舌动脉和舌下神经的解剖特点及与舌根的解剖关系

Anatomic characteristics and relationship of lingual artery and hypoglossal nerve with tongue base

目的:观察舌动脉、舌下神经的走行及其与舌表面标志点的关系,以及舌动脉、舌下神经的相互关 系,为临床提供舌动脉、舌下神经的形态学资料,指导舌根手术,提高手术安全性。方法:10具(20侧)甲醛固定、 颌面部发育正常的成人尸头标本,颈总动脉灌注红色乳胶。观察:①舌动脉和舌下神经的起源、走行、分段,测量 各段长度;②舌动脉和舌下神经与各解剖标志点的距离;③舌动脉和舌下神经的解剖关系。结果:舌动脉全长为 (9.73±0.83)cm;第1、2、3、4段分别为(1.81±0.46)cm、(2.98±0.45)cm、(1.24±0.39)cm、(3.79±0.28)cm。 舌动脉主干距舌盲孔前1cm、舌盲孔、舌盲孔后1cm及舌盲孔至舌骨、舌侧缘,舌动脉距舌侧缘的距离分别为 (2.34±0.20)cm、(2.48±0.14)cm、(2.43±0.26)cm、(2.53±0.33)cm、(2.14±0.16)cm、(1.11±0.09)cm。舌 下神经距舌盲孔前1cm、舌盲孔、舌盲孔后1cm、舌骨、舌侧缘及下颌骨内侧缘的距离分别为:(2.28±0.14)cm、 (2.36±0.18)cm、(2.34±0.21)cm、(1.25±0.42)cm、(1.86±0.32)cm、(2.64±0.28)cm。舌下神经与舌动脉最 小距离、舌下神经在舌骨大角距舌动脉距离、舌下神经与舌动脉交叉点距舌骨的垂直距离分别为: (0.38±0.38)cm、(0.35±0.31)cm、(1.48±0.26)

Objective:To investigate the anatomic characteristics of lingual artery and hypoglossal nerve and relationship between lingual artery and hypoglossal nerve in tongue base,for the purpose of improving data with clinic and increasing safety in the operation of tongue base.Method:Twenty extraoral dissections of the submandibular region were performed on 10 human cadavers.The origin and distribution of lingual artery and hypoglossal nerve were observed:① The lingual artery was divided into four segments, length and adjacent organs were observed and measured;②The hypoglossal nerve length and adjacent organs were observed and measured;③The anatomic relationship of lingual artery and hypoglossal nerve was observed and measured.Result:The whole length of lingual artery was (9.73±0.83)cm.At points of foramen cecum of the tongue,1 cm prior to foramen cecum ,1cm behind foramen cecum and at adjacent part of foramen cecum to lateral tongue, hyoid, and distances between lingual artery and lateral of the tongue were separately measured. The distances were (2.34±0.20)cm,(2.48± 0.14)cm,(2.43±0.26)cm,(2.53±0.33)cm,(2.14±0.16)cm,(1.11±0.09)cm,respectively,At points of foramen cecum of the tongue,1 cm prior to foramen cecum ,1 cm behind foramen cecum and at adjacent part of hyoid, lateral tongue,and distance between hypoglossal nerve and midline of the inner mandible were separately measured.The distances were(2.28±0.14)cm,(2.36±0.16)cm,(2.34±0.21)cm,(1.25±0.42)cm,(1.86±0.32)cm,(2.64±0.28)cm,respectively.The position of the tongue base,lingual artery and hypoglossal nerve are significantly inferior and lateral, that is,2 cm inferior and (1.11±0.09)cm lateral to the foramen cecum; (2.08±0.33)cm medial to the inner mandible.Conclusion:This inferior lateral location-'V' type- allows the potential for aggression tongue base resection without neurovascular bundle compromise. To ensure the operating safety, the depth and angle of radiofrequency of the tongue base for OSAHS should be controlled.