女性乳房深部神经的走行分布及其临床意义

Anatomical basis for the deep nerves in the female breast and its clinical signi ficance

目的:研究女性乳房深部神经的走行分布,为设计合理的乳房缩小整形术式提供解剖学基础。方法:对7具女性尸体的14个乳房标本的肋间神经分支进行解剖观测,其中3具为乳房肥大伴下垂标本。结果:第4肋间神经外侧皮支的深支恒定到达乳头乳晕,于乳房后间隙向内走行约(2.8±1.0)cm后进入乳腺,距乳晕缘(2.2±1.3)cm穿出乳腺,于皮下走行进入乳晕皮下;在下垂乳房,该神经随乳房下垂而下降。3、5肋间神经深支到达乳晕者分别为2个乳房和4个乳房。前皮支没有深支进入乳腺。结论:乳头乳晕总是恒定地接受来自第4肋间神经外侧皮支深支的神经支配,因此在乳晕周围环形切口乳房缩小整形术中,在皮下浅支均被切断的情况下,应最大限度地保留外下方腺体携带乳头乳晕转移,以保证乳头乳晕的感觉。

Objective: To investigate the course and the distribution of the deep nerve innervating the female breast and provide anatomic basis for des igning reasonable patterns of the reduction mammaplasty. Methods: The dissection of the intercostal nerves innervating the breasts was performed on the 14 breas ts of the 7 female breasts, of which 3 cadavers associated with mammary hypertro phy. Results: In 14 breasts, the deep branches of the lateral cutaneous branches of the 4th intercostal nerves run into the nipple-areola. That of the 3rd, 5th intercostal nerves approaching the nipple-areola were in 2 breasts and in 4 brea sts respectively and that of the 3rd and 5th simultaneously running into the nip ple-areola were in 4 breasts. These branches first run about 2.78±1.02 cm media lly in the retromammary space before entering into gland, and emerged from the s urface of the gland 2.23±1.31 cm from the edge of the areola, and then run towa rd the nipple-areola in the subcutaneous tissue. In the ptosic breasts, these ne rve branches descent with the drop of the breasts. The deep branches of the ante rior cutaneous branches of the intercostal nerves were not found in the breasts. Conclusions: The nipple-areola constantly accepts innervations from the deep br anches of the lateral cutaneous branches of the 4th intercostal nerve. Therefore , the lateral-inferior gland should be preserved in periareola reduction mammapl asty in which the superficial branches of the intercostal nerve are all cut out.