颞下窝解剖学结构及毗邻关系

The anatomic structures and adjacent relations of infratemporal fossa

目的探讨颞下窝的解剖结构及毗邻关系,为颞下窝入路提供相关的解剖学依据。方法通过对15例成人头部标本的测量,确定耳屏前缘中点、颧弓点至颞下窝内各结构的距离和夹角。结果耳屏前缘中点至面神经各分支的连线长度及各连线与水平面成角分别为:颞支的上支(19.25±3.90)mm、(45.4°±12.5°);颞支的中支(20.31±4.41)mm、(35.9°±10.5°);颞支的下支(22.89±4.41)mm、(29.2°±10.5°);颧支的上支(27.66±4.55)mm、(26.9°±9.6°);颧支的中支(25.10±5.57)mm、(30.0°±8.2°);颧支的下支(30.43±6.37)mm、(21.0°±9.6°);颊支的上支(29.36±7.66)mm、(31.5°±14.1°);颊支的中支(39.74±0.96)mm、(50.0°±10.0°);颊支的下支(36.05±4.78)mm、(39.9°±16.8°)。耳屏前缘中点至腮腺导管的出腮腺部位的连线长度及连线与水平面成角分别为(34.62±9.33)mm、(32.9°±12.1°)。颧弓点距眶下裂外侧缘外端点37.95mm、距卵圆孔外端点46.47mm、距棘孔外端点42.11mm、距上颌动脉起始点41.84mm、距脑膜中动脉起始点36.51mm、距下颌神经起始点43.15mm、距舌神经和下牙槽神经分叉点46.42mm。结论颞下窝相关解剖结构数据的测量,有助于设计手术入路,并可为术中准确定位有关结构提供参考依据,减少术后并发症的产生。

Objective To investigate the anatomic structure of infratemporal approach and its adjacent relation,providing anatomic evidences for the management of the critical structures in the operation of infratemporal fossa.Methods The length of lines linking the midpoint of antilobium anterior border,zygion to the structures in infratemporal fossa and the angles between these lines and median vector were measured on the 15 craniums. Results The distances and the angles from the midpoint of antilobium anterior border to nervous ramification of facial nerve： rami temporales,rami zygomatici,ramus buccalis,thyroid gland drive pipe thyroid gland spot were （19.25±3.90） mm and （45.4°±12.5°）,（20.31±4.41） mm and （35.9°±10.5°）,（22.89±4.41） mm and （29.2°±10.5°）,（27.66±4.55） mm and （26.9°±9.6°）,（25.10±5.57） mm and （30.0°±8.2°）,（30.43±6.37） mm and （21.0°±9.6°）,（29.36±7.66） mm and （31.5°±14.1°）,（39.74±0.96） mm and （50.0°±10.0°）,（36.05±4.78） mm and （39.9°±16.8°）,（34.62±9.33） mm and （32.9°±12.1°）. The distances from zygion to the outer end of inferior orbital fissure was 37.95 mm,to oval foramen 46.47 mm,to spinous foramen 42.11 mm,to arteria maxillaries 41.84 mm,to middle meningeal artery 36.51 mm ,to the initial point of mandibular nerve 43.15 mm,to branch points of lingual nerves and inferior alveolar nerves 46.42 mm. Conclusion This measurements could be benefit to the design of surgical treatment and provide some useful references for defining the position of important structures in operations and decrease complication.