【摘要】 目的通过体表标志区对面神经颞支走行进行平面区域定位与穿行层次分析,为相关手术预防颞支损伤提供解剖学标记范围。方法对12具经福尔马林防腐处理后成人尸头标本进行大体和显微解剖,观测并记录跨经耳屏水平线、耳屏点-外眦连线、耳上基点-眉外端连线的面神经颞支数和位置,记录穿行于颞浅筋膜上脂肪垫、筋膜间脂肪层、颞肌深筋膜下脂肪层的颞支支数。保存拍摄的数码照片并进行图片分析。结果颞支在三条标志线上的分支数及最后支至最前支的位置分别为:跨经耳屏水平线(2.6±0.7)支,耳屏前(21.46±2.34)～(30.18±5.88)mm;跨经耳屏点-外眦连线(6.5±2.2)支,耳屏点前(24.26±5.64)～(37.98±8.90)mm;跨经耳上基点-眉外端连线(5.3±1.5)支,耳上基点前(35.68±10.46)mm。面神经颞支在筋膜间脂肪垫层有相当数量的穿行支(16/62支)。结论面神经颞支的颞部行程可通过体表标志线进行平面区域定位,并可针对手术解剖划分为“危险区”和“相对危险区”。翼点手术行颞肌筋膜下分离可最大程度地防止面神经颞支的损伤。更多还原

【Abstract】 Objectives To locate the run of the frontotempral branch (FB) of facial nerve in the temporal region and its distribution in the different strata, and to provide an anatomical basis for avoiding injury of FB in the relative surgery. Methods Twelve adult corpse heads fixed by formalin were used. The number and the site of FB running in the regions into which the frontotempral area of face was divided by three specified lines were observed. The number of FB running in three different fat layers was recorded. The obtained data including the digital photoes were analyzed. Results There were (2.6±0.7) rami of FB intersecting the horizontal line through the tragus apex, and they were from (21.46±2.34) to (30.18±5.88)mm distance of the tragus. There were (6.5±2.2) rami of FB intersecting the line connecting the tragion with the outer canthus and they were from (24.26±5.64)mm to (38.98±8.9)mm distance of the tragion. There were (5.3±1.5) rami of FB intersecting the line connecting the otobasion superius with the brow end and they were (35.68±10.46) mm distance of the otobasion superius. There were a few of FB rami (16/62) running in the infra-fascia fat pad. Conclusion The run of FB in the temporal region can be traced in a plane, and a "risk zone" and a "relative risk zone" with regard to surgical dissection were defined. The technique of severing under the temporal muscle fascia through the pterional approach can sufficiently prevent injury of FB.更多还原