Apinhasmit Wandee, Chompoopong Supin, Jansisyanont Pornchai, Supachutikul Kwan, Rattanathamsakul Natthapon, Ruangves Suthacha, Sangvichien Sanjai
Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330 Thailand.
Surg Radiol Anat. 2011 May;33(4):337-43. doi: 10.1007/s00276-010-0700-y. Epub 2010 Jul 16.
This study aims to investigate positions of the antilingula (AL), the midwaist of the mandibular ramus (MW) and the midpoint between the coronoid process and the gonion (MCG) in relation to the lingula of dried mandibles. Bilateral rami of 92 Thai dried mandibles were studied. The AL, the MW, the MCG and the corresponding position of the tip of lingula (L) were marked on the external aspect of the mandibular ramus. The distances from the AL, the MW and the MCG to the L were measured in the anterior-posterior and the superior-inferior planes using computerized image analysis. The results showed the AL was discernible in 80.4% of lateral mandibular rami studied. The most of the AL was found anterior-superior to the L with a maximum distance of 5.9 mm anteriorly and 8.2 mm superiorly. The MW was frequently located anterior-inferior to the L with a maximum distance of 9.3 mm anteriorly and 9.9 mm inferiorly. The majority of the MCG was found anterior-superior to the L with a maximum distance of 9.6 mm anteriorly and 8.9 mm superiorly. A 5 mm radius from the L included 84.5% of the AL, 81.5% of the MW and 79.4% of the MCG. Medians (interquartiles) of distances from the AL, the MW and the MCG to the L were 3.4 (2.3-5.0) mm, 3.8 (2.5-5.3) mm and 4.1 (2.8-5.3) mm, respectively. In conclusion, the AL was identified in 80.4% of lateral mandibular rami studied. The AL and the MCG were commonly found anterior-superior to the lingula, whereas the MW was mostly observed anterior-inferior to the lingula. Therefore, a cut made more than a 5 mm posterior or superior to these landmarks would be in 79% of cases, within a statistically safe area avoiding encroaching upon the inferior alveolar neurovascular bundle passing immediately lateral to the lingula. Although the MW and the MCG might be alternative surgical guides when the AL is absent, their use alone as surgical landmarks is not recommended.
本研究旨在调查下颌小舌（AL）、下颌支中腰部（MW）以及冠突与下颌角中点（MCG）相对于干燥下颌骨舌骨的位置关系。对92例泰国干燥下颌骨的双侧下颌支进行了研究。在每个下颌支的外侧标记出AL、MW、MCG以及舌骨尖端（L）的相应位置。利用计算机图像分析技术，在前后平面和上下平面测量从AL、MW和MCG到L的距离。结果显示，在所研究的下颌支外侧中，80.4%可辨认出AL。大多数AL位于L的前上方，向前最大距离为5.9 mm，向上最大距离为8.2 mm。MW常位于L的前下方，向前最大距离为9.3 mm，向下最大距离为9.9 mm。大多数MCG位于L的前上方，向前最大距离为9.6 mm，向上最大距离为8.9 mm。以L为圆心、半径5 mm的范围内包含了84.5%的AL、81.5%的MW和79.4%的MCG。从AL、MW和MCG到L的距离中位数（四分位间距）分别为3.4（2.3 - 5.0）mm、3.8（2.5 - 5.3）mm和4.1（2.8 - 5.3）mm。总之，在所研究的下颌支外侧中，80.4%可辨认出AL。AL和MCG通常位于舌骨的前上方，而MW大多位于舌骨的前下方。因此，在这些标志点后方或上方超过5 mm处进行切口，在79%的情况下，将处于统计学上安全的区域，可避免侵犯紧邻舌骨外侧走行的下牙槽神经血管束。虽然当AL不存在时，MW和MCG可能是替代的手术导向，但不建议单独将它们用作手术标志。
