舌骨大角尖端周围血管神经的解剖学研究

目的为临床颈部手术以舌骨大角尖端(THB)为标志定位周围血管神经提供解剖学资料。方法在21例防腐罐注红色乳胶的成人头颈部标本上显露THB及其周围结构(颈总动脉分叉,甲状腺上动脉、舌动脉、舌下神经、喉上神经),通过THB做互相垂直的水平线和垂直线,测量相关结构与此两线间的距离。结果颈总动脉分叉点A位于THB后方8.5±2.3 mm,下方12.8±4.8 mm;甲状腺上动脉起点B位于THB后方4.6±2.2 mm,下方12.8±4.2 mm;舌动脉起点C位于THB后方4.1±2.5 mm,上方0.2±3.8 mm;其弓形最高点D位于THB前方0.2±2.1 mm,上方7.5±2.6 mm;舌下神经与垂直轴交点E位于THB上方5.1±1.6 mm;喉上神经内支与两轴的交点F、G分别距THB后方7.9±2.5 mm,下方6.5±2.0 mm。结论以THB为标志定位其周围血管神经有利于临床医生处理颈部的手术。

Anatomic Study of the Blood Vessels and Nerves Adjacent to Tip of the Greater Horn of Hyoid Bone

Objective To provide anatomical data for the clinical operation on neck to locate the acroteric vascular nerves of the tip of the greater horn of hyoid bone(THB) with taking THB as a landmark.Methods THB and surrounding structures(the carotid bifurcation,the superior thyroid and lingual arteries,and the hypoglossal and superior laryngeal nerves) were revealed on 21 adult cadavers perfused with red latex,sharp measurements were made along two orthogonal axes crossing exactly on THB,the vertical axis was parallel to the craniocaudal axis of the body.Results The carotid bifurcation(A) is located posterior to THB(8.5±2.3) mm,inferior to THB(12.8±4.8) mm,the starting point(B) of the superior thyroid artery is located pesterior to THB(4.6±2.2) mm,inferior to THB(12.8±4.2) mm.The starting point(C) of the lingual artery is located posterior to THB(4.1±2.5) mm,superior to THB(0.2±3.8) mm;the culmination of the lingual artery is anterior to THB (0.2±2.1) mm,superior to THB(7.5±2.6) mm.The point of intersection(E) of the hypoglossal nerve and vertical axis is located superior to THB(5.1±1.6) mm, the points of intersection(F,G) of the internal branch of the superior laryngeal nerve and two orthogonal axes are located posterior to THB(7.9±2.5) mm,inferior to THB(6.5±2.0) mm respectively.Conclusion Taking THB as a landmark to locate the blood vessels and nerve surrounding THB would be beneficial for dealing with the operation on neck.