保护性解剖面神经下颌缘支在颌下入路手术中的积极作用  

Positive effects of protectively dissecting marginal mandibular branch in submandibular operation approach

作　　者：彭布强 高振杰[1] 申露露[1] 陈献礼[1] 

机构地区：[1]河南宏力医院口腔颌面外科,新乡453400

出　　处：《河南外科学杂志》2016年第1期1-3,共3页Henan Journal of Surgery

摘　　要：目的探讨面神经下颌缘支在颌下入路手术中的显露方式,为临床预防面神经功能障碍的手术入路选择提供参考。方法选择下颌骨及颌下区疾病患者45例,其中下颌骨疾病27例,颌下区者18例。种类涵盖创伤、肿瘤、囊肿、感染等疾病。均采用保护性解剖下颌缘支的颌下入路。结果本组中仅2例结核性淋巴结炎患者发生轻度的下颌缘支功能障碍,并于3个月内恢复。结论保护性解剖面神经下颌缘支的颌下入路,可有效避免神经功能损伤,尤其适用于低位髁状突、下颌升支、下颌角及下颌体后部疾病。在单纯颌下腺切除手术中,与传统显露方式相比,优越性不明显。熟练的局部解剖基础和规范的手术操作可减少下颌缘支损伤的发生。Objective To discuss the way of exposing marginal mandibular branch in operations via submandibular approach,and to supply a safety、reliable and effective ideal method for clinical operations. Methods Totally 45 patients with mandibular（ 27 cases） or submandibular area diseases（ 18 cases） which contain traumatic、neoplastic、cystic and infectious diseases were choosed,whose operations were all carried out via submandibular approach with protectively dissecting the marginal mandibular branch. Results Only two patients with tuberculous lymphnoditis was found the marginal mandibular branch was injured during the operation and with a mild functional disorder,which finally recovered in 3 months. Conclusion Protectively dissecting the marginal mandibular branch in submandibular approach can effectively prevent facial nerve injuries,especially for operations at the subcondylar、ramus、angle and body of the mandible. However,compared with the traditional methods,the superiority is unconspicuous during the simple resection of the sunmandibular gland. Both good knowledge of topographic anatomy and standard procedure play an important role in preventing the injury of the marginal mandibular branch.

关 键 词：下入路手术 下颌骨 面神经 保护性解剖 

分 类 号：R782.05[医药卫生—口腔医学]