Colbert S, Parry David A, Hale Beverley, Davies James, Brennan P A
Department of Oral and Maxillofacial Surgery, Queen Alexandra Hospital, Portsmouth PO6 3LY, UK.
Guys Campus, GKT, London SE1 1UL, UK.
Br J Oral Maxillofac Surg. 2014 Mar;52(3):230-5. doi: 10.1016/j.bjoms.2013.12.001. Epub 2013 Dec 25.
There seems to be only individual clinical experience and some anecdotal evidence about a relation between the width of the great auricular nerve (GAN) and the size of the main trunk of the facial nerve during parotidectomy. To our knowledge no anatomical studies have been published. In this cadaveric and clinical study we measured the widest point of the GAN as it crosses the sternomastoid muscle before it divides, and the main trunk of the facial nerve before it bifurcates. Measurements were obtained from 16 patients who required formal superficial parotidectomies with identification of the facial nerve, and from 21 cadavers (16 formalin-fixed and 5 fresh frozen) where both sides were dissected. We recorded the results and the side of dissection. The mean (SD) width of the GAN and facial nerve from all the dissections was 2.75 (0.53)mm and 2.83 (0.54)mm, respectively. There was a strong correlation between the width of the nerves from both sides (left: r=0.934, p<0.001; right: r=0.940, p<0.001). The nerves did not differ significantly in size in patients or cadavers (GAN: right, p=0.873; left, p=0.486; facial nerve: right, p=0.931; left, p=0.691). We have found that the GAN accurately predicts the width of the main trunk of the facial nerve. This is particularly useful surgically as a narrow GAN can alert the surgeon to expect a small facial nerve.
关于腮腺切除术中耳大神经（GAN）的宽度与面神经主干大小之间的关系，似乎只有个人临床经验和一些传闻证据。据我们所知，尚无解剖学研究发表。在这项尸体和临床研究中，我们测量了耳大神经在穿过胸锁乳突肌且未分支之前的最宽点，以及面神经主干在分叉之前的宽度。测量数据来自16例需要进行正式浅叶腮腺切除术并识别面神经的患者，以及21具尸体（16具用福尔马林固定，5具新鲜冷冻），对其双侧进行了解剖。我们记录了结果和解剖的侧别。所有解剖中，耳大神经和面神经的平均（标准差）宽度分别为2.75（0.53）mm和2.83（0.54）mm。双侧神经宽度之间存在很强的相关性（左侧：r = 0.934，p < 0.001；右侧：r = 0.940，p < 0.001）。在患者或尸体中，神经大小无显著差异（耳大神经：右侧，p = 0.873；左侧，p = 0.486；面神经：右侧，p = 0.931；左侧，p = 0.691）。我们发现耳大神经能够准确预测面神经主干的宽度。这在手术中特别有用，因为狭窄的耳大神经可提醒外科医生预期会遇到较细的面神经。
