舌神经在下颌磨牙区舌下间隙的解剖学研究

Anatomical study of lingual nerves in the mandibular molar region of sublingual space

目的探讨舌神经在舌下间隙处与下颌舌骨肌线的位置关系,为口腔临床制作稳固的下颌义齿和下颌磨牙局部义齿提供形态学依据。方法 15例福尔马林固定成人头颅正中矢状面切开,观测舌神经与下颌第3、2、1磨牙的关系、舌神经与下颌舌骨肌线附着点的关系。另15例血管灌注、冰冻,每隔0.5 cm行冠状切面,拍照并观测。结果 (1)下颌磨牙区舌下间隙进行解剖后测得舌神经与左、右下颌3、2、1磨牙远中面的水平距离依次增大,45°角的距离及垂直距离也依次增大。舌神经在下颌3、2、1磨牙区与左、右下颌舌骨肌线附着点的距离也是依次增大。(2)冠状切面每隔0.5 cm,测得舌神经在下颌第3、2、1磨牙区与左、右下颌舌骨肌线附着点之间的距离也是依次增大。结论根据上述测量结果,在临床制作稳固的下颌义齿和下颌磨牙局部义齿,经下颌磨牙区手术入路磨平下颌舌骨肌线从第三磨牙到第一磨牙损伤舌神经的机会越小,因此,在操作时熟悉此处的解剖位置关系有利于防止这些结构的损伤。

Objective To explore the location relationship of lingual nerves in sublingual space and in the mylohyoid muscle line and provide morphological evidence for clinical production of oral solid full-mouth and mandibular molar denture.Methods 15 cases（30 sides） formalin-fixed adult head specimens were sawed along median sagittal plane.The left and right mandibular molar area in sublingual space were probed to observe the distance between lingual nerves and mandibular molar 3,2,1 horizontally,45-degree angle vertically and the distance between lingual nerves and mylohyoid muscle attachment points.The other 15 cases were given vascular perfusion,the heads were frozen in refrigerators and were cut at intervals of 0.5 cm in the coronal aspecst and taken photographs.The distance between the lingual nerves and mylohyoid muscle attachment points were measured.Results（1）The distance between lingual nerves and（the left and right） mandibular molar 3,2,1 increased gradually.45-degree angle distance was between（0.86±0.03）cm and（0.82±0.08）cm,the vertical distance was between（0.32±0.07）cm and（0.30±0.05）cm.The distance between lingual nerves and mylohyoid muscle line in the mandibular molar 3,2,1 also increased respectively.（2）Application of the surgical approach showed some important clinical information on the structure and anatomic data.Conclusion Based on the above measurement results,the mandibular molar surgical approach polished mylohyoid muscle line from molar 3 to molar 1,the little chance of the lingual nerves were injured for the clinical production of oral solid full-mouth and mandibular molar denture.Thus,being familiar with the relationship between the anatomical location of these structures would prevent damage during the operation.