胸锁乳突肌应用解剖学研究

了解胸锁乳突肌和副神经的解剖关系及在痉挛性斜颈中的作用，为手术治疗痉挛性斜颈的切口 和方法提供解剖依据。方法：观测活体成人男女各１００名例胸锁乳突肌长度、宽度，标本６５具（男３５具，女３０具） 该肌长、宽和厚度及其周围结构。结果：见乳突尖向胸锁乳突肌前缘４ ｃｍ（上 １／４下 ３／４交点）和向下至后缘５ ｃｍ （上中１／３交点）处连线深面有副神经（８０％±１５％），该处是切断胸锁乳突肌及其副神经肌支的最佳部位之一。二腹 肌后腹深面为高位结扎切断副神经点，若再向上易伤颈内静脉。在胸锁乳突肌深面的副神经最大横径为（２．３± ０．５）ｍｍ。结论：沿副神经的体表投影线，设计出和投影线相应的手术切口，切断副神经和部分胸锁乳突肌是治疗痉 挛性斜颈的较好部位。

Applied anatomical study of the sternocleidomastoid muscles

Aim:To understand the function of the sternocleidomastoid muscle and the accessory nerve in spasmodic torticollis and to provide the appropriate surgical incision and surgical method.Methods:We Examined the length and width of sternocleidomastoid muscles in 200 adults(men 100,women 100)and examined the length,width and thickness and the surrounding structures of this muscles in 65 adults cadvers(male35,female30).Result:We found that the line from the apes of the mastoid process making for the front margin 4cm(superior 1/4joint with inferior 3/4)of the sternocleidomastoid muscle to the posterior margin 5 cm(superior1/3 joint with inferior 2/3)is the projective line of the accessory nerve.(80% 0.5).On this projective line is the good position for cuting the sternoeleidomastoed muscle and accesory nerve.The position in the deep surface of the digastric muscle is the hightest position for cuting the accessory nerve.It will harm the internal jugular vein if we cut the nerve over this muscle is cut .The diameter of the accessory nerve under sternocleidomastoid muscle is (2.3 0.5)mm.Conclusion:partly cutting the sternocleidomastoid mascle and the accessry nerve along the projective line of the accessory nerve on the body surface if good.