腮腺摘除术中寻找面神经主干的新途径

<正> 在腮腺摘除术中不损伤面神经,早已成为颌面外科领域中的一个重要问题。临床在进行腮腺摘除术时,对于腮腺浅叶和位于面神经表面的腮腺良性和低度恶性肿瘤,根据肿瘤所在的部位和移动性,一般采用两种不同的方法来解剖面神经以摘除腮腺:即先找面神经主干,然后再循主干向远端分离分支;或先找面神经分支,再循此而至主干。由于面神经主干位置较深,加之其支配范围

INTRODUCING AN APPROACH IN SEARCHING FOR THE MAIN TRUNK OF THE FACIAL NERVE IN PAROTIDECTOMY

The relationship between the tympanomastoid fissure and the stylomastoid foramen were studied in 100 dried skull and 35 adult cadavers, the result were outline as follows: 1. The average distance between the tympanomastoid fissure and the stylomastoid foramen is 10.05 mm, SD is 2.11 mm, SE is 1.54mm. 2. The position of the stylomastoid foramen may be classified into three types: Typel Ⅰ: The position of the stylomastoid foramen is situated at frontal line through the tympanomastoid fissure; Type Ⅱ: Anterior; Type Ⅲ: posterior. Type Ⅰ is the most common (52%); Type Ⅱ, less (39.5%); Type Ⅲ, the least (8.5%). Based on the above, the authors introduce an approach in searching for the main trunk of the facial nerve in parotidectomy, i. e. via the tympanomastoid fissure, it is practically subcutaneous, follow it inferiorly and medially to the stylomstoid foramen and the main trunk of the facial nerve is emerging.