腮腺外面神经颊支的应用解剖研究

Applied anatomy of the extraparotid buccal branches of facial nerve

目的:观测面神经颊支出腮腺后的各级分支,为相关外科手术提供解剖学依据。方法:10例(20侧)防腐人头标本,描述面神经颊支出腮腺后的走行、定位及层次。结果:面神经颊支出腮腺后分为2～4支,均走行在SMAS筋膜下;颊Ⅰ、颊Ⅱ恒定出现,其一级分支距腮腺导管分别为(1.1±0.5)cm及(0.5±0.3)cm,且分别向前走行(1.3±0.9)cm及(1.8±0.5)cm后发出二级分支。结论:面神经颊支较为恒定,在面瘫治疗中健侧面神经颊支的二级分支可以作为受体神经,可不损伤面神经颊支主干。面神经颊支的分布及走行也可指导除皱术、扩张器植入、瘢痕切除等手术的剥离范围,不致产生并发症。

Objective To explore extraparotid buccal branches of facial nerve and provide anatomic basis for corresponding surgery. Methods The distributions, orientations and layers were observed on 20 halves of 10 embalmed cadaveric head specimens. Results The buccal branches came out of the parotid and divided into 2- 4 branches under the deep surface of SMAS. Buccal branch I and buccal branch II emerged without exception from parotid and bifurcated. The distance between the first grade of buccal branch land parotid duct is （1.1±0.5）cm. The distance between the first grade of buccal branch II and parotid duct is （0.5±0.3）cm. The secord graed of buccal branch emorgel after adrancing（1.3±0.9）cm and （1.8±0.5）cm respectively. Conclusion With high reliability, the buccal branches of facial nerve can be used as receptor nerve during the treatment of facial paralysis. In the operation of rhytidectomy, placing of expanders or scar excision, the distributions of buccal branches of facial nerve can be labeled to avoid the nerve from being injuried.