舌下神经-面神经直接侧端吻合的应用解剖学研究

Applied anatomy of direct side-to-end anastomosis of hypoglossal and facial nerve

目的:为舌下神经-面神经直接侧端吻合提供解剖学依据。方法:①在21例防腐固定的成人头颈部标本上,测量面神经干及其颞骨内乳突段、鼓室段长度;面神经干分叉处至舌下神经颈部的最短距离。②3例新鲜标本取舌下神经及面神经干行组织学检测,测定其神经束数目和横切面积。③2例标本摹拟术式设计。结果:舌下神经干在寰椎水平为单束形式,横切面积为(8.5±0.3)mm2;面神经干在出茎乳孔处为单束形式,横切面积为(5.1±0.2)mm2;面神经干的长度为(15.7±2.0)mm,颞骨内面神经乳突段的长度为(14.6±1.5)mm、鼓室段的长度为(9.6±1.2)mm;面神经干分叉处至舌下神经颈部的最短距离为(17.2±2.3)mm。结论:舌下神经-面神经直接侧端吻合治疗面瘫具有可行性。

Objective： To provide anatomical basis for direct side-to-end anastomosis of hypoglossal and facial nerve. Methods： ① The length of facial nerve trunk and the segment in mastoid and tympanic cavity and the most nearest distance between crotch of facial nerve trunk and hypoglossal nerve were measured on 21 adult cadavers; ② hypoglossal nerve and facial nerve were taken from 3 fresh specimens, The number of fasciculus and the cross-sectioned area of nerve were measured as well; ③The operation was imitate on 2 cadavers. Results： Both hypoglossal nerve and facial nerve trunk showed the type of single beam. The cross-sectioned area of the hypoglossal nerve was about （8.5±0.3）mm^2, whereas that of the facial nerve was （5.1 ±0.2）mm^2. The lengths of facial nerve trunk, the segment in mastoid and tympanic cavity and the most nearest distance between crotch of the facial nerve trunk and the hypoglossal nerve were （15.7±2.0）mm, （14.6±1.5）mm, （9.6±1.2）mm and （17.2±2.3）mm respectively.Conclusions： Direct side-to-end anastomosis of hypoglossal and facial nerve could be used in treating the patient with facial palsy.