面神经腮腺段的定位解剖[10-10-1416:24:00]编辑:studa20作者:姜吉良,吴斌,刘冬强,曹妍群【摘要】目的为腮腺区外科手术提供面神经腮腺段的定位解剖学资料。方法以颞骨的颧突根与下颌角后缘的连线为y轴,以过乳突尖并垂直于y轴的直线为x轴设定坐标系,以该坐标系为参照观测32具(64侧)成年尸体腮腺内面神经干的起、止点和面神经主要分支起点、出腮腺的位置和行走方向。结果面神经上、下干的起点位置分别是:(-17.32±1.22)mm和(-7.24±0.86)mm、(-17.32±1.22)mm和(-7.24±0.86)mm,止点位置分别是:(-10.26±1.02)mm和(17.24±1.22)mm、(-12.82±1.12)mm和(-12.22±0.88)mm,行走方向与x轴成角分别是:(36.20°±5.20°)、(-38.30°±4.60°);颞支、颧支、上颊支、下颊支、下颌缘支、颈支的起点位置分别是:(-10.26±1.02)mm和(27.24±1.22)mm、(-3.27±0.24)mm和(24.36±4.27)mm、(-3.85±0.86)mm和(18.42±2.06)mm、(-3.26±1.04)mm和(14.24±3.26)mm、(-11.72±2.35)mm和(-6.43±2.06)mm、(-12.82±1.12)mm和(-12.22±0.88)mm,出腮腺点位置分别是:(0.42±0.08)mm和(38.56±6.68)mm、(8.2±2.44)mm和(36.04±4.28)mm、(18.26±3.64)mm和(26.82±3.86)mm、(25.48±4.76)mm和(9.66±1.58)mm、(4.25±0.54)mm和(-13.63±5.23)mm、(-1.08±0.22)mm和(-16.26±3.64)mm,行走方向与x轴成角分别是:(68.10°±2.040°)、(34.80°±4.70°)、(9.40°±1.560°)、(-3.70°±1.350°)、(-55.60°±2.850°)、(-68.30°±2.630°)。结论根据颌面部外科手术需要,可通过体表标志线精确确定面神经干及其主要分支在腮腺内的位置和行走方向。【关键词】面神经干;面神经主要分支;定位解剖Abstract:ObjectiveToobserveandmeasurethefacialnerveinparotidsegmentinordertoprovideanatomicdataforoperationinparotidregion.MethodsAframeofaxeswasestablishedbymeansofsettingthelinelinkingrootofzygomaontemporalbonetothetrailingedgeofangulusmandibulaeasYaxis,andsettingthestraightlinepassingacrossmastoidaleandperpendiculartotheYaxisasXaxis.Thepositionandtravellingdirectionofthefacialnervetrunksandtheirmainbranchesintheparotidwereobservedandmeasuredon32adults(64sides)cadaverheadsrefertotheframeofaxes.ResultsThestartingpointoftheupper,lowertrunksoffacialnervewere(-17.32±1.22)mmand(-7.24±0.86)mm,(-17.32±1.22)mmand(-7.24±0.86)mmrespectively.Theirterminalpointwere(-10.26±1.02)mmand(17.24±1.22)mm,(-12.82±1.12)mmand(-12.22±0.88)mmrespectively.TheincludedanglebetweenthetrunksandtheXaxiswere(36.2°±5.2°),(-38.3°±4.6°)respectively.Thestartingpointofthetemporl,zygomatc,upperbuccal,lowerbuccal,marginalmandbularandcervicalbranchoffacialnervewere(-10.26±1.02)mmand(27.24±1.22)mm,(-3.27±0.24)mmand(24.36±4.27)mm,(-3.85±0.86)mmand(18.42±2.06)mm,(-3.26±1.04)mmand(14.24±3.26)mm,(-11.72±2.35)mmand(-6.43±2.06)mm,(-12.82±1.12)mmand(-12.22±0.88)mmrespectively.Thepointmovingawayfromtheparotidofthesebrancheswere0.42±0.08mmand(38.56±6.68)mm,(8.2±2.44)mmand(36.04±4.28)mm,(18.26±3.64)mmand(26.82±3.86)mm,(25.48±4.76)mmand(9.66±1.58)mm,(4.25±0.54)mmand(-13.63±5.23)mm,(-1.08±0.22)mmand-16.26±3.64)mmrespectively.TheincludedanglebetweenthebranchesandtheXaxiswere(68.1°±2.04°),(34.8°±4.7°),(9.4°±1.56°),(-3.7°±1.35°),(-55.6°±2.85°),(-68.3°±2.63°)respectively.ConclusionThepositionandtravellingdirectionofthefacialnervetrunksandtheirmainbranchesintheparotidmightbemadeaccuratelythroughthemarkerlineonthebodysurfaceaccordingtotherequirementofsurgery.Keywords:trunkoffacialnerve;mainbranchoffacialnerve;addressableanatomy鉴于面神经与腮腺的特殊解剖关系,手术治疗腮腺肿瘤时误伤面神经及其分支是发生...