颊间隙的解剖学结构及其临床意义

Anatomical structure of buccal space and its clinical significance

目的为了给颊间隙疾病的诊治提供解剖学基础,探讨颊间隙的解剖边界、内容物及其与颊间隙疾病的关系。方法选用成年尸体头颈部5例,逐层解剖分离,观察颊间隙的解剖结构、内容物以及与相邻组织的关系;选用2例健康人、3例颊间隙感染和2例颊间隙肿瘤患者进行电子计算机断层扫描和磁共振成像检查,观察其解剖及疾病影像特征。结果颊间隙有较为明确的前后、内外及下界,而无明确的上界;在间隙内有面神经、面动脉、颊神经、颊动脉、面深静脉走行,也有少许淋巴结及脂肪组织分布;颊间隙内并未发现面静脉、腮腺导管;电子计算机断层扫描和磁共振成像是颊间隙病变诊断的重要方式。结论颊间隙可以认为是一个不完全封闭的相对独立空间,依据其内容物的特点可以指导颊间隙及相关疾病提供合理的治疗手段,颊间隙的影像学与解剖对比研究对颌面部疾病的诊治也具有重要意义。

Objective To provide an anatomical basis for the diagnosis and treatment of maxillofacial space diseases.Methods Five cases of head and neck of adult cadaver were selected.Based on the dissection of facial structures layer by layer,careful separation and precise identification were performed.The boundary of the buccal space,its contents,and its relationship with adjacent facial fat,facial muscles,facial nerve motor branches and fa⁃cial blood vessels were observed and determined.Two healthy subjects,three patients with buccal space infection and two patients with buccal space tumors were examined by CT and MRI.The anatomical features and disease char⁃acteristics were observed.Results The buccal space had clear anteroposterior,medial,and inferior boundaries,but no clear upper boundaries.In the space,there were buccal nerve,buccal artery,deep facial vein and fat tissue filling.At the same time,there were a few lymph nodes and lymphatic vessels,facial nerve and facial artery passing through the space.Facial vein,parotid duct and buccal fat pad were not found in the buccal space.CT and MRI are important methods for the diagnosis of lesions in the buccal space,and have certain diagnostic value for the qualita⁃tive diagnosis.Conclusion The anatomy of the buccal space and the comparative study of imaging and anatomy are of great significance for the diagnosis and treatment of maxillo facial diseases.