Anatomy of the motor innervation of the corrugator supercilii muscle: clinical significance and development of a new surgical technique for frowning.
OBJECTIVE
This study was conducted to determine the motor innervation of the corrugator supercilii muscle and, based on this information, develop a new surgical technique to treat patients with hyperfunctional corrugator muscles with deep vertical glabellar creases.


METHODS
Microdissection of five fresh-frozen cadaveric heads was performed. Following this, patients presenting with a complaint of vertical glabellar creases (frown lines) due to hyperfunctional corrugator supercilii muscles were offered a new surgical technique to divide the nerve lateral to its entry into the corrugator supercilii muscle.


RESULTS
The motor innervation of the corrugator supercilii muscle is constant and predictable in its course. Patients treated with motor nerve neurotomy showed considerable weakening of the corrugator supercilii muscle function as determined by clinical testing; however, the nerve lysis did not affect the glabellar depressor muscles.


CONCLUSIONS
The anatomy of the motor nerve supply to the corrugator supercilii muscle is described. Lysis of the nerve appears to be safe, reliable, and effective in weakening the strength of the corrugator supercilii muscles and improving the appearance of vertical glabellar creases.
Ellis
D A
DA
Department of Otolaryngology, University of Toronto, Ontario.
Bakala
C D
CD
D002102:Cadaver; D004210:Dissection; D005149:Facial Expression; D005152:Facial Muscles / Q000294:innervation* / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005546:Forehead / Q000294:innervation* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons; D015361:Rhytidoplasty / Q000379:methods