滑车上神经及滑车上动脉主干坐标定位的解剖学观测

目的 观测滑车上神经和滑车上动脉主干的解剖定位,为临床手术去除眉间皱纹时防止滑车上神经、动脉的损伤提供解剖学依据。方法 选取10%甲醛固定的成人尸头标本20例(40侧),测量滑车上切迹至额前正中线、眶上切迹、皱眉肌起点的距离。在尸头标本上以经过两侧眉弓的最高点的水平线作为横坐标(X轴),经过额前正中线作X轴的垂直线作为纵坐标(Y轴),二者的交点为原点(即O点),制作滑车上神经、动脉主干的走行范围轨迹。结果 20例(40侧)标本中,12例(24侧)见滑车上切迹,出现率为60.0%。滑车上切迹至额前正中线的距离为(15.85±2.52)mm,其中左侧(16.56±3.08)mm、右侧(15.04±1.51)mm;滑车上切迹位于眶上切迹的内侧,距离为(9.42±3.51)mm,其中左侧(8.78±3.24)mm、右侧(10.16±3.91)mm。滑车上切迹至皱眉肌起点的距离为(10.73±2.41)mm,其中左侧(10.91±2.82)mm、右侧(10.35±1.57)mm。滑车上神经和滑车上动脉主干的走行范围轨迹显示:眉弓上32.5mm至眉弓下20mm的范围内,在额前正中线左侧(坐标轴右侧)由(7.18±3.82) mm～(13.90±1.60)mm、右侧(坐标轴左侧)由(-7.27±4.06)mm~(-13.28±2.76)mm是滑车上神经主干"危险区";而眉弓上20mm至眉弓下20mm的范围内,在额前正中线左侧(坐标轴右侧)由(8.67±2.46) mm~(16.92±2.36)mm、右侧(坐标轴左侧)由(-9.43±3.07)mm～(-15.48±1.62)mm是滑车上动脉主干“危险区”。结论 在额眉部有易损伤滑车上神经和滑车上动脉的“危险区”,额眉部手术时应谨慎操作,减小对神经、动脉的损伤。

Anatomical observation of the stem location of supratrochlear nerve and supratrochlear artery

Objective To observe the anatomic localization of supratrochlear nerve and supratrochlear artery. To provide anatomical basis for preventing the injury of supratrochlear nerve and supratrochlear artery.Methods Forty hemibrows of the 20 heads of the cadavers which were fixed in 10% formaldehyde were chosen. The distances from the foramen supratrochlear to the anterior median line, the supraorbital notch and the origin of the corrugator supercilii were measured. The horizontal line which was through the apogee of the two sides superciliaris arch was X-axis. The vertical which was through the anterior median line was Y-axis. The two points of intersection was O point. The pictures of track of supratrochlear nerve and supratrochlear artery were made by using SigmaPlot software.Results Twenty-four hemibrows of the 12 heads of the cadavers was occurrence foramen supratrochlear in the 40 hemibrows of the 20 heads of the cadavers. The occurrence rate was 60%. The distance between the foramen supratrochlear and the anterior median line was (15.85±2.52)mm, the left was (16.56±3.08)mm, the right was (15.04±1.51)mm. The foramen supratrochlear was located the medial of the supraorbital notch (9.42±3.51)mm, the left was (8.78±3.24)mm, the right was (10.16±3.91)mm. The distance between the foramen supratrochlear and the origin of the corrugator supercilii was (10.73±2.41)mm, the left was (10.91±2.82)mm, the right was (10.35±1.57)mm.According to the range trajectory we could get: The most danger zone of damaging the supratrochlear nerve was(7.18±3.82)mm-(13.90±1.60)mm in the left of the forehead and (-7.27±4.06)mm-(-13.28±2.76)mm in the right of the forehead on the superciliary arch above 32.5cm and below 20cm; the most danger zone of damaging the supratrochlear artery was (8.67±2.46)mm-(16.92±2.36)mm in the left of the forehead and (-9.43±3.07)mm-(-15.48±1.62)mm in the right of the forehead on the superciliary arch above 20 mm and below 20 mm.Coclusions There is a danger zone in forehead brow in which it is easy to damage the supratrochlear nerve and supratrochlear artery.