面神经下颌缘支的应用解剖

目的了解面神经下颌缘支的正常层次解剖位置,为涉及面侧区和颌下区的美容外科手术提供临床应用解剖学资料。方法解剖33具（共66例）成人尸体标本的头颈部标本,观察了面神经下颌缘支的分支类型、走行、与面动脉的位置关系以及穿出腮腺处和与面动脉的交叉处的体表位置。结果面神经下颌缘支为1-2支,以单干型居多,约占58%,大多行于下颌骨下缘上方约占44%,行于骨下缘下方者占5%。未发现面神经下颌缘支不与面动脉交叉,位置在均下颌角下缘上、下方约0.5-1 cm范围内。面神经下颌缘支经过面动脉的浅面和深面者分别占89%和6%;面神经下颌缘支穿出腮腺处的体表位置分别在下颌角上方和下颌支后缘前方1 cm交点附近,面神经下颌缘支与面动脉交处距下颌支后缘约4 cm,距下颌骨下缘约1 cm。结论面神经下颌缘支的毗邻和行程关系较为复杂,了解其与周围结构的重要位置关系,可以减少美容外科手术因神经损伤造成下唇及口角功能障碍的发生。

Applied anatomy of the marginal mandibular branch of the facial nerve

Objective To address the anatomical position of anatomic location of the marginal mandibular branch of the facial nerve,providing clinical anatomical data for cosmetic surgery on the side and submaxillary region.Methods Totally 33 cases(66 sides) autopsies were observed,including the types and courses of the marginal mandibular branch of the facial nerves and their surface locations and relations with the facial artery in the area of heads and necks.Results A single trunk marginal mandibular branches accounts for 58%,the branches witch run along the upper and lower inferior border of border of mandible account for 44% and 5%.The surface location of the branches running out of the parotid gland is near the intersection between 0.5 to 1.0 cm above mandibular angle and the anterior of the posterior border of the mandible.The marginal mandibular branches which pass superficially and deep to the facial artery account for 89% and 6%,respectively.The surface location of the branches running out of the parotid gland is near the intersection between 1.0 cm above mandibular angle and the anterior of the posterior border of the mandible.The distances from the intersection between the nerve and the facial artery to the posterior border of the marginal mandibular branch and to lower border of the mandible were 4.0 cm and 1.0 cm,respectively.Conclusion Marginal mandibular branch of the facial nerve has a complicated adjacent and course,so understanding the adjacent relationships can reduce the nerve injury during cosmetic surgery.