面神经颞支走行区域及其对沿途肌肉支配的解剖学研究

发布时间：2018-01-24 03:44

本文关键词： 皱眉肌面神经颞支神经支配除皱术　出处：《大连医科大学》2009年硕士论文　论文类型：学位论文

【摘要】： 目的:通过研究和探讨皱眉肌的形态分布、定位投影以及面神经颞支的走行及对其走行所经肌肉支配的路径和入肌点,从而确定面神经颞支在颞区、眉区分布和支配范围,为临床开展注射肉毒素和手术除皱或各种涉及面神经颞支的手术提供理论依据及参考数据。方法:对8具以10%福尔马林溶液浸泡2至8年、年龄在30~70岁、发育正常而无畸形的成人尸体(蒙古人种)半侧颜面共16侧做眉区、颞区解剖分离(包括大体解剖和显微解剖),研究和测量黄种人皱眉肌的形态分布定位以及面神经颞支进入皱眉肌、眼轮匝肌的路径及其入肌点,从而确定面神经颞支在眉区、颞区的分布和支配范围,并用数码相机拍照记录以及手绘肌肉神经分布图。实验结果:皱眉肌的形态为两块斜行向上的小块肌肉,左右各一,该肌肉起源于额骨鼻部下部的骨膜,眶上孔的内侧,多为斜向外上方走行,呈扇形发散状穿过眼轮匝肌眶部深面,肌厚度由厚到薄向浅部走行止于眉区皮肤。其体表投影在鼻根稍斜上侧过皱眉肌起点的长约36.5±4.5 mm、纵向宽约21.9±3.6 mm的矩形内。支配皱眉肌的主要神经为面神经颞支吻合网的次级支。该次级支平均3~4支大多于皱眉肌深面中外1/2的区域内进入皱眉肌。测量面神经颞支在颧弓下缘平面、耳根水平面、过眶上孔垂直线上的走行分布区域宽度分别为7.8±2.1mm、17.2±3.8mm、25.1±3.3mm。此外,面神经颞支的最前支在位于颧弓水平处深入眼轮匝肌,在此过程中该支常与面神经颧支形成结构复杂的吻合网,分布于外眦水平线之下的眼轮匝肌;在外眦水平附近,颞支的中间支约1~2支直接或分出次级支进入眼轮匝肌,控制外眦周围眼轮匝肌的收缩。实验结论:通过确定皱眉肌及面神经颞支在颞区、眉区的分布范围及入肌点使临床进行肉毒素注射除皱定位更加准确,同时为眉区除皱术,尤其是眉间微创除皱如高选择性面神经离断术、鱼尾纹除皱术或各种涉及面神经颞支的手术具有指导意义,可使手术更加精确、并缩短显微手术时间和提高手术效率。
[Abstract]:Objective: to determine the temporal branch of facial nerve in temporal region by studying and discussing the morphological distribution of the frowning muscle, the location projection, the route of the temporal branch of the facial nerve and the innervation of the muscle and the point of entry of the muscle through the route of the temporal branch of the facial nerve. The distribution and innervation of the eyebrow provide theoretical basis and reference data for the clinical application of botulinum toxin injection and wrinkle removal or operations involving the temporal branch of the facial nerve. Methods: eight adult cadavers (Mongol) were soaked in 10% formalin solution for 2 to 8 years, aged 30 to 70 years, and 16 sides of half face of adult cadavers (Mongol race) were used as eyebrow area. Anatomical separation of temporal region (including gross anatomy and microanatomy) study and measurement of the morphological distribution of the frowning muscles of yellow people and the route of the temporal branch of the facial nerve into the frowning muscles and the orbicularis oculi muscles. The distribution and innervation of temporal branch of facial nerve in eyebrow and temporal region were determined, and the distribution of muscle nerve was recorded and hand-drawn by digital camera. The results showed that the frowning muscle was composed of two small, oblique and upward muscles, one on the left and the other on the left. The muscle originated from the periosteum in the lower part of the frontal bone and the medial part of the supraorbital foramen. It was fan-shaped and diffused through the deep surface of orbital part of orbicularis oculi muscle, and the thickness of muscle moved from thick to thin to the superficial part of the eyebrow skin. The length of the body surface projecting to the upper side of the nasal root was about 36.5 卤4.5 mm. Longitudinal width about 21.9 卤3.6. The main nerve innervating the frowning muscle is the secondary branch of the temporal branch anastomosing network of facial nerve. The average of the inferior branch is 34 branches, mostly entering the frowning muscle in the area 1/2 at the deep side of the frown muscle. The temporal nerve of facial nerve is measured. At the lower edge of the zygomatic arch. The width of the stride distribution area across the vertical line of supraorbital foramen was 7.8 卤2.1 mm ~ 17.2 卤3.8 mm ~ 25.1 卤3.3 mm ~ (-1), respectively. The anterior branch of the temporal branch of the facial nerve is located at the level of zygomatic arch into the orbicularis oculi muscle. During this process it often forms a complex anastomotic network with the zygomatic branch of the facial nerve and is distributed in the orbicularis oculi muscle below the lateral canthus level. Near the outer canthus level, the middle branch of the temporal branch is about 1 or 2 branches into the orbicularis oculi muscle directly or separately to control the contraction of the orbicularis oculi muscle around the outer canthus. Conclusion: by determining the distribution of frowning muscle and temporal branch of facial nerve in temporal region and the point of entry of facial nerve, the location of Botulinum toxin injection to remove wrinkle is more accurate, and it is also the frown area. In particular, minimally invasive interfacial wrinkle removal such as highly selective facial nerve amputation, crow tail rhytidectomy or all kinds of operations involving the temporal branch of the facial nerve has guiding significance, which can make the operation more accurate. And shorten the time of microsurgery and improve the efficiency of operation.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2009
【分类号】：R322

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