摘要
目的明确面神额支在颧弓及颢部的软组织走行层次和分布。方法对9具尸头(18侧)颜面行大体解剖观察。结果面神经额支的分支数目为3～7支,平均5支,无恒定的行径及体表投影。将颧弓均分成三段,统计跨过各段表面的额支分支数,发现额支并非仅限于颧弓的中后段,而是近全颧弓均有额支分支跨过,其分布密度以中1/3段最高,占总数的44.44%(40/90);前1/3段次之,占38.89%(35/90);后1/3段又次之,占16.67%(15/90)。额支分布于颧弓和颞部的浅筋膜层(即 SMAS)的深面,其前段表面分支支配下外侧的眼轮匝肌,中段表面分支支配外侧的眼轮匝肌及少部分额肌,后段表面分支支配额肌和耳前肌。结论行骨膜下剥离面部上提术时,为减少面神经额支的损伤,应注意辨认颞部和颧弓部位的软组织层次,并非靠限制颧弓部位的解剖范围。
Objective To further understand the distribution and course of the frontal branch of the facial nerve in the temporal and zygomatic areas.Methods Facial dissection was performed on 9 ca- daver heads(18 sides).Results It was found that the frontal of the facial nerve had 3 to 7 divisions(aver- age 5)instead of one.The divisions of the frontal branch showed no constant course and distributed nearly all over the zygomatic arch.We divided the zygomatic arch into 3 equal parts and found that the middle third had the highest density of the branch distribution,accounting for 44.44% of the total divisions;the anterior third and the lateral third possessed 38.89% and 16.66% of the total divisions respectively. These divisions entered deeply into the temporoparietal fascia(the superficial temporal fascia).The divi- sions in the anterior third of the zygomatic arch innervate the lower and lateral orbicularis oculi muscle; the divisions in the middle third innervate the lateral orbicularis oculi muscle and the frontal muscle;the divisions in the lateral third innervate the frontal muscle and the anterior auricularis.Conclusion We rec- ommend discriminating the layers of the soft tissue over the zygomatic arch,not limiting the dissection range of the zygomatic arch to avoid damaging the nerve divisions while doing subperiosteal dissection of the zygomatic arch in facelifting.
