额颞颧入路中面神经额颞支的显微解剖研究

Observation on microsurgery of frontotemporal branch of facial nerve in frontotemperal transzygamatic craniotomy

目的了解国人面神经额颞支在额颞区的显微解剖,为临床手术预防额颞支损伤提供解剖学依据。方法应用国人成人头颅标本10例(20侧),模拟额颞颧入路对面神经额颞支及额颞区进行显微外科解剖,并对其测量。结果面神经额颞支通常有1～4支,在颧弓上缘与颞浅动脉起始部距离为(0.8±0.3)cm,在颧弓表面行走于颞深筋膜浅层与结缔组织融合膜的浅层,向上行于颞区,位于颞浅筋膜和颞深筋膜浅层之间,而在眶外侧角水平以上则行走于帽状腱膜浅层。结论为防止面神经额颞支损伤,切口应在颞浅动脉后,并采用筋膜间皮瓣技术。

[Objectives] To study the microanatomy of the frontotemporal branch of the facial nerve （FTBFN） and provide the anatomic basis for clinical operation. [Methods] The mierosurgical anatomy and measurement were performed under microscope by mimicking the frontotemperal transzygamatie eraniotomy on twenty sides of ten adult formalin-fixed cadavic heads, to obtain anatomic information about FTBFN and temperal region. [Result] The FTBFN had one to four branehs in general. The FTBFN located at the point of （0.8±0.3） em anteroinferior to the frontal branch of the superficial artery. The FTBFN emerged the porotid gland lies between the temperoparital fascia and the superficial layer of the deep temperal fascia （DTF） in the temporal region, crossed above the galea over the superalateral angle of the orbital rim. [Conclusion] To avoid injuring FTBFN, the incision must behind the temperal superficial artery, and the interfaseial temperalis flap technique must be used.