【摘要】 背景:封闭疗法可改善面肌痉挛临床特征,但穿刺点的位置、穿刺角度难以掌握,而穿刺深度不准确则严重影响疗效。目的:探讨面神经阻滞入路相关结构的解剖关系,为面神经阻滞的进针入路和减少并发症的发生提供解剖学依据。设计:以尸体为研究对象,模拟穿刺进行测量,观察性研究。单位:一所医学院解剖学教研室。对象:选择成年男性尸体28具(56侧,均为承德地区死后所捐献的尸体),对尸体进行面神经阻滞模拟穿刺,对相关指标进行测量获得了有关数据。方法:尸体仰卧,在其外耳门下、乳突前缘和下颌支后缘交汇处垂直进针,进针深度为针受阻为止;由穿刺点至下颌角作一纵行切口,向深面钝性分离找到面神经干、耳后动脉及颈静脉球在保留原位前提下,测量有关数据并进行统计学处理。主要观察指标:穿刺点位置、穿刺角度及穿刺点至面神经干的距离,面神经与穿刺针的位置关系及面神经与其主要毗邻结构间的距离关系。结果:面神经阻滞穿刺点的位置为外耳门下、乳突前缘和下颌支后缘的交汇处,垂直于正中矢状面进针,左侧深度为(19.91±0.09)m m ,右侧深度为(19.82±0.10)m m 。结论:确定了面神经阻滞准确的穿刺点、穿刺角度及深度,有利于阻滞治疗发挥确切效应。更多还原

【Abstract】 BACKGROUND:The blocking treatment can improve the clinic symptom of facial spasm.But the site,depth and the angle of puncturing point are very difficult to be defined,which will seriously infect the curative effect.OBJECTIVE:To study the applied anatomy of the related structures of facial muscle for blocking the facial nerve,and to provide anatomical bases for accurate puncturing point and preventing complications.DESIGN:An observation study based on cadavers and making the mimic puncture and measuring the correlative structures with anatomical method.SETTING:Department of anatomy in a medical college.PARTICIPANTS:Totally 28 adult male cadavers(56 sides) were used and the correlative index were measured.METHODS:The blocking point was located at the convergent point of the interior edge of cartilage of the external acoustic canal,the anterior fringe of mastoid processes and the posterior fringe of mandible ramus,the needle must be thrust vertically to the median sagittal plane.The puncturing needle stopped until it was barred.A longitudinal incision was made from the puncturing point to mandibula angle,and skin,superficial fascia were cut separately.Then carotid superficial fascia was cut from the posterior fringe of parotidean.The facial nerve trunk and the posterior auricular artery were preserved in site.A blunt isolation was made along its incision.Jugular glomus was appeared.Then the correlative index were measured and dealt with statistics method.MAIN OUTCOME MEASURES:The puncturing point,angle and depth,the distance between facial nerve trunk and puncturing point,the position relationship between facial nerve and puncturing needle and the distance relationship between facial nerve and principal structures adjacent to it.RESULTS:The blocking point was located at the convergent point of the interior edge of the external acoustic canal,the anterior fringe of mastoid processes and the posterior fringe of mandible ramus,the needle must be thrust vertically to the median sagittal plane.On the left side,the puncturing depth was(19.91± 0.09) mm,On the right side,the puncturing depth was(19.28± 0.10) mm.CONCLUSION:The experimental study could provide accurate puncturing point,angle and depth for blocking the facial nerve and bring the blocking treatment into full play.更多还原