额神经末支解剖特点及其在前额除皱术中的意义

Applied anatomy of the supratrochlear nerve and the supraorbital nerve and its significance in the forehead rhytidectomy

目的 :为前额除皱术切口位置和分离平面的选择提供解剖学依据。方法 :对 1 8例成人头部标本进行大体和显微解剖研究以及组织切片观察。结果 :①眶上神经绕过眶上缘后分为深、浅二支 ,浅支位额肌深面并穿过该肌分布于额部皮肤。深支行于额肌、帽状腱膜与骨膜之间直达人字缝 ;②滑车上神经在皱眉肌外侧和穿经皱眉肌后穿过额肌到达头皮。结论 :①前额除皱术中冠状切口应尽量靠近人字缝 ,并在骨膜下剥离皮瓣 ,以避免损伤眶上神经 ;②切断皱眉肌时宜在直视下仔细操作以减少对滑车上神经的损伤。

Objective: To provide anatomic basis for the selection of cut position and apart plane in forehead rhytidectomy.Methods:18 adult cadaver head face specimens were dissected, microdissected and observed in tissue sections.Full thickness tissue in glabella from one fresh cadaver specimens were processed for histological study.Results:① After rounding the supraorbital rim, the supraorbital nerve is divided into two branches, a superficial branch and a deep branch. The superficial one pass through the deep of the frontalis muscle and then distribute in the forehead skin.The deep one run cephalad through the fromtalis muscle, the galea aponeurotica and the pericranium and then to lambdoid suture.② The supratrochlear nerve run through the lateral corrugator and then through frontalis muscle, arrive at acalp.Conclusion: ① The coronal incision should be near to the lambdoid suture and the flap should be dissected in subperiosteum to avoid damaging the supraorbital nerve. ② When amputating the corrugator, we should operate carefully under direct vision to avoid damaging superaortibal nerve.