成年男性舌下神经在舌根部的定位研究

Study of the anatomical location of hypoglossal nerve at tongue base of male adults

目的:探讨成年男性舌根部舌下神经解剖走行特点,指导临床舌根部射频温控减容术治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)时针形电极刺入舌根部的部位及深度,以避免损伤舌下神经。方法:选择10具成年男性的舌标本,定型后在冰冻状态下作冠状切面,通过计算机图像处理与测量系统行舌下神经定位测量,并进行相关的统计学分析。结果:(1)两侧舌下神经呈对称性分布。(2)成年男性舌下神经舌内部分的主干(本实验为舌盲孔前后15mm范围内)其垂直向解剖走行基本恒定,距舌表面(22.21±2.22)mm;水平向走行中,舌盲孔后一般位于舌中内(近中线侧)(28.61±2.66)％处,舌肓孔前为(21.89±1.93)％处。结论:本实验为舌根部射频温控减容术治疗OSAHS提供了一个相对安全的范围:在不超过(22.21±2.22)mm深度且舌盲孔后避开中内(近中线侧)(28.61±2.66)％区域、舌盲孔前避开中(内近中线侧)(21.89±1.93)％区域,基本不会损伤舌下神经。

PURPOSE: This study was undertaken to analyze the anatomical location of hypoglossal nerve at tongue base of male adults to avoid creating a function deficit during radiofrequency of tongue base in OSAHS. METHODS: Ten tongues of male adults in frozen were coronally dissected at foramen cecum, 5mm,10mm,15mm before/after the foramen cecum. Vertical and horizontal distance of hypoglossal nerve to the surface and middle line of the tongue were measured using computer image procession in micrometer. The data were analyzed with such statistical methods as descriptive statistics, paired t-test-ing, linear correlation analysis. RESULTS: (1) The anatomical location of the bi-lateral hypoglossal nerve is symmetrical in principle. (2) At the tongue base: 1) The distance of hypoglossal nerve to the surface is 22.21±2.22mm ,and has no correlation to the length and the width of the tongue. 2) There are some regularities of the anatomical location of the hypoglossal nerve before/after the foramen cecum . Before the foramen cecum the hypoglossal nerve is located in the mid-medial (21.89±1.93)% and after the foramen cecum is in the mid-medial (28.61±2.66)%. CONCLUSION: We conclude that if the depth of the needle-polar penetrating into the tongue base doesn't exceed (22.21±2.22)mm , and keep away from mid-medial (21.89±1.93)% ( before the foramen cecum ) or mid-medial (28.61±2.66) % after the foramen cecum , it may be helpful to avoid creating a function deficit when radiofrequency tongue base in snoring and OSAHS is performed.