成年女性下颌骨的断层解剖及应用解剖研究

目的在成年女性尸头标本的冠状面和水平面以及离体成年女性干燥下颌骨上，测量相关数据，以期为成年女性下颌骨整复术提供形态学依据。方法1）选取国人成年女性无器质性病变尸头标本20例，随机分为两组，每组10例，分别固定在自制的头颅固定器上进行切片，其中10例行冠状面切片，另10例行水平面切片，观察测量下颌骨在相应层面的有关数据；2）在50例离体成年女性干燥下颌骨上观测与下颌骨整复术有关数据后，于下颌牙槽平面和下颌升支前缘断开下颌升支和下颌骨体，测量下颌管的管径和位置，并对所得结果进行统计学分析。结果在尸头标本冠状面上，下颌角间距离（103．53±2．47）mm，左、右侧下颌管到下颌下缘的距离（12．27±0．84）mm、（12．36±0．75）mm；在水平面上，左、右侧下颌管到下颌角的距离（20．01±0．74）mm、（19．94±0．69）mm，左、右侧下颌管到颊侧骨皮质的距离（6．33±0．21）mm、（6．26±0．24）mm，左、右侧颊侧骨皮质的厚度（3．27±0．15）mm、（3．26±0．13）mm，左、右侧平口角平面咬肌厚度（13．07±0．14）mm、（13．45±0．20）mm。在离体成年女性干燥下颌骨上，左、右侧下颌角角度（118．27±6．84）°、（117．99±6．94）°，左、右侧下颌支高度（66．97±4．54）mm、（67．09±4．83）mm，左、右侧下颌角厚度（5．27±1．84）mm、（5．30±1．78）mm；在下颌升支前缘断面上，左、右侧下颌管的内外径（2．47±0．24）mm、（2．47±0．23）mm，左、右侧下颌管的上下径（3．27±0．35）mm、（3．25±0．37）mm，左、右侧下颌管至下颌骨内侧面的距离（3．36±0．58）mm、（3．41±0．54）mm，左、右侧下颌管至下颌骨外侧面的距离（6．27±1．40）mm、（6．29±1．37）mm，左、右侧下颌管至牙槽嵴的距离（15．24±1．64）mm、（15．33±1．59）mm，左、右侧下颌管至下颌骨下缘的距离（11．77±1．63）mm、（11．74±1．70）mm；在下颌牙槽平面断面上，左、右侧下颌管的内外径（2．55±0．33）mm、（2．58±0．29）mm，左、右侧下颌管的前后径（4．01±0．83）mm、（4．03±0．79）mm，左、右侧下颌管至下颌骨内侧面的距离（1．77±0．63）mm、（1．75±0．65）mm，左、右侧下颌管至下颌骨外侧面的距离（5．71±1．43）mm、（5．69±1．44）mm。结论通过对下颌骨的断层解剖及应用解剖学观测，为临床医师提供了更为详尽准确的参考数据，有助于下颌骨整复术的术前设计；行下颌骨整复术时，应当尽量向下颌升支及下颌体外侧去除下颌骨骨量。

Study on the Sectional Anatomy and Applied Anatomy of Adult Female Mandible

Objective To measure and collect mandibular data from coronal and horizontal planes of female adult cadaveric head specimens and from isolated adult female dry mandibles Methods Twenty cadaveric head specimens from Chinese adult women without pathological changes were divided into two groups, and placed in a home-made skull fixer to perform coronal section for 10 cases and horizontal section for the other 10 cases. The mandibular data were then measured. In 50 cases of isolated adult female dry mandibles, mandibular ramus and corpora mandibulae were disconnected between mandibular alveolar plane and mandibular ramus front, and the diameter and position of mandibular canal was measured and analyzed. Results On the coronal plane, the distance between the mandibular angles was （103.53±2.47） mm, the distance from the left and right side of mandibular canal to the lower margin of mandible was （12.27±0.84） mm and （12.36±0.75） mm, respectively. On the horizontal plane, the distance from the left and right side of mandibular canal to mandibular angle was （20.01± 0. 74） mm and （19.94±0.69） mm, the distance from the left and right side of mandibular canal to genal cortical bone was （6.33±0.21） mm and （6.26±0.24） mm. The thickness of the left and right side of genal cortical bone was （3.27±0.15） mm and （3. 26±0.13） mm. The thickness of the left and right masseter was （13.07±0.14） mm and （13. 45 ± 0. 20） mm. On the isolated female adult dry mandibles, the left and right mandibular angle was （118.27±6.84）°and （117.99±6.94）°. The left and right mandibular ramus height was （66. 97±4.54） mm and （67. 09±4.83） mm. The left and right mandibular angle thickness was （5.27±1.84） mm and （5. 30±1.78） mm. On the mandibular ramus front section, the inner and outer diameter of left and right mandibular canal was （2. 47± 0.24） mm and （2. 47±0.23） mm. The vertical diameter of left and right mandibular canal was （3. 27±0.35） mm and （3. 25±0.37） mm. The distance from left and right mandibular canal to the inside of mandible was （3. 36± 0.58） mm and （3. 41±0.54） mm. The distance from left and right mandibular canal to the outside of mandible was （6. 27±1.40） mm and （6. 29±1.37） ram. The distance from left and right mandibular canal to alveolar ridge was （15.24±1.64） mm and （15. 33±1.59） mm. The distance from left and right mandibular canal to the lower margin of mandible was （11.77±1.63） mm and （11. 74±1.70） mm. On the alveolar plane section of mandible, the inner and outer diameter of left and right mandibular canal was （2. 55 ± 0. 33） mm and （2. 58 ± 0. 29） mm. The anteroposterior diameter of left and right mandibular canal was （4.01 ± 0.83） mm and （4.03 ± 0.79） mm. The distance from left and right mandibular canal to the inside of mandible was （1.77±0.63） mm and （1. 75±0.65） mm. The distance from left and right mandibular canal to the outside of mandible was （5.71± 1.43） mm and （5.69 ± 1. 44） mm. Conclusion The observation and measurement of sectional and applied mandibular anatomy will provide a more detailed and accurate reference data for doctors to design surgery strategy before mandibular reconstruction. When performing mandibular sagittal split ramus osteotomy, it should be close to the outside of mandibular ramus.