颞区解剖学特点及临床应用

Anatomic feature and clinical application of temporal region

目的；获得颞区解剖学数据、探讨颞中间隙在颞区二期植骨术的临床应用价值。方法：10％甲醛固定的成人湿性头颅标本15具（30侧），在手术显微镜下对标本颞区进行逐层解剖，观察解剖层次及神经血管结构的走行及分布。把颞浅动脉主干与颧弓上缘交点、面神经颞支最颞侧支与颧弓上缘相交点、冠状缝与颞上线交点、颧弓后根前2cm处颧弓上缘分别设为A、B、C、D点，测量A、B点与颧弓后根距离，观察CD线与面神经颞支的关系。结果：①颞区是头皮中富含筋膜和脂肪组织的区域，并有三个潜在的解剖间隙；②A点距颧弓后根0．3～0．8cm[（0．5±0．1）cm]、B点距颧弓后根2．2～3．5cm[（2．6±0．3）cm]；③面神经颞支均在CD连线前方的颞区内，75．0％行于皮下、21．4％行于颞浅间隙、3．6％行于颞中间隙。结论：①颞中脂肪层是颞中间隙重要的解剖标志；②在颧弓后根前1cm处切开皮肤，不会损伤颞浅动脉主干；③CD线后方颞区为避免面神经颞支损伤的安全操作区。

Objective To provide a detailed anatomic data of temporal region and evaluate the clinical application of intermedial temporal space in re-time bone graft operation. Methods Stepwise dissection was performed in the temporal region in 15 pre-fixed adult cadavers （30 sides） with the aid of surgical microscope, and the anatomic layers, the distribution of nerves and blood vessels in temporal region were observed. Results （I） Temporal region was rich in fascia layers, fatty tissue layers, and contained 3 latent anatomic spaces; （2） The distance between point A, B and dorsal root of ygumatic arch was 0. 3-0.85 em [ （0.5±0.1） cm], 2.2--3.5 cm [ （2.6±0.3） cm], respectively. （3） All of the temporal branches of facial nerve were located in front of line CD, 75.0% in subcutaneous tissue, 21.4% in superficial temporal space, 3.6% in intermedial temporal space. Conclusion （1） The intermediate fat layer is an important landmark of intermediate temporal space; （2） The skin flap before dorsal root of ygomatic arch 1 cm is safety to temporal artery; （3） The temporal space after the line CD is a safety operation area for the protection of temporal branch of facial nerve.