下颌下淋巴结的解剖学研究

Anatomic study of submandibular lymphatic nodes

目的 :研究下颌下淋巴结的分布状况 ,为临床颈淋巴结清扫术提供解剖学依据。方法 :对 57侧成人头颈部标本进行观测分析 ,并对 6侧新生儿下颌下腺进行序列切片 ,组织学检查。结果 :成人及新生儿标本中均未见腺内淋巴结。下颌下淋巴结数目多为 3个 ,其中腺上、腺前、腺后和腺深群淋巴结数目分别占标本淋巴结总数的 59.4 %、2 4 .2 %、1 5 .2 %、1 .2 % ;从分布区域看 ,腺上群淋巴结出现率最高(1 0 0 % ) ,其次依次为腺前群 (61 .4 % )、腺后群 (38.6 % )和腺深群 (3 .5 % )。结论 :对下颌下淋巴结进行分群研究 ,为临床颈淋巴结清扫术提供了解剖学依据 ,并对此术式是否一定要摘除下颌下腺提出了建议。由于腺内淋巴结存在的机率极小 ,在较早期的口腔癌行选择性颈淋巴结清扫术时 ,可考虑保留下颌下腺及其功能 。

Objective: To study submandibular lymphatic nodes for radical neck dissection. Methods: Fifty seven cases of submandibular lymphatic nodes in adult cadaveric specimens were dissected and measured. Submandibular glands in 6 newborn specimens were continuously sectioned and observed histologically. Results: No submandibular lymphatic node was found in both adult and newborn submandibular gland specimens. The number of submandibular lymphatic nodes was three in most cases. Among them the superglandular, preglandular, retroglandular and deep glandular groups accounted for 59.4%, 24.2%, 15.2% and 1.2% respectively. The superglandular group was found in all cases while the emergence rate of the preglandular, retroglandular and deep glandular group were 61.4%, 38.6% and 3.5% respectively. Conclusions: The distribution references of submandibular lymphatic nodes can provide anatomical basis for radical neck dissection. The author suggests that in early stage of oral cancer it is not always necessary to remove submandibular gland in selective neck dissection, but it is important to remove all the lymphatic nodes around submandibular gland.