CAJ | 학술논문

目的：进一步探讨从口内入路咬肌神经的解剖方式和毗邻关系特点,为临床行咬肌神经切断手术提供解剖学基础。方法将甲醛固定12个月以上的12具成年尸头标本,从标本中部矢状劈开,共23侧,去除头面部皮肤及皮下组织,显露咬肌,将咬肌下端止点自下颌骨剥离,在颧骨的咬肌前缘和后缘锯断颧骨,将咬肌瓣向后上翻转,显露咬肌间隙,精细分离咬肌神经干进入咬肌处和在肌肉内的走行,测量相应数据,并进行统计学分析。结果咬肌神经在咬肌内侧,自颞肌腱后缘进入咬肌间隙后,在咬肌筋膜下走行,逐渐进入肌肉深层,走行约(8.86±3.07)mm 后,多数分为前后2支主干,并与咬肌血管伴行。咬肌神经自颞肌腱后缘穿出点到神经分叉点距离为：左侧(9.84±2.88)mm,右侧(7.88±3.08)mm；咬肌神经自颞肌腱后缘绕出点到咬肌颧骨附着点前缘距离为：左侧(56.14±3.33)mm,右侧(56.23±4.35)mm；咬肌神经自颞肌腱后缘绕出点到下颌切迹最低点距离为：左侧(12.70±2.51)mm,右侧(11.30±3.31)mm；咬肌神经绕出颞肌腱点距下颌支前缘凹陷处距离为：左侧(38.09±5.00)mm,右侧(36.48±5.32)mm。进行统计学分析,比较左侧和右侧咬肌神经与各解剖点的距离,其差异无统计学意义。结论咬肌神经走行较稳定,周围有典型的解剖标记,口内入路显露咬肌神经可行,可以设计口内入路咬肌神经切断手术。
목적：진일보탐토종구내입로교기신경적해부방식화비린관계특점,위림상행교기신경절단수술제공해부학기출。방법장갑철고정12개월이상적12구성년시두표본,종표본중부시상벽개,공23측,거제두면부피부급피하조직,현로교기,장교기하단지점자하합골박리,재권골적교기전연화후연거단권골,장교기판향후상번전,현로교기간극,정세분리교기신경간진입교기처화재기육내적주행,측량상응수거,병진행통계학분석。결과교기신경재교기내측,자섭기건후연진입교기간극후,재교기근막하주행,축점진입기육심층,주행약(8.86±3.07)mm 후,다수분위전후2지주간,병여교기혈관반행。교기신경자섭기건후연천출점도신경분차점거리위：좌측(9.84±2.88)mm,우측(7.88±3.08)mm；교기신경자섭기건후연요출점도교기권골부착점전연거리위：좌측(56.14±3.33)mm,우측(56.23±4.35)mm；교기신경자섭기건후연요출점도하합절적최저점거리위：좌측(12.70±2.51)mm,우측(11.30±3.31)mm；교기신경요출섭기건점거하합지전연요함처거리위：좌측(38.09±5.00)mm,우측(36.48±5.32)mm。진행통계학분석,비교좌측화우측교기신경여각해부점적거리,기차이무통계학의의。결론교기신경주행교은정,주위유전형적해부표기,구내입로현로교기신경가행,가이설계구내입로교기신경절단수술。
Objective To further explore the intraoral anatomy of masseter nerve and adjacent tissues, providing anatomical basis for masseter nerve amputation in masseter hypertrophy therapy.Methods:12 adult cadaver specimens was fixed in formalin for over a year.The specimens were sagittal split from the middle. 23 sides was got and removed the skin and subcutaneous tissue on the head and face.Masseter muscle was exposed.Masseter bottom was peeled from the mandible.Methods Malar bone was sawed off at the leading and trailing edges of masseter muscle.Masseter space was exposed by flipping masseter disc backwards.The position where masseter nerve trunk gets into the masseter muscle was finely separated.The shape of masseter nerve trunk in the masseter muscle was carefully separated.The measurement data was sta-tistically analyzed.Results Masseter nerve was on the inside of the masseter muscle,getting into the masseter space from the trailing edge of temporal tendon,going through the masseteric fascia,gradually deep into the muscle.About (8.86 ± 3.07)mm going through the masseteric fascia,two masseter nerve branches was formed,paralleling with the masseter blood vessels.The distance between the trailing edge of temporal tendon and the masseter nerve branching point was left side (9.84±2.88)mm,right side (7.88 ±3.08)mm. The distance between the trailing edge of temporal tendon and leading edge of masseter zygomatic attach-ment point was left side (56.14±3.33)mm,right side (56.23±4.35)mm.The distance between the trailing edge of temporal tendon and the mandibular notch was:left side (12.70±2.5 1)mm,right side (1 1.30±3.31)mm.The distance between the trailing edge of temporal tendon and the mandibular ra-mus front cavity was:left side (38.09±5.00)mm,right side (36.48±5.32)mm.Left and right facial masseteric nerve comparision of distances between masseter nerve and respective anatomical point was not significantly different.Conclusion The shape of masseter nerve is stable,surrounded by typical ana-tomical landmarks.Thus the intraoral approach to expose masseter nerve is feasible,that can be de-signed for masseter nerve amputation in masseter hypertrophy.