Kim Deog-Im, Nam Seong-Han, Nam Yong-Seok, Lee Kyu-Seok, Chung Rak-Hee, Han Seung-Ho
Department of Anatomy, Kwandong University College of Medicine, Gangneung, Republic of Korea.
Clin Anat. 2009 Mar;22(2):207-14. doi: 10.1002/ca.20739.
The marginal mandibular branch (MMB) has a particular risk of injury during surgical procedures in the submandibular region, especially over the lower border of the mandible. The facial nerve has been described in many studies, but the MMB is dealt with generally as a branch of the facial nerve. The purpose of this study was to document the anatomy of the MMB by correlation with anatomical landmarks. Eighty-five facial halves were examined for this study. The MMB was classified according to the number of branches and their connections with other branches, and by its relationship with landmarks of the gonion, facial artery, and retromandibular vein. The MMB showed one (28%), two (52%), three (18%), or four branches (2%) where it exited the parotid gland. Classification was based on connection with other branches. Type I (60%) did not communicate with other branches. Type II (40%) communicated with the buccal or cervical branches, or with another branch of the MMB. The cervicofacial division coursed along the lateral aspect of the retromandibular vein in 83% of specimens. The MMB passed the facial artery superficially (42%), passed it deeply in 4%, and ran on both sides of it in 54% of the facial halves. The distribution of the MMB formed a quadrilateral with angles +19.8 mm, -8.1 mm, +30.0 mm, and -15.3 mm measured from two sides on the inferior border of the mandible. These topographical data should help to decrease the incidence of injuries during surgery on the submandibular regions in Koreans.
在下颌下区手术过程中,下颌缘支(MMB)有特别的损伤风险,尤其是在靠近下颌骨下缘处。许多研究都对面神经进行了描述,但下颌缘支通常被视为面神经的一个分支来处理。本研究的目的是通过与解剖标志的关联来记录下颌缘支的解剖结构。为此研究检查了85侧面部标本。根据分支数量及其与其他分支的连接情况,以及其与下颌角、面动脉和下颌后静脉等标志的关系,对下颌缘支进行分类。下颌缘支穿出腮腺时显示为1支(28%)、2支(52%)、3支(18%)或4支(2%)。分类基于与其他分支的连接情况。I型(60%)不与其他分支相连。II型(40%)与颊支或颈支或下颌缘支的另一分支相连。在83%的标本中,颈面干沿下颌后静脉的外侧走行。下颌缘支从面动脉浅面通过的占42%,从其深面通过的占4%,在54%的面部标本中从其两侧通过。下颌缘支的分布形成一个四边形,从下颌骨下缘两侧测量的角度分别为+19.8毫米、-8.1毫米、+30.0毫米和-15.3毫米。这些地形学数据应有助于降低韩国人下颌下区手术期间的损伤发生率。