颞区解剖学特点及临床应用

目的：获得颞区解剖学数据、探讨颞中间隙在颞区二期植骨术的临床应用价值。 方法：10%甲醛固定的成人湿性头颅标本15具(30侧)，在手术显微镜下对标本颞区进行逐层解剖，观察解剖层次及神经血管结构的走行及分布。把颞浅动脉主干与颧弓上缘交点、面神经颞支最颞侧支与颧弓上缘相交点、冠状缝与颞上线交点、颧弓后根前2 cm处颧弓上缘分别设为A、B、C、D点，测量A、B点与颧弓后根距离,观察CD线与面神经颞支的关系。 结果：① 颞区是头皮中富含筋膜和脂肪组织的区域，并有三个潜在的解剖间隙； ② A点距颧弓后根0.3～0.8 cm［（0.5±0.1） cm］、B点距颧弓后根2.2～3.5 cm［（2.6±0.3）cm］； ③面神经颞支均在CD连线前方的颞区内，75.0%行于皮下、21.4%行于颞浅间隙、3.6%行于颞中间隙。 结论： ① 颞中脂肪层是颞中间隙重要的解剖标志；② 在颧弓后根前1 cm处切开皮肤，不会损伤颞浅动脉主干；③ CD线后方颞区为避免面神经颞支损伤的安全操作区。

Anatomic feature and clinical application of temporal region

Objective To provide a detailed anatomic data of temporal region and evaluate the clinical application of intermedial temporal space in re-time bone graft operation.Methods Stepwise dissection was performed in the temporal region in 15 pre-fixed adult cadavers(30 sides) with the aid of surgical microscope,and the anatomic layers,the distribution of nerves and blood vessels in temporal region were observed.Results ① Temporal region was rich in fascia layers,fatty tissue layers,and contained 3 latent anatomic spaces;② The distance between point A,B and dorsal root of ygomatic arch was 0.3-0.85 cm(0.5±0.1)cm],2.2-3.5 cm (2.6±0.3)cm],respectively.③ All of the temporal branches of facial nerve were located in front of line CD,75.0% in subcutaneous tissue,21.4% in superficial temporal space,3.6% in intermedial temporal space.Conclusion ① The intermediate fat layer is an important landmark of intermediate temporal space;② The skin flap before dorsal root of ygomatic arch 1 cm is safety to temporal artery;③ The temporal space after the line CD is a safety operation area for the protection of temporal branch of facial nerve.