颈部Ⅱ～Ⅳ区副神经和耳大神经及颈横神经临床解剖学研究  

Study on clinical anatomy of the accessory nerve,the great auricular nerve and the transverse nerve of neck in neck levelⅡ-Ⅳ

作　　者：余崇仙[1] 刘业海[1] 陶冶[1] 

机构地区：[1]安徽医科大学第一附属医院耳鼻咽喉头颈外科,安徽合肥230022

出　　处：《中国耳鼻咽喉头颈外科》2008年第6期339-342,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：安徽省卫生厅临床医学重点学科应用技术计划资助项目(05A007)

摘　　要：目的研究颈部Ⅱ～Ⅳ区副神经和颈丛耳大、颈横神经解剖标志,为颈部Ⅱ～Ⅳ区功能性颈淋巴结清扫术提供临床解剖资料。方法在42例(56侧)Ⅱ～Ⅳ区颈淋巴结清扫术中,重点观测副神经、颈丛耳大神经和颈横神经的行程、分布以及与周围毗邻结构关系。结果副神经进入胸锁乳突肌点距乳突尖的距离(4.93±0.75)cm;其穿出胸锁乳突肌后缘点均位于耳大神经出肌点上方,两者出肌点的距离(1.04±0.59)cm;副神经出肌点到锁骨中点距离(8.09±0.65)cm。颈丛耳大神经穿出胸锁乳突肌后缘后在下颌角水平分支,出肌点与分支点的距离(6.37±0.73)cm;耳大神经出肌点到锁骨中点距离(7.67±1.00)cm,耳大神经与前方颈外静脉在同一层面,大多数病例中两者几乎平行,两者距离(1.02±0.61)cm。颈横神经于耳大神经下方穿出胸锁乳突肌后缘后近水平在其浅面并于颈外静脉深面向前,其分支点变异较大,分支后呈扇形向前分布颈侧。颈部左右侧各测量数据差异无统计学意义。结论深入了解副神经和颈丛耳大神经、颈横神经临床解剖资料,功能性颈清扫时保留其功能是可行的。OBJECTIVE To study the anatomical landmarks of the accessory nerve （AN） , the great auricular nerve （GAN）and the transverse nerve of neck （TN） in neck level Ⅱ-Ⅳ and provide a reliable surgical basis for treatment of functional neck dissection in neck level Ⅱ-Ⅳ. METHODS The courses of the AN, GAN and TN were studied in 42 patients （56 sides） who underwent lateral neck dissection. Meanwhile, the correlations among the three nerves above and their surrounding structures were observed. RESULTS After emerging from the inferior border of the posterior belly of digastric muscle, the AN descends obliquely downward and backward before the transverse process along with the sternocleidomastoid branch of occipital artery to the upper part of the deep surface of the sternomastoid muscle. The distance from the mastoid process to the point where AN enters the sternocteidomastoid muscle is （4.93 ±0.75） cm. The point where AN emerges from sternocleidomastoid muscle （point A） located above the point where the GAN exits the sternocleidomastoid muscle （point B）. The distance between the cm while the distance from two points is （1.04±0.59） point A to the middle point of clavicle （point C） is （8.09±0.65） cm. The GAN leaves the cervical plexus at the posterior border of the sternocleidomastoid muscle and run anteriorly between the lateral surface of this muscle and the deep surface of platysma. It is （6.37±0.73） cm long from point B to point D where the GAN send out posterior aurem branches, auricular lobule branches and anterior auricular branches. The distance from point B to point C is （7.67± 1.00） cm. Most of GAN and external jugular vein run nearly in parallel and the distance between them is （1.02±0.61） cm. The point where the TN emerges from the posterior border of the sternocleidomastoid muscle is below point B. Then the TN which is below the external jugular vein runs almost horizontally over the surface of the sternocleidomastoid muscle to sector branches in th

关 键 词：颈淋巴结清扫术 副神经 解剖学 局部 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学] R322.85[医药卫生—基础医学]