下颌支截骨术手术入路的应用解剖学研究  

Applied Anatomy on the Operative Approaches of Mandibular Osteotomy

作　　者：廖进民[1] 陈海芳[1] 李忠华[2] 王兴海[2] 钟世镇[2] 

机构地区：[1]广东医学院解剖学教研室,广东湛江524023 [2]南方医科大学解剖学教研室

出　　处：《解剖与临床》2007年第3期152-156,共5页Anatomy and Clinics

基　　金：广东省科技计划项目(编号:A302020401)

摘　　要：目的:进一步探讨咬肌区浅层的组织结构,为临床行下颌截骨术避免损伤咬肌区的重要结构提供解剖学基础。方法:18例头颈部标本,经双侧颈总动脉插管,加压注入红色乳胶或明胶墨汁,解剖观测咬肌区浅层的组织结构。结果:咬肌区浅层由浅入深的组织层次是:皮肤、皮下组织、SMAS、腮腺咬肌筋膜、咬肌、咬肌下间隙和骨膜。咬肌表面横行结构有面神经颧支、面横动脉、面神经上颊支、腮腺导管、面神经下颊支、下颌缘支和颈支,它们距离下颌角分别为(5.8±0.5)cm、(5.2±0.5)cm、(5.1±0.6)cm、(4.3±0.5)cm、(3.3±0.8)cm、(0.9±0.5)cm和(-0.8±0.4)cm;离角前切迹的距离分别为(6.7±0.6)cm、(5.6±0.6)cm、(5.6±0.7)cm、(4.7±0.5)cm、(3.5±0.7)cm、(1.2±1.0)cm和(-1.0±0.2)cm。该区的动脉供应来源于颞浅动脉、面横动脉、颈外动脉、面动脉和咬肌动脉。结论:行下颌支截骨术时,应熟悉下颌支浅层的组织层次及咬肌浅层横行结构的布局,以免造成误伤。Objective： Further to explore the tissue structures of superficial masseteric region of mandible and provide anatomic basis for avoiding damages of important structures when osteotomy of mandibular ramus was clinically performed. Methods：Red latex or carbonic black ink containing 5% gelatin was injected into the arteries of 18 adult head specimens by both common carotid artery catheterization. The tissue structures of the superficial part of mandibular ramus were observed and measured. Results： The tissue structures in superficial part of mandibular ramus, from superficial to deep layer, were as follows： skin, subcutaneous tissue, subcutaneous musculoaponeurotic system （SMAS）, parotideomasseteric fascia, masseter, spaces of submasseter and periosteum of mandible. The distances on the superficial face of masseter from zygomatic branch, transverse facial artery, superior buccal branch, parotid duct, inferior buccal branch, marginal mandibular branch and cervical branch to mandibular angle were （5.8 ±0.5 ） cm, （5.2 ± 0.5 ） cm, （ 5.1 ± 0.6 ） cm, （4.3 ± 0.5 ） cm, （3.3±0.8） cm,（0.9 ± 0.5 ） cm and （ - 0.8 ± 0.4） cm, respectively; and to the antegonial notch were （6.7 ±0.6） cm,（5.6 ±0.6） cm,（5.6 ±0.7） cm,（4.7 ±0.5） cm,（3.5 ±0.7） cm,（1.2 ±1.0） cm and （ - 1.0 ± 0.2） cm, respectively. The blood supply in the masseteric region of mandible come from the superficial temporal artery, transverse facial artery, external carotid artery, facial artery and masseteric artery. Conclusion：The tissue structures in the superficial layer of mandibular ramus and positions of the transverse structures on the superficial part of masseter should be well known when osteotomy of mandibular ramus performed in order to avoid accidental injury.

关 键 词：面神经 咬肌 截骨术 下颌骨 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学] R323[医药卫生—基础医学]