耳大神经的分支及其临床应用解剖  

Branches of great auricular nerve and its applied amatomy

作　　者：安高[1] 洪丽[1] 

机构地区：[1]南华大学解剖学教研室,衡阳421001

出　　处：《解剖学杂志》2012年第5期632-634,共3页Chinese Journal of Anatomy

基　　金：湖南省教育厅资助课题（06c707）

摘　　要：目的：为腮腺区手术能够有效地保护耳大神经的主干及分支提供解剖学基础。方法：取常规固定头部标本20侧，取1张厚度为0．5mm的透明塑料膜，用圆规在塑料薄膜上建立直角坐标系，其最小刻度为0．2cm，将带有刻度的软塑料薄膜铺于标本的面侧区，坐标原点正对下颌角后下方的最凸点，Y轴垂直于该连线（颧弓向外的最凸点与外眦之间线段的延长线）。用油画笔将耳大神经比较完整地描点到薄膜上。最后将薄膜平铺于玻璃上，测量得出坐标参数指标。结果：耳大神经常见的分支为腮腺支、耳前支、耳垂支、耳后支，其出现率分别为25％、50％、95％、85％，耳大神经主干的体表投影为胸锁乳突肌后缘中点与耳垂根部的连线。结论：外科医生熟练掌握耳大神经的位置、走行、层次、分支和分布，在行切除腮腺肿瘤、解剖面神经等步骤时可避免损伤耳大神经主干及分支。Objective： To provide the anatomical basis for the surgery in parotidectomy region, and establish a simple and fea- sible 2D coordinate system. It can help to protect the great auricular nerve, and raise the accuracy rate of the operation. Methods： On a page of transparent plastic film with a thickness of 0. 5 mm, 20 side routine fixed head specimens were used to construct a rectangular coordinate system with compass needles. The scale division value of the rectangular coordinate system was 0. 2 cm. Then, we put the soft plastic film on the face lateral area, and delimited the zero of the rectangular co- ordinate system on the plastic film exactly to the most prominent dot of the angle of mandible. Y axis was perpendicular to the line that was between the most prominent dot on lateral-posterior direction on zygornatic arch and the lateral dot of the outer canthus. We traced these dots of the great auricular nerve and the branch of the nerve Results： The branches of the great auricular nerve were parotid branch, anterior auricular branch, earlobe branch and posterior auricular branch. Their emergence rates were 25% and 50% and 95% and 85% respectively. The surface projection line of the great auricular nerve trunk was between the mid- point of the sternocleidomastoid muscle posterior border and earlobe root. Conclusion： Accurate knowledge of anatomical location, course, branches and distribution of the great auricular nerve is helpful in surgeries of parotid tumor and facial nerve.

关 键 词：耳大神经 坐标定位 腮腺 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学]