Balaya V, Aubin A, Rogez J-M, Douard R, Delmas V
URDIA EA 4465, université Paris Descartes, 45, rue des Saints-Pères, 75006 Paris, France; Service d'obstétrique et de chirurgie gynécologique, hôpital de la Pitié-Salpétrière, 47, boulevard de l'Hôpital, 75013 Paris, France.
Laboratoire d'anatomie, faculté de médecine, université de Nantes, 1, rue Gaston-Veil, 44035 Nantes cedex, France.
Morphologie. 2014 Mar;98(320):8-17. doi: 10.1016/j.morpho.2013.12.001. Epub 2014 Jan 23.
To describe the course of the dorsal nerve of the clitoris (DNC) to better define its anatomy in the human adult and to help surgeons to avoid iatrogenic injury during surgical procedures.
An extensive review of the current literature was done on Medline via PubMed by using the following keywords: "anatomie du clitoris", "anatomy of clitoris", "nerf dorsal du clitoris", "dorsal nerve of clitoris", "réparation clitoridienne", "transposition clitoridienne", "surgery of the clitoris", "clitoridoplasty". This review analyzed dissection, magnetic resonance imaging, 3-dimensional sectional anatomy reconstruction and immuno-histochemical studies.
The DNC comes from the pudendal nerve. He travels from under the inferior pubis ramus to the posterosuperior edge of the clitoral crus. The DNC reappears under the pubic symphysis and enters the deep component of the suspensory ligament. He runs on the dorsal face of the clitoral body at 11 and 1 o'clock. Distally, he gives many nervous ramifications, runs along the tunica and enters the glans.
The NDC might be surgically injured (i) under the pubic symphysis, at the union of the two crus of clitoris and (ii) on the dorsal surface of the clitoral body. The pathway of the DNC on the dorsal face of the clitoris permits to approach the ventral face of the clitoris without risk of iatrogenic injuries. The distance between the pubic symphysis and the DNC implies that the incision should be done just under the pubic symphysis. Distally, the dissection of the DNC next the glands appears as dangerous and impossible, considering that the DNC is too close to the glandular tissues.
描述阴蒂背神经（DNC）的走行，以便更好地明确其在成年人体内的解剖结构，并帮助外科医生在手术过程中避免医源性损伤。
通过PubMed在Medline上对当前文献进行广泛检索，使用以下关键词：“anatomie du clitoris”（阴蒂解剖）、“anatomy of clitoris”（阴蒂解剖学）、“nerf dorsal du clitoris”（阴蒂背神经）、“dorsal nerve of clitoris”（阴蒂背神经）、“réparation clitoridienne”（阴蒂修复）、“transposition clitoridienne”（阴蒂移位）、“surgery of the clitoris”（阴蒂手术）、“clitoridoplasty”（阴蒂成形术）。该检索分析了解剖、磁共振成像、三维断层解剖重建和免疫组织化学研究。
阴蒂背神经源自阴部神经。它从耻骨下支下方走行至阴蒂脚的后上缘。阴蒂背神经在耻骨联合下方再次出现并进入悬韧带的深层部分。它在阴蒂体的背侧11点和1点位置走行。在远端，它发出许多神经分支，沿白膜走行并进入阴蒂头。
阴蒂背神经可能在手术中受到损伤：（i）在耻骨联合下方，阴蒂两脚结合处；（ii）在阴蒂体的背侧表面。阴蒂背神经在阴蒂背侧的走行路径使得在不发生医源性损伤风险的情况下接近阴蒂腹侧成为可能。耻骨联合与阴蒂背神经之间的距离意味着切口应在耻骨联合正下方进行。在远端，考虑到阴蒂背神经与腺体组织过于接近，在阴蒂头附近解剖阴蒂背神经似乎既危险又不可行。
