【摘要】 目的列举常用的描述颞区解剖的术语,对颞区的解剖学特点进行详尽研究,并探讨颞区手术的策略,以优化颞区解剖策略,尽可能减少面神经额颞支损伤的机会。方法尸头10个(20侧),在手术显微镜下逐层解剖;在34例翼点开颅和11例经颧开颅手术中,运用特定的技术解剖颞区。结果所有经典定义的各层次在尸解中均可清晰辨认。所不同之处在于所有标本中颞深筋膜在整个颞区均可分为深浅两层,而非仅限于颞中脂肪垫存在处。事实上,在超出颞中脂肪垫以外的有些区域,尽管这两层结构变得极为薄弱,但均可用钝性剥离将其分离。在2例患者中发现颞中脂肪垫缺如。结论颞深筋膜在整个颞区均由深浅两层构成。颞中脂肪垫是临床实践中实施筋膜间解剖的重要标志,但绝非必不可少的标志,即使该脂肪垫缺如,仍可完成筋膜间解剖。更多还原

【Abstract】 Objective To list the commonly used terms to describe the anatomy of temporal region, provide a detailed review of the anatomical features, and make a new research on the intraoperative strategies in temporal region to optimize the dissection and minimize the possibility of potential injury to the frontotemporal branches of facial nerve.Methods A total of 10 cadaveric heads (20 sides) stepwise dissection was performed with the aid of surgical microscope; pterional craniotomy was performed in 34 cases and transzygomatic craniotomy performed in 11 cases, dealing with the temporal region with certain techniques.Results All the conventionally described structures in the temporal region could be clearly defined in the cadaver dissections. The discrepancy was that the deep temporal fascia was divided into superficial and deep layers all over the whole temporal regions in all the specimens, not confined only to where the intermediate fat pad sits. In fact, the two layers could easily be separated by blunt dissection beyond the fat pad in all the cadaveric specimens although they became astonishing thinner in some areas. The intermediate fat pad was found absent in two of our patients.Conclusion The deep temporal fascia consists of superficial and deep layers in the whole temporal regions, by no means confined merely to where the intermediate fat pad sits as previously described. The intermediate fat pad is an important and a useful but not the indispensable landmark in clinical practices and the interfascial dissection can still be completed even if the fat pad is absent.更多还原