腮腺手术中面神经主干定位的新方法

A novel approach for identification of the facial nerve trunk in parotidectomy

摘要:

目的试图探索定位面神经主干的新方法，指导腮腺手术中面神经的解剖与保护。方法通过冰冻尸体解剖及临床研究，测量面神经主干与下颌骨后缘及周围解剖标志点的解剖学关系。将临床病例分为实验组和对照组，分别通过不同的面神经定位方法对面神经进行解剖，比较两组之间在手术时间和出血量的差异。结果尸体解剖与临床研究测量AO距离（t=1.114,P=0.272）和α角（t=1.416,P=0.165）之间差异无统计学意义。临床研究的实验组与对照组在手术时间方面分别为（10.4±5.3）min和（23.0±6.7）min ，出血量分别为（11.0±3.5）ml和（45.5±6.4）ml；两组之间差异具有统计学意义（P=0.000）。结论本研究得到的定位面神经主干的新方法，有利于安全、快速地解剖面神经主干，对于临床手术具有重要的意义。

关键词:腮腺肿瘤|面神经主干|应用解剖|胸锁乳突肌|二腹肌

Abstract:

ObjectiveTo explore a novel approach for identification of the facial nerve trunk so as to guild the dissection and protection of the facial nerve in parotidectomy.MethodsThrough anatomical and clinical investigations, the anatomical relationships among the intersection of facial nerve trunk and the posterior margin of the mandible and surrounding anatomical points were measured. In the clinical investigation, the patients were randomly divided into experimental group and control group. The facial nerve trunk was identified with different approaches respectively in the two groups. The operation time and bleeding volume in both groups were recorded and analyzed statistically.ResultsThe differences of the data (AO distance and αangle) obtained anatomically and intraoperatively were statistically insignificant(both P>0.05). The operation time and bleeding volume of the experimental group were 10.4±5.3 min and 11.0±3.5 ml, respectively. And those of the control group were 23.0±6.7 min and 45.5±6.4 ml. Their differences between the two groups were statistically significant (P=0.000).ConclusionIn favor of safe and prompt dissection of facial nerve trunk, the novel approach we proposed is of great importance for the parotid surgery.

Key words:Parotide tumor|Facial nerve trunk|Practical anatomy|Sternocleidomastoid muscle|Digastric muscle