下颌角整形术安全平面的解剖学研究

Anatomical study of safe level in mandibular angle plasty

目的 通过对下颌角区域主要血管和下颌管走行特点的解剖观察，探讨下颌角整形术的安全平面。方法选取10例（20侧）成人头颅标本。在下颌骨各特定截面上测量下颌管后缘与下颌骨升支后缘以及下颌管下缘与下颌骨下缘的距离。各数据计算进行t检验分析。结果下颌后静脉距下颌骨升支后缘的距离为（3．00±0．56）mm，距下颌角的距离为（12．20±1．09）mm。面动脉、面静脉在下颌骨下缘水平距下颌角的距离分别为（30．06±4．25）mm、（27．55±4．02）mm。第三磨牙外缘下颌管下缘距下颌角、颏孔处距下颌骨下缘分别为（16．64±0．88）mm、（15．22±1．29）mm。结论下颌角区域血管和下颌管解剖结构关系复杂，但又有一定规律；综合以上因素确定安全平面，可提高手术的安全性。

Objective To discuss the safe level in mandibular angle plasty by observing the main blood vessels of mandibular angle region and the characteristics of mandibular canal. Methods Ten adult skull specimens were chosen in the study. Anatomical observation and measurement were carried out in the main blood vessels of mandibular angle region. The distances from posterior border of mandibular canal to posterior border of mandibular ascending branch and the distance from inferior border of mandibular canal to inferior border of mandible in each section were measured. The results were analysed by T-test. Results The distance from retromandibular vein to posterior border of mandibular ascending branch and to mandibular angle were （ 3.00 ±0.56） mm and （ 12.20 ± 1.09 ） mm respectively. The distance from facial artery, facial vein to mandibular angle were （30. 06 ±4.25） mm and （27.55 ±4.02） mm respectively. The distance from inferior border of mandibular canal at outer margin of third molar to mandibular angle and the distance from mental foramen to inferior border of mandible were （ 16.64 ±0.88） mm and （ 15.22± 1. 29） mm respectively. Conclusion The relationship between the blood vessels of mandibular angle region and the characteristics of mandibular canal is complex, but there are also some rules between them. Those factors are used to make sure the safe level, which would increase the safety of mandibular angle plasty.