本文選題：腮腺 + 面神經(jīng)分支��； 參考：《遵義醫(yī)學(xué)院》2012年碩士論文

【摘要】：目的：通過(guò)對(duì)腮腺外段面神經(jīng)的分支走行及吻合進(jìn)行較全面的解剖觀察及測(cè)量,獲得面神經(jīng)各分支更詳細(xì)、準(zhǔn)確的解剖學(xué)知識(shí)。 方法：通過(guò)對(duì)20側(cè)尸體頭頸部標(biāo)本于顯微鏡下進(jìn)行分層分區(qū)解剖,并結(jié)合外科手術(shù)方法研究了面部神經(jīng)腮腺外分支的走行及分支間的吻合規(guī)律。并通過(guò)游標(biāo)卡尺及計(jì)算機(jī)對(duì)相關(guān)數(shù)據(jù)進(jìn)行測(cè)算,確定了面神經(jīng)各支的體表投影。 結(jié)果：觀測(cè)到了各神經(jīng)支的體表投影,走行層次,分支吻合以及面肌的支配情況,以及面神經(jīng)在到達(dá)支配肌肉的之前有“集中吻合”的普遍現(xiàn)象 結(jié)論：1.面神經(jīng)頸支恒為1支,其它各神經(jīng)支的數(shù)量均1支。 2.利用5個(gè)坐標(biāo)點(diǎn)(計(jì)算機(jī)計(jì)算的質(zhì)心點(diǎn)),可以方便、準(zhǔn)確標(biāo)識(shí)顴弓下區(qū)安全區(qū)界線。 3.面神經(jīng)顳支走行于顳中筋膜中,后位顳支先淺出顳中筋膜后走行至顳淺筋膜SMAS深面。以顳支的腮腺淺出點(diǎn)坐標(biāo),距外眥點(diǎn)的水平距離和距眉梢點(diǎn)的水平距離,能簡(jiǎn)便準(zhǔn)確地標(biāo)識(shí)出顳支的體表投影線和顳區(qū)安全區(qū)界線。 4.顴、頰支和下頜緣支走行于咬肌筋膜深面或中間,上位頰支可能(35%)在咬肌中份時(shí)淺出咬肌筋膜,提前到達(dá)SMAS深面。咬肌筋膜可以有效的保護(hù)顴支和下頜緣支,顴支的體表投影線與顴弓基本是平行走行的,下頜緣支為2支(30%)的情況,則大部分下頜體表面被神經(jīng)支主干及其吻合支覆蓋。 5.在各部SMAS中,均無(wú)面神經(jīng)主干走行,分支可進(jìn)入SMAS的肌性部分。 6.面神經(jīng)分支在進(jìn)入支配面肌之前,存在著集中吻合。 7.通過(guò)顯微外科技術(shù)而進(jìn)行面神經(jīng)的細(xì)致解剖,為面神經(jīng)腮腺外分支的研究提供了準(zhǔn)確、客觀的資料。
[Abstract]:Objective: to obtain more detailed and accurate anatomical knowledge of the branches of the facial nerve in the parotid gland by anatomic observation and measurement. Methods: 20 specimens of head and neck of cadavers were dissected under microscope and combined with surgical methods to study the route and anastomosis of the lateral branches of facial nerve and parotid gland. The surface projection of each branch of facial nerve was determined by Vernier caliper and computer. Results: the surface projection, walking level, branch anastomosis and facial muscle innervation of the nerve branches were observed, as well as the common phenomenon of "concentrated anastomosis" of the facial nerve before reaching the innervated muscle. Conclusion 1. The cervical branch of facial nerve was one branch, and the number of other nerve branches was 1 branch. 2. By using five coordinate points (the centroid points calculated by computer), it is convenient and accurate to identify the security zone under zygomatic arch. 3. The temporal branch of the facial nerve was located in the middle temporal fascia, and the posterior temporal branch was first shallowly out of the middle temporal fascia and then on the deep side of the superficial temporal fascia SMAS. Based on the coordinates of the superficial parotid gland of the temporal branch, the horizontal distance from the outer canthus point and the horizontal distance from the eyebrow tip point, the surface projection line of the temporal branch and the boundary of the safe area of the temporal region can be easily and accurately identified. 4. The zygomatic, buccal and mandibular marginal branches were located on the deep or middle side of the masseter fascia, and the upper buccal branch could reach the deep surface of SMAS in the middle portion of the masseter muscle. Masseter fascia can effectively protect zygomatic branch and mandibular marginal branch. The surface projection line of zygomatic branch is basically parallel to the zygomatic arch and the mandibular marginal branch is 30 branches. 5. In all SMAS, there was no facial nerve trunk, and the branches could enter the muscular part of SMAS. 6. There is a concentrated anastomosis of the facial nerve branches before entering the innervated facial muscles. 7. The detailed anatomy of the facial nerve by microsurgical technique provides accurate and objective data for the study of the extraparotid branches of the facial nerve.
【學(xué)位授予單位】：遵義醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R322

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