下颌支内面骨性解剖结构的观测及分析

Observation and analysis of the internal bone anatomical structure of mandibular ramus

目的通过观测和分析下颌支内面骨性解剖结构,了解各结构间的关系和规律。方法用游标卡尺等测量210个下颌骨(420侧),检测双侧下颌角、下颌支、下颌切迹、下颌隆突、髁突颈部、下颌小舌和下颌孔的角度和间距。结果下颌支的高度为39.20-79.90 mm,平均(59.94±7.12)mm。下颌角的角度为101°-140°,平均120.63°±6.76°。下颌小舌位于下颌孔后上方、上方和前上方者分别有231侧(55.00%)、133侧(31.67%)和56侧(13.33%)。下颌孔内面最低点位于下颌支内面中点前、附近和后方者分别有332侧(79.05%)、40侧(9.52%)和48侧(11.43%)。下颌隆突最高点到下颌支前、后缘点、下颌小舌最高点、下颌孔内面最低点、下颌切迹最低点、髁突颈部点、喙突最高点和髁突最高点的距离分别为(15.40±2.31)mm(9.06-23.50 mm)、(23.13±2.22)mm(15.72-29.52 mm)、(12.75±2.95)mm(3.90-25.88 mm)、(19.46±3.26)mm(11.28-30.68 mm)、(9.84±2.12)mm(4.32-18.90 mm)、(19.52±2.39)mm(10.26-25.60 mm)、(22.23±3.21)mm(13.94-33.30 mm)和(33.00±3.20)mm(22.62-41.10 mm)。下颌小舌最高点和下颌孔内面最低点分别到下颌支前、后缘点、下颌切迹最低点、髁突颈部点的距离和下颌骨下缘平面的垂直距离为(19.18±2.64)mm(12.48-28.54 mm)、(17.48±2.27)mm(11.80-25.80 mm)、17.62±2.51mm(11.10-26.72 mm)、19.62±3.11mm(11.00-28.54 mm)、35.16±4.23mm(23.16-48.62 mm),以及19.64±2.52mm(12.40-27.16 mm)、16.02±2.99mm(9.22-27.80 mm)、24.57±3.10mm(16.62-34.60 mm)、26.31±3.56mm(11.78-35.90 mm)、25.95±3.63mm(16.52-36.40 mm)。下颌切迹最低点到下颌支前、后缘点、髁突颈部点、喙突最高点、髁突最高点的距离和下颌下缘平面的垂直距离分别为(19.28±2.30)mm(11.10-25.00 mm)、(19.45±2.15)mm(13.40-29.00 mm)、(14.24±2.29)mm(9.42-24.50 mm)、(19.69±2.63)mm(11.70-26.68 mm)、(24.39±3.14)mm(15.90-33.42 mm)和(49.11±5.25)mm(35.40-62.60 mm)。髁突最高点到喙突最高点的距离为26.00-45.50 mm,平均(35.01±3.42)mm。各骨性解剖结构间左右两侧的距离经统计分析差异无统计学意义。结论通过下颌支内面骨性解剖结构的观测与分析,明确了各结构间的关系和规律,为该部位的临床麻醉、正颌及美容等手术提供了解剖学和形态学指导。

Objective To observe and analyze the bony anatomical structure of the inner surface of the mandibular ramus,and to understand the relationships and rules between the structures.Methods A total of 210 mandibles(420 mandibular ramus)were mea-sured by vernier calipers.The distance and angle between bilateral mandibular angles,mandibular ramus,mandibular notch,mandibular protuberance,mandibular condylar neck,mandibular lingual and mandibular foramen were examined.Results The height of the mandibular ramus was(59.94±7.12)mm(39.20-79.90 mm).The angle of the mandibular angle was 120.63°±6.76°(101°-140°).There were 231 sides(55.00%),133 sides(31.67%)and 56 sides(13.33%)of the mandibular lingula located on the posterior superior,superior and anterior upper parts of the mandibular foramen,respectively.There were 332 sides(79.05%),40 sides(9.52%)and 48 sides(11.43%)with the lowest point of the mandible foramen located on the front,near and back of the middle point of the mandible ramus,respectively.The distance from the highest point of the mandibular protuberance to the anterior and posterior edge points of the mandibular ramus,the highest point of mandibular lingula,the lowest point of mandibular foramen,the lowest point of mandibular notch,the point of the neck of condyle process,the highest point of coracoid process and the highest point of condyle process were(15.40±2.31)mm(9.06-23.50 mm),(23.13±2.22)mm(15.72-29.52 mm),(12.75±2.95)mm(3.90-25.88 mm),(19.46±3.26)mm(11.28-30.68 mm),(9.84±2.12)mm(4.32-18.90 mm),(19.52±2.39)mm(10.26-25.60 mm),(22.23±3.21)mm(13.94-33.30 mm)and(33.00±3.20)mm(22.62-41.10 mm).The distance from the highest point of the mandibular lingula and the lowest point of the inner surface of the mandibular foramen to the anterior and posterior edge points of the mandibular ramus,the lowest point of the mandibular notch,the point of the neck of the condyle process,and the vertical distance from the plane of the lower edge of the mandible were(19.18±2.64)mm(12.48-28.54 mm),(17.48±2.27)mm(11.80-25.80 mm),(17.62±2.51)mm(11.10-26.72 mm),(19.62±3.11)mm(11.00-28.54 mm),(35.16±4.23)mm(23.16-48.62 mm);and(19.64±2.52)mm(12.40-27.16 mm),(16.02±2.99)mm(9.22-27.80 mm),(24.57±3.10)mm(16.62-34.60 mm),(26.31±3.56)mm(11.78-35.90 mm),(25.95±3.63)mm(16.52-36.40 mm),respectively.The distance from the lowest point of the mandibular notch to the anterior and posterior edge points of the mandibular ramus,the point of the neck of the condyle process,the highest point of the coracoid process,the highest point of the condyle process and the vertical distance to the plane of the lower edge of the mandible were(19.28±2.30)mm(11.10-25.00 mm),(19.45±2.15)mm(13.40-29.00 mm),(14.24±2.29)mm(9.42-24.50 mm),(19.69±2.63)mm(11.70-26.68 mm),(24.39±3.14)mm(15.90-33.42 mm)and(49.11±5.25)mm(35.40-62.60 mm).The distance between the highest point of the condyle process and the highest point of the coracoid process was(35.01±3.42)mm(26.00-45.50 mm).There was no statistically significant difference in the distance between the left and right sides of each bony anatomical structure.Conclusion The observation and analysis of the bony anatomical structure of the mandibular ramus clarify the relationship and rules between the structures,and provide anatomic and morphological guidance for clinical anesthesia,orthognathic and cosmetic surgery.