面神经分支与口角平面位置关系的解剖学研究

Positional relationship between branches of the facial nerve and the plane of angulus oris： an anatomical study

目的 探讨面神经下颌缘支与下颊支间的相对安全的解剖位置,为颌后穿腮腺入路治疗成人髁突基部骨折提供参考.方法 对20例来源于郑州大学解剖教研室的成人单侧头颅尸体标本进行解剖,测量并观察口角平面（自然闭口状态下,经过口角并平行于眶耳平面的平面）在下颌支后缘附近与面神经下颌缘支和下颊支的位置关系,测量C点（口角平面与下颌支后缘的交点）与D点（口角平面与面神经下颊支最下支的交点）的距离.结果 20例标本中1例因面神经下颌缘支和下颊支均起始于下颌支后缘前方,与下颌支后缘无交叉而排除;18例口角平面在下颌支后缘处恰好位于面神经下颌缘支与下颊支之间,1例标本口角平面在下颌支后缘处位于面神经下颌缘支和下颊支之下.C点与D点的距离为（14.96±8.55）mm,95%置信区间为10.23~19.69 mm.结论 大多数情况下口角平面在下颌支后缘附近位于面神经下颌缘支与下颊支之间,沿口角平面、下颌支后缘前方约1.0 cm范围内为面神经下颌缘支与下颊支间的一个相对安全的位置.

Objective To investigate the relationship between the inferior buccal branch and mandibular marginal branch of the facial nerve in the plane of angulus oris. Methods Twenty unilateral adults cadaveric heads were dissected. In the vicinity of the posterior border of mandibular ramus, the positional relationship between mandibular marginal branch and the plane of angulus oris, the inferior buccal branch and the plane of angulus oris was recoded and analyzed. Results In 18 of the 20 samples, the plane of angulus oris was between the inferior buccal branch and mandibular marginal branch in the vicinity of the posterior border of mandibular ramus. In one sample, the plane of angulus oris was below the inferior buccal branch and mandibular marginal branch in the vicinity of the posterior border of mandibular ramus. Another sample was excluded because the starting points of the inferior buccal branch and mandibular marginal branch were in front of the posterior border of mandibular ramus. The distance from the intersection of the posterior border of mandibular ramus and the plane of angulus oris to the intersection of inferior buccal branch and the plane of angulus oris was （14.96 ± 8.55） mm. Conclusions In most cases studied, the plane of angulus oris is between the inferior buccal branch and mandibular marginal branch in the vicinity of the posterior border of mandibular ramus. Along the plane of angulus oris, within 1.0 cm anterior to the posterior border of mandibular ramus, it is a relatively safe place for surgical approach.