Scott K R, Tse D T, Kronish J W
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, School of Medicine, FL 33101.
Ophthalmology. 1992 Feb;99(2):222-6. doi: 10.1016/s0161-6420(92)31989-x.
Vertically oriented suborbicular nerve fibers are frequently encountered during upper eyelid surgery. It has not been well established whether these fibers are terminal motor branches of the facial nerve (VII) or sensory branches of the ophthalmic nerve (V-1). To investigate the origin of these nerve fibers, three different techniques were used: (1) intraoperative nerve stimulation; (2) cadaver dissection; and (3) immunohistochemical analysis. The results of all three investigative methods are in agreement and conclusively demonstrate that these fibers represent sensory branches of the ophthalmic nerve (V-1) and not motor branches of the facial nerve (VII). Anatomical dissection showed that the sensory fibers to the upper eyelid do not travel solely within the suborbicular fascial plane, but also course in the preorbicular plane and within the orbicularis muscle itself. The terminal branches of the facial nerve to the upper eyelid innervate the orbicularis oculi from the undersurface and in a horizontal orientation. Clinical correlation of these findings is discussed.
在上睑手术中经常会遇到垂直排列的眼轮匝肌下神经纤维。这些纤维是面神经（VII）的终末运动分支还是眼神经（V-1）的感觉分支，目前尚未明确。为了研究这些神经纤维的起源，采用了三种不同的技术：（1）术中神经刺激；（2）尸体解剖；（3）免疫组织化学分析。所有三种研究方法的结果一致，并确凿地表明这些纤维代表眼神经（V-1）的感觉分支，而非面神经（VII）的运动分支。解剖显示，上睑的感觉纤维并非仅在眼轮匝肌下筋膜平面内走行，还在前眼轮匝肌平面和眼轮匝肌本身内走行。面神经至上睑的终末分支从下表面以水平方向支配眼轮匝肌。本文讨论了这些发现的临床相关性。
