Mitsukawa Nobuyuki, Moriyama Hiroshi, Shiozawa Kei, Satoh Kaneshige
From the *Department of Plastic, Reconstructive and Aesthetic Surgery, Chiba University, Faculty of Medicine, Chiba; Departments of †Anatomy and ‡Plastic and Reconstructive Surgery, Showa University, Faculty of Medicine, Tokyo, Japan.
Ann Plast Surg. 2014 Jan;72(1):71-4. doi: 10.1097/SAP.0b013e318284eca0.
There have been many anatomical reports to date regarding the course of the facial nerve to the mimetic muscles. However, reports are relatively scarce on the detailed distribution of the terminal branches of the facial nerve to the mimetic muscles. In this study, we performed detailed examination of the terminal facial nerve branches to the mimetic muscles, particularly the branches terminating in the orbicularis oculi muscle and orbicularis oris muscle. Examination was performed on 25 Japanese adult autopsy cases, involving 25 hemifaces. The mean age was 87.4 years (range, 60-102 years). There were 12 men and 13 women (12 left hemifaces and 13 right hemifaces). In each case, the facial nerve was exposed through a preauricular skin incision. The main trunk of the facial nerve was dissected from the stylomastoid foramen. A microscope was used to dissect the terminal branches to the periphery and observe them. The course and distribution were examined for all terminal branches of the facial nerve. However, focus was placed on the course and distribution of the zygomatic branch, buccal branch, and mandibular branch to the orbicularis oculi muscle and orbicularis oris muscle. The temporal branch was distributed to the orbicularis oculi muscle in all cases and the marginal mandibular branch was distributed to the orbicularis oris muscle in all cases. The zygomatic branch was distributed to the orbicularis oculi muscle in all cases, but it was also distributed to the orbicularis oris muscle in 10 of 25 cases. The buccal branch was not distributed to the orbicularis oris muscle in 3 of 25 cases, and it was distributed to the orbicularis oculi muscle in 8 cases. There was no significant difference in the variations. The orbicularis oculi muscle and orbicularis oris muscle perform particularly important movements among the facial mimetic muscles. According to textbooks, the temporal branch and zygomatic branch innervate the orbicularis oculi muscle, and the buccal branch (or the buccal branch and marginal mandibular branch) innervates the orbicularis oris muscle. In this study, we performed dissection of the terminal facial nerve branches that terminate in the orbicularis oculi muscle and orbicularis oris muscle and performed detailed examination of their courses. The results revealed 5 multiple anomalies not in conventional books, and the movements of the muscles might be compensated.
迄今为止,已有许多关于面神经至表情肌走行的解剖学报告。然而,关于面神经终末支至表情肌的详细分布的报告相对较少。在本研究中,我们对面神经至表情肌的终末支,特别是止于眼轮匝肌和口轮匝肌的分支进行了详细检查。对25例日本成年尸检病例进行了检查,涉及25个半侧面部。平均年龄为87.4岁(范围60 - 102岁)。男性12例,女性13例(12个左侧半侧面部和13个右侧半侧面部)。在每例中,通过耳前皮肤切口暴露面神经。从茎乳孔解剖面神经主干。使用显微镜将终末支向周围解剖并观察。检查了面神经所有终末支的走行和分布。然而,重点关注颧支、颊支和下颌缘支至眼轮匝肌和口轮匝肌的走行和分布。颞支在所有病例中均分布至眼轮匝肌,下颌缘支在所有病例中均分布至口轮匝肌。颧支在所有病例中均分布至眼轮匝肌,但在25例中有10例也分布至口轮匝肌。颊支在25例中有3例未分布至口轮匝肌,在8例中分布至眼轮匝肌。这些变异无显著差异。眼轮匝肌和口轮匝肌在面部表情肌中执行特别重要的运动。根据教科书,颞支和颧支支配眼轮匝肌,颊支(或颊支和下颌缘支)支配口轮匝肌。在本研究中,我们解剖了止于眼轮匝肌和口轮匝肌的面神经终末支,并对其走行进行了详细检查。结果揭示了5种传统书籍中未记载的多发异常情况以及肌肉运动可能存在的代偿情况。