Department of Surgery, Division of Plastic and Reconstructive Surgery, Microsurgical Research Center, Eastern Virginia Medical School, Norfolk, VA 23501, USA.
Plast Reconstr Surg. 2010 Mar;125(3):879-89. doi: 10.1097/PRS.0b013e3181ccdc78.
Facial nerve explorations and microstimulation of distal nerve branches during facial reanimation procedures by the senior author (J.K.T.) have yielded various observations. This prompted the authors to quantify the surgical findings with an anatomical study and a subsequent analysis of the electrophysiologic intraoperative data. The present report details the microanatomical observations.
Ten fresh cadaveric hemiface dissections (five specimens) were performed. The facial nerve branches were traced distally under the operating microscope and mapped with India ink. A number of nerve branches exited the parotid at approximately 9 +/- 0.85 cm from the facial nerve trunk division, and their distribution was noted. Photographic documentation was obtained.
The mean number of nerve branches was 7.70 +/- 1.05 at the anterior parotid border and 13.80 +/- 1.81 distally. Differences in the number and configuration of nerve branches existed even between the two sides of the face. The frontal branch had a mean nerve number of 2.80 +/- 0.63; the zygomatic branch, 4.40 +/- 1.34, the buccal branch, 3.20 +/- 0.78; and the marginal mandibular branch, 2.30 +/- 0.48. In 70 percent of specimens, the buccal branches originated from both upper and lower nerve divisions and interconnected with the marginal mandibular branch in 50 percent of specimens. Distally, connectivity was found between buccal branches and the infraorbital nerve, the marginal mandibular branches, and the mental nerve. A constant lower zygomatic or zygomaticobuccal branch reached the procerus and corrugator supercilii muscles. A twig from the frontal branch reached the corrugator muscle in 60 percent of cases.
Diversity of facial nerve anatomy is recognized and documented. Specific anatomical relationships are clarified and demonstrated as a guiding map.
资深作者（J.K.T.）在面部再神经化手术中对面神经进行了探查和远端神经分支的微刺激，获得了各种观察结果。这促使作者通过解剖学研究和随后对术中电生理数据的分析来量化手术发现。本报告详细介绍了微观解剖学的观察结果。
进行了 10 例新鲜尸体半面解剖（5 例标本）。在手术显微镜下追踪面神经分支并进行印度墨水标记。一些神经分支在面神经干分叉处距腮腺前缘约 9±0.85cm 处穿出，并记录其分布。获得了照片记录。
在前腮腺缘处的神经分支平均数量为 7.70±1.05 个，在远端处为 13.80±1.81 个。即使在面部两侧之间，神经分支的数量和形态也存在差异。额支的神经数量平均为 2.80±0.63；颧支为 4.40±1.34；颊支为 3.20±0.78；下颌缘支为 2.30±0.48。在 70%的标本中，颊支起源于上、下神经分支，并在 50%的标本中与下颌缘支相互连接。在远端，颊支与眶下神经、下颌缘支和颏神经之间存在连接。恒定的下颧支或颧颊支到达降眉肌和皱眉肌。额支的一个分支 60%的情况下到达皱眉肌。
认识并记录了面神经解剖的多样性。特定的解剖关系被阐明并作为指导图谱进行演示。
