本文關(guān)鍵詞： 皺眉肌 面神經(jīng)顳支 神經(jīng)支配 除皺術(shù)　出處：《大連醫(yī)科大學(xué)》2009年碩士論文　論文類型：學(xué)位論文

【摘要】： 目的:通過(guò)研究和探討皺眉肌的形態(tài)分布、定位投影以及面神經(jīng)顳支的走行及對(duì)其走行所經(jīng)肌肉支配的路徑和入肌點(diǎn),從而確定面神經(jīng)顳支在顳區(qū)、眉區(qū)分布和支配范圍,為臨床開(kāi)展注射肉毒素和手術(shù)除皺或各種涉及面神經(jīng)顳支的手術(shù)提供理論依據(jù)及參考數(shù)據(jù)。 方法:對(duì)8具以10%福爾馬林溶液浸泡2至8年、年齡在30~70歲、發(fā)育正常而無(wú)畸形的成人尸體(蒙古人種)半側(cè)顏面共16側(cè)做眉區(qū)、顳區(qū)解剖分離(包括大體解剖和顯微解剖),研究和測(cè)量黃種人皺眉肌的形態(tài)分布定位以及面神經(jīng)顳支進(jìn)入皺眉肌、眼輪匝肌的路徑及其入肌點(diǎn),從而確定面神經(jīng)顳支在眉區(qū)、顳區(qū)的分布和支配范圍,并用數(shù)碼相機(jī)拍照記錄以及手繪肌肉神經(jīng)分布圖。 實(shí)驗(yàn)結(jié)果:皺眉肌的形態(tài)為兩塊斜行向上的小塊肌肉,左右各一,該肌肉起源于額骨鼻部下部的骨膜,眶上孔的內(nèi)側(cè),多為斜向外上方走行,呈扇形發(fā)散狀穿過(guò)眼輪匝肌眶部深面,肌厚度由厚到薄向淺部走行止于眉區(qū)皮膚。其體表投影在鼻根稍斜上側(cè)過(guò)皺眉肌起點(diǎn)的長(zhǎng)約36.5±4.5 mm、縱向?qū)捈s21.9±3.6 mm的矩形內(nèi)。支配皺眉肌的主要神經(jīng)為面神經(jīng)顳支吻合網(wǎng)的次級(jí)支。該次級(jí)支平均3~4支大多于皺眉肌深面中外1/2的區(qū)域內(nèi)進(jìn)入皺眉肌。測(cè)量面神經(jīng)顳支在顴弓下緣平面、耳根水平面、過(guò)眶上孔垂直線上的走行分布區(qū)域?qū)挾确謩e為7.8±2.1mm、17.2±3.8mm、25.1±3.3mm。此外,面神經(jīng)顳支的最前支在位于顴弓水平處深入眼輪匝肌,在此過(guò)程中該支常與面神經(jīng)顴支形成結(jié)構(gòu)復(fù)雜的吻合網(wǎng),分布于外眥水平線之下的眼輪匝肌;在外眥水平附近,顳支的中間支約1~2支直接或分出次級(jí)支進(jìn)入眼輪匝肌,控制外眥周圍眼輪匝肌的收縮。 實(shí)驗(yàn)結(jié)論:通過(guò)確定皺眉肌及面神經(jīng)顳支在顳區(qū)、眉區(qū)的分布范圍及入肌點(diǎn)使臨床進(jìn)行肉毒素注射除皺定位更加準(zhǔn)確,同時(shí)為眉區(qū)除皺術(shù),尤其是眉間微創(chuàng)除皺如高選擇性面神經(jīng)離斷術(shù)、魚(yú)尾紋除皺術(shù)或各種涉及面神經(jīng)顳支的手術(shù)具有指導(dǎo)意義,可使手術(shù)更加精確、并縮短顯微手術(shù)時(shí)間和提高手術(shù)效率。
[Abstract]:Objective: to determine the temporal branch of facial nerve in temporal region by studying and discussing the morphological distribution of the frowning muscle, the location projection, the route of the temporal branch of the facial nerve and the innervation of the muscle and the point of entry of the muscle through the route of the temporal branch of the facial nerve. The distribution and innervation of the eyebrow provide theoretical basis and reference data for the clinical application of botulinum toxin injection and wrinkle removal or operations involving the temporal branch of the facial nerve. Methods: eight adult cadavers (Mongol) were soaked in 10% formalin solution for 2 to 8 years, aged 30 to 70 years, and 16 sides of half face of adult cadavers (Mongol race) were used as eyebrow area. Anatomical separation of temporal region (including gross anatomy and microanatomy) study and measurement of the morphological distribution of the frowning muscles of yellow people and the route of the temporal branch of the facial nerve into the frowning muscles and the orbicularis oculi muscles. The distribution and innervation of temporal branch of facial nerve in eyebrow and temporal region were determined, and the distribution of muscle nerve was recorded and hand-drawn by digital camera. The results showed that the frowning muscle was composed of two small, oblique and upward muscles, one on the left and the other on the left. The muscle originated from the periosteum in the lower part of the frontal bone and the medial part of the supraorbital foramen. It was fan-shaped and diffused through the deep surface of orbital part of orbicularis oculi muscle, and the thickness of muscle moved from thick to thin to the superficial part of the eyebrow skin. The length of the body surface projecting to the upper side of the nasal root was about 36.5 鹵4.5 mm. Longitudinal width about 21.9 鹵3.6. The main nerve innervating the frowning muscle is the secondary branch of the temporal branch anastomosing network of facial nerve. The average of the inferior branch is 34 branches, mostly entering the frowning muscle in the area 1/2 at the deep side of the frown muscle. The temporal nerve of facial nerve is measured. At the lower edge of the zygomatic arch. The width of the stride distribution area across the vertical line of supraorbital foramen was 7.8 鹵2.1 mm ~ 17.2 鹵3.8 mm ~ 25.1 鹵3.3 mm ~ (-1), respectively. The anterior branch of the temporal branch of the facial nerve is located at the level of zygomatic arch into the orbicularis oculi muscle. During this process it often forms a complex anastomotic network with the zygomatic branch of the facial nerve and is distributed in the orbicularis oculi muscle below the lateral canthus level. Near the outer canthus level, the middle branch of the temporal branch is about 1 or 2 branches into the orbicularis oculi muscle directly or separately to control the contraction of the orbicularis oculi muscle around the outer canthus. Conclusion: by determining the distribution of frowning muscle and temporal branch of facial nerve in temporal region and the point of entry of facial nerve, the location of Botulinum toxin injection to remove wrinkle is more accurate, and it is also the frown area. In particular, minimally invasive interfacial wrinkle removal such as highly selective facial nerve amputation, crow tail rhytidectomy or all kinds of operations involving the temporal branch of the facial nerve has guiding significance, which can make the operation more accurate. And shorten the time of microsurgery and improve the efficiency of operation.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2009
【分類號(hào)】：R322

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