颌下入路保护面神经下颌缘支的临床解剖研究

目的探讨保护面神经下颌缘支的颌下入路解离方法,为临床手术提供解剖学依据。方法成年尸体(男女不限)15具(30侧),模拟颌下入路,显露颌下三角区;分别用三种不同的解剖分离方法来保护面神经下颌缘支。结果方法一:无法直视面神经下颌缘支,仅在颌下腺表面可以分离;方法二与方法三均可直视下保护面神经下颌缘支,但以方法三最为可靠、安全。结论在颈阔肌浅面掀起皮瓣,在下颌骨下缘1.5～2.0cm以下切开颈阔肌,在颈阔肌深面逐层解剖显露面神经下颌缘支的方法较为可靠。

Study of Clinical Anatomy for Submandibular Operation Approach to Protect Marginal Mandibular Branch

Objective To discuss submandibular operation approach to protect marginal mandibular branch and supply anatomical basis for clinical operation.Methods 15 cases of cadavers(30 hemispheres)were used to simulate the submandibular operation and reveal sub-mandibular triangle,and then to protect marginal mandibular branch of facial nerve by three methods respectively.Results The second and the third method both protected marginal mandibular branch directly and the third one was more reliable and safe,but the first didn't and only separated the branch at the superficies of submandibular gland.Conclusion The third method,lifting skin flap at the superficial sur-face of platysma,dissecting platysma on the inferior border of mandible about 1.5-2.0 cm and then dissecting and revealing marginal mandibular of facial nerve on the deep surface of platysma,is most reliable and safe.