颧面部缩小术中耳颞部辅助切口设计的应用解剖学  

Applied anatomy of auriculotemporal incision in zygomatic reduction surgery

作　　者：单磊[1] 柳大烈[1] 李玉[1] 陈兵[1] 詹朝双[2] 

机构地区：[1]南方医科大学珠江医院整形科,广州510282 [2]南京大学医学院解剖学教研室,南京210093

出　　处：《中国临床解剖学杂志》2007年第1期17-19,共3页Chinese Journal of Clinical Anatomy

基　　金：广东省医学科研基金资助(A2006406)

摘　　要：目的:研究颞浅动脉额支、面神经额支的行程和颞下颌关节的位置,探讨三者的解剖学关系,为颧面部缩小手术中设计耳颞部辅助切口提供解剖学依据。方法:对14例防腐成人尸体(28侧)和2例新鲜成人尸体(4侧)头部标本进行解剖,建立坐标系观察并测量颞浅动脉额支、面神经颞支的走向和颞下颌关节位置,并分析三者关系。结果:①在耳屏点X轴和眉外端B作X轴平行线之间,颞浅动脉额支总走行在面神经额支后上方,面神经额支走向角度与颞浅动脉额支基本一致。在耳屏点与眉外端上方30m m处(TE)连线的区域以下为面神经额支分布区域,在该连线的垂直方向上可获得面神经额支最上支与颞浅动脉之间最远距离为(22.32±9.16)m m,分布范围在耳上基点前(32.68±7.53)m m;②颞下颌关节盘前缘距关节结节止点距离为(3.40±0.75)m m,在耳屏点前(18.60±3.60)m m。结论:在TE连线后上方,无血管搏动的发际内作平行TE连线的切口,可有效避免神经血管损伤;在关节结节止点前至少5 m m的距离外(约耳屏前25 m m处)截骨,避免进入颞下颌关节腔内损伤关节盘。Objective： To investigate the anatomic characteristics and relationships of the frontal branches of the superficial temporal artery and facial nerve, temporal mandibular joint and discuss their clinical significances, Methods： The distribution of frontal branches of the superficial temporal artery and facial nerve, the location of temporal mandibular joint were observed on 32 sides of seventeen cadaveric specimens （15 antiseptic specimens and two fresh cadavers）, Results： In the area between horizontal lines of ectoconchion and tragion, the frontal branches of facial nerve always run anteroinferiorly to the frontal branches of superficial temporal artery with the farthest distance in the vertical direction of TE line about （22.32±9.16）mm. The area distributed about （32.68±7.53）mm anterior to Obs point. E point located 30mm above ectoconchion. The anterior border of temporomandibular joint disc located （3.40 ±0.75）mm posterior to zygomatic articular tubercle insertion and （18.60±3.60）mm anterior to tragion. Conclusions： The temporal incision parallelling posterosuperiorly to TE line could avoid the damage for related nerve and artery. The osteotomy point of zygomatic arch locating 25mm anterior to tragion could avoid the injury for articular disc.

关 键 词：颞浅动脉额支 面神经额支 颞下颌关节 应用解剖 

分 类 号：R622[医药卫生—整形外科]