面神经下颌缘支的应用解剖.doc

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1、面神经下颌缘支的应用解剖【摘要】目的了解面神经下颌缘支的正常层次解剖位置，为涉及面侧区和颌下区的美容外科手术提供临床应用解剖学资料。方法解剖33具(共66例)成人尸体标本的头颈部标本，观察了面神经下颌缘支的分支类型、走行、与面动脉的位置关系以及穿出腮腺处和与面动脉的交叉处的体表位置。结果面神经下颌缘支为1～2支，以单干型居多，约占58%，大多行于下颌骨下缘上方约占44%，行于骨下缘下方者占5%。未发现面神经下颌缘支不与面动脉交叉，位置在均下颌角下缘上、下方约0.5～1cm范围内。面神经下颌缘支经过面动脉的浅面和深面者分别占89%和6%；面神经下颌缘支穿出腮腺处的体表位置分别在下颌角上方和

2、下颌支后缘前方1cm交点附近，面神经下颌缘支与面动脉交处距下颌支后缘约4cm，距下颌骨下缘约1cm。结论面神经下颌缘支的毗邻和行程关系较为复杂，了解其与周围结构的重要位置关系，可以减少美容外科手术因神经损伤造成下唇及口角功能障碍的发生。【关键词】面神经下颌缘支；应用解剖学；美容外科［AppliedanatomyofthemarginalmandibularbranchofthefacialnerveAbstract:ObjectiveToaddresstheanatomicalpositionofanatomiclocationofthemarginalmandibularbrancho

3、fthefacialnerve，providingclinicalanatomicaldataforcosmeticsurgeryonthesideandsubmaxillaryregion.MethodsTotally33cases(66sides)autopsieswereobserved,includingthetypesandcoursesofthemarginalmandibularbranchofthefacialnervesandtheirsurfacelocationsandrelationswiththefacialarteryintheareaofheadsandne

4、cks.ResultsAsingletrunkmarginalmandibularbranchesaccountsfor58%,thebrancheswitchrunalongtheupperandlowerinferiorborderofborderofmandibleaccountfor44%and5%.Thesurfacelocationofthebranchesrunningoutoftheparotidglandisneartheintersectionbetween0.5to1.0cmabovemandibularangleandtheanterioroftheposteri

5、orborderofthemandible.Themarginalmandibularbrancheswhichpasssuperficiallyanddeeptothefacialarteryaccountfor89%and6%,respectively.Thesurfacelocationofthebranchesrunningoutoftheparotidglandisneartheintersectionbetween1.0cmabovemandibularangleandtheanterioroftheposteriorborderofthemandible.Thedistan

6、cesfromtheintersectionbetweenthenerveandthefacialarterytotheposteriorborderofthemarginalmandibularbranchandtolowerborderofthemandiblewere4.0cmand1.0cm,respectively.ConclusionMarginalmandibularbranchofthefacialnervehasacomplicatedadjacentandcourse,sounderstandingtheadjacentrelationshipscanreduceth

7、enerveinjuryduringcosmetic4surgery.Keywords:marginalmandibularbranchofthefacialnerve;appliedanatomy;aestheticsurgery面神经下颌缘支的走行有许多变异，在颌下部施行某些美容外科手术时，往往易受损伤而导致口角及下唇运动障碍。目前有关面神经下颌缘支的应用解剖学资料不多［1］，尤其是体表定位资料尚少，面神经下颌缘支的应用解剖对颌