面神经腮腺外分支与吻合的解剖学研究

发布时间：2018-05-02 04:29

本文选题：腮腺 + 面神经分支　；参考：《遵义医学院》2012年硕士论文

【摘要】：目的：通过对腮腺外段面神经的分支走行及吻合进行较全面的解剖观察及测量,获得面神经各分支更详细、准确的解剖学知识。方法：通过对20侧尸体头颈部标本于显微镜下进行分层分区解剖,并结合外科手术方法研究了面部神经腮腺外分支的走行及分支间的吻合规律。并通过游标卡尺及计算机对相关数据进行测算,确定了面神经各支的体表投影。结果：观测到了各神经支的体表投影,走行层次,分支吻合以及面肌的支配情况,以及面神经在到达支配肌肉的之前有“集中吻合”的普遍现象结论：1.面神经颈支恒为1支,其它各神经支的数量均1支。 2.利用5个坐标点(计算机计算的质心点),可以方便、准确标识颧弓下区安全区界线。 3.面神经颞支走行于颞中筋膜中,后位颞支先浅出颞中筋膜后走行至颞浅筋膜SMAS深面。以颞支的腮腺浅出点坐标,距外眦点的水平距离和距眉梢点的水平距离,能简便准确地标识出颞支的体表投影线和颞区安全区界线。 4.颧、颊支和下颌缘支走行于咬肌筋膜深面或中间,上位颊支可能(35%)在咬肌中份时浅出咬肌筋膜,提前到达SMAS深面。咬肌筋膜可以有效的保护颧支和下颌缘支,颧支的体表投影线与颧弓基本是平行走行的,下颌缘支为2支(30%)的情况,则大部分下颌体表面被神经支主干及其吻合支覆盖。 5.在各部SMAS中,均无面神经主干走行,分支可进入SMAS的肌性部分。 6.面神经分支在进入支配面肌之前,存在着集中吻合。 7.通过显微外科技术而进行面神经的细致解剖,为面神经腮腺外分支的研究提供了准确、客观的资料。
[Abstract]:Objective: to obtain more detailed and accurate anatomical knowledge of the branches of the facial nerve in the parotid gland by anatomic observation and measurement. Methods: 20 specimens of head and neck of cadavers were dissected under microscope and combined with surgical methods to study the route and anastomosis of the lateral branches of facial nerve and parotid gland. The surface projection of each branch of facial nerve was determined by Vernier caliper and computer. Results: the surface projection, walking level, branch anastomosis and facial muscle innervation of the nerve branches were observed, as well as the common phenomenon of "concentrated anastomosis" of the facial nerve before reaching the innervated muscle. Conclusion 1. The cervical branch of facial nerve was one branch, and the number of other nerve branches was 1 branch. 2. By using five coordinate points (the centroid points calculated by computer), it is convenient and accurate to identify the security zone under zygomatic arch. 3. The temporal branch of the facial nerve was located in the middle temporal fascia, and the posterior temporal branch was first shallowly out of the middle temporal fascia and then on the deep side of the superficial temporal fascia SMAS. Based on the coordinates of the superficial parotid gland of the temporal branch, the horizontal distance from the outer canthus point and the horizontal distance from the eyebrow tip point, the surface projection line of the temporal branch and the boundary of the safe area of the temporal region can be easily and accurately identified. 4. The zygomatic, buccal and mandibular marginal branches were located on the deep or middle side of the masseter fascia, and the upper buccal branch could reach the deep surface of SMAS in the middle portion of the masseter muscle. Masseter fascia can effectively protect zygomatic branch and mandibular marginal branch. The surface projection line of zygomatic branch is basically parallel to the zygomatic arch and the mandibular marginal branch is 30 branches. 5. In all SMAS, there was no facial nerve trunk, and the branches could enter the muscular part of SMAS. 6. There is a concentrated anastomosis of the facial nerve branches before entering the innervated facial muscles. 7. The detailed anatomy of the facial nerve by microsurgical technique provides accurate and objective data for the study of the extraparotid branches of the facial nerve.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R322

【参考文献】