腮腺良性肿瘤切除术中腮腺导管和面神经颊支解剖关系的观察

Dissection of parotid duct and buccal branch of the facial nerve for benign tumors of the parotid gland

目的观察研究腮腺导管与面神经颊支的解剖关系,为术中用腮腺导管作为面神经探查标记物提供解剖依据。方法在腮腺良性肿瘤切除术中观察和测量42例患者的腮腺导管和面神经颊支的解剖关系,包括深浅、成角和距离关系。结果在深浅关系上,颊支位于腮腺导管浅面占69.05%(29/42),同层面占14.29%(6/42),深面占16.67%(7/42)。从二者走形角度上,基本平行占76.19%(32/42),明显成角的占23.81%(10/42)。以出腮腺处测量距离来看,上颊支位于腮腺导管上0.2~1.0 cm,平均(0.61±0.13)cm;下颊支位于导管下0.2~1.5 cm,平均(0.77±0.27)cm。结论腮腺导管与面神经上下颊支解剖关系相对恒定,可以用于腮腺肿瘤术中寻找解剖面神经的标志物。

Objective To observe the anatomical relationship between the parotid duct and the buccal branch of facial nerve so as to provide an anatomical basis for the intraoperative use of parotid duct as a marker in facial nerve exploration.Methods The anatomic relationships between the parotid duct and the buccal branch of facial nerve, including the depth, angle and distance, were observed and measured in 42 patients undergoing benign tumor resection. Results As for the depth, the buccal branch was located in the shallow surface of the parotid duct in 29 cases(69.05%, 29/42), the same level in 6(14.29%, 6/42), and the deep surface in 7(16.67%, 7/42). In terms of angle, the parotid duct was substantially parallel with the buccal branch in 76.19%(32/42), and apparently angled in 23.81%(10/42). On the measurement of distance from point where the nerve leaves the parotid gland, the upper buccal branch was located 0.2-1.0 cm above the parotid duct with an average of(0.61 ± 0.13) cm, and the lower buccal branch was located 0.2-1.5 cm below the duct with an average of(0.77 ± 0.27) cm.Conclusion The anatomical relationship between the parotid duct and the facial nerve on the upper and lower buccal branches is relatively constant, which can be used as a marker for dissecting facial nerve in the surgery of parotid gland tumors.