volume was prominently less in women and the downward displacement of modiolus in women was 3.3 times higher than in men. Gender and age had significant effects on modiolus level. The right and left modiolus volumes were similar (P=0.975). Conclusion: Surgeon's knowledge on modiolus and its relations will provide benefit, not only for the procedures such as face lifting and botulinum toxin injection, but also for the surgeries of facial paralysis and trauma patients.

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“…The lower lip is associated with four, including the orbicularis oris inferior, depressor labii inferioris, depressor anguli oris, and mentalis muscles (Zemlin, 1998). Several muscles converge just lateral to the buccal angle and interlace to form a dense, three-dimensionally mobile, fibromuscular mass known as the modiolus (Al-Hoqail & Meguid, 2009). Nearly all muscles converging toward the modiolus have dermal terminations.…”

Section: Introductionmentioning

confidence: 99%

OroSTIFF: Face-referenced measurement of perioral stiffness in health and disease

Chu

Barlow

Kieweg

et al. 2010

Journal of Biomechanics

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A new device and automated measurement technology known as OroSTIFF is described to characterize non-participatory perioral stiffness in healthy adults for eventual application to patients with orofacial movement disorders associated with neuromotor disease, traumatic injury, or congenital clefts of the upper lip. Previous studies of perioral biomechanics required head stabilization for extended periods of time during measurement which precluded sampling patients with involuntary body/head movements (dyskinesias), or pediatric subjects. The OroSTIFF device is face-referenced and avoids the complications associated with head-restraint. Supporting data of non-participatory perioral tissue stiffness using OroSTIFF are included from 10 male and 10 female healthy subjects. The OroSTIFF device incorporates a pneumatic glass air cylinder actuator instrumented for pressure, and an integrated subminiature displacement sensor to encode lip aperture. Perioral electromyograms were simultaneously sampled to confirm passive muscle state for the superior and inferior divisions of the orbicularis oris muscles. Perioral stiffness, derived as a quotient from resultant force (ΔF) and interangle span (ΔX), was modeled with multilevel regression techniques. Real-time calculation of the perioral stiffness function demonstrated a significant quadratic relation between imposed interangle stretch and resultant force. This stiffness growth function also differed significantly between males and females. This study demonstrates the OroSTIFF ‘proof-of-concept’ for cost-effective non-invasive stimulus generation and derivation of perioral stiffness in a group of healthy unrestrained adults, and a case study to illustrate the dose-dependent effects of Levodopa on perioral stiffness in an individual with advanced Parkinson’s disease who exhibited marked dyskinesia and rigidity.

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An Anatomical and Analytical Study of the Modiolus: Enlightening Its Relevance to Plastic Surgery

Abstract: The modiolus is of critical importance in aesthetic and reconstructive plastic surgery of the face.

Cited by 21 publications

References 10 publications

Quantitative facial muscle ultrasound: Feasibility and reproducibility

Quantitative facial muscle ultrasound: Feasibility and reproducibility

Anatomical and radiological evaluation of modiolus anguli oris in facial anatomy

OroSTIFF: Face-referenced measurement of perioral stiffness in health and disease

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