Baltimore, Md.; and Toronto, Ontario, Canada From The Johns Hopkins Medical Institute; the R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine; and The Hospital for Sick Children, University of Toronto.
Plast Reconstr Surg. 2013 Feb;131(2):253-257. doi: 10.1097/PRS.0b013e3182778753.
The anatomy of the facial nerve and its branches has been well documented. The course of the extratemporal facial nerve, its anatomical planes, and the surface landmarks of the temporal division and marginal mandibular division are well known. However, the surface landmark of the middle division of the facial nerve has not been studied to date.
Eighteen hemifacial dissections in 10 fresh human cadavers were performed through a preauricular face-lift incision. An 18-gauge needle with brilliant green dye was used to mark the nerve through the skin before dissection. The exact location of the middle division branches of the facial nerve was documented in relation to the transcutaneous marking.
The middle division branches of the facial nerve were found to lie at a mean of 2.3 mm from the tattooed point, with a range of 0 to 6 mm. A nerve branch was found directly tattooed by the needle seven of 18 times, inferior to the tattoo five of 18 times, and superior to the tattoo six of 18 times.
The zygomatic/buccal motor branch that innervates the zygomaticus major muscle can be reliably found at the midway point on a line drawn from the root of the helix and the lateral commissure of the mouth. This study will help guide surgeons to the middle division of the facial nerve as it applies to facial surgery.
面神经及其分支的解剖结构已有详细记载。颞区面神经的走行、解剖平面以及颞区和下颌缘支的表面标志都已为人熟知。然而，面神经中区的表面标志尚未进行研究。
通过耳前除皱切口对 10 具新鲜人体尸体的半侧面部进行 18 次解剖。在解剖前，用 18 号针将亮绿染料注射至皮肤下，以标记神经。记录面神经中区分支与经皮标记点的关系。
面神经中区分支位于皮内标记点的平均距离为 2.3 毫米，范围为 0 至 6 毫米。有 7 次在皮内标记点直接发现神经分支，18 次中有 5 次在标记点下方，18 次中有 6 次在标记点上方。
支配颧大肌的颧颊运动支可在从耳轮根部到口角外侧的连线的中点处可靠地找到。本研究将有助于指导外科医生在面部手术中找到面神经中区。
