Pereira José A, Merí Alex, Potau José María, Prats-Galino Alberto, Sancho Joan José, Sitges-Serra Antonio
Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain.
Arch Surg. 2004 Jul;139(7):745-7; discussion 748. doi: 10.1001/archsurg.139.7.745.
External palpable landmarks can be used to identify the facial nerve trunk quickly and safely.
Prospective anatomical dissection study.
University department of human anatomy and university hospital.
A total of 40 human cadaver heads (79 facial nerves) were dissected by 2 prosectors, a surgeon with experience in the anatomy of the parotid region (J.A.P.; n = 39) and a medical student with experience in anatomical dissection and basic knowledge of the facial nerve disposition (A.M.; n = 40). A 3-cm skin incision was made in the center of the triangle formed by the temporomandibular joint, the mastoid process, and the angle of the mandible, and dissection was continued deep until the main facial nerve trunk was identified.
The time taken from the skin incision to the identification of the nerve was monitored with a chronometer by an independent observer. The distance between the predicted and actual position of the facial nerve was measured.
In all cases, the facial nerve was identified and there were no significant differences in the dissection time between the 2 prosectors (144 vs 148 seconds). The mean distance between the predicted and the actual position of the nerve was 1.42 mm.
The proposed localization landmarks allowed a fast and safe identification of the facial nerve and may be of significant help during surgery around the parotid region.
可通过外部可触及的标志快速且安全地识别面神经干。
前瞻性解剖学研究。
大学人体解剖学系和大学医院。
由两名解剖人员对总共40个尸体头部（79条面神经）进行解剖，一名是在腮腺区解剖方面有经验的外科医生（J.A.P.；n = 39），另一名是在解剖学解剖方面有经验且对面神经分布有基础知识的医学生（A.M.；n = 40）。在由颞下颌关节、乳突和下颌角形成的三角形中心做一个3厘米的皮肤切口，然后继续深入解剖，直到识别出主要的面神经干。
由一名独立观察者用秒表监测从皮肤切口到识别神经所需的时间。测量面神经预测位置与实际位置之间的距离。
在所有病例中均识别出了面神经，两名解剖人员的解剖时间无显著差异（144秒对148秒）。神经预测位置与实际位置之间的平均距离为1.42毫米。
所提出的定位标志可实现对面神经的快速且安全的识别，并且在腮腺区周围手术期间可能有很大帮助。
