Chen Liangsi, Huang Xiaoming, Liang Lu, Zhang Bei, Lu Zhongming, Luo Xiaoming, Zhang Siyi
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2014 Nov;28(21):1672-5.
To provide anantomical basis for the endoscope-assisted partial superficial parotidectomy via retroauricular hairline approach (EASPRHA) and assess its feasibility and safety.
The surgical anatomy of retroauricular hairline region and parotid gland region were observed in 15 fresh human cadavers (30 halves). The EASPRHA was performed on 5 human cadavers (10 halves). After the procedure, the related vascular and neural structures were evaluated.
The retroauricular hairline region extends between superficial musculoaponeurotic system and superficial cervical fascia. On the superficial surface of the upper sternocleidomastoid lie the lesser occipital nerve, the great auricular nerve and the external jugular vein. The bifurcation of great auricular nerve is(22.85 ± 2.01) mm from the bottom of earlobe. The parotid gland region extends between parotidomassteric fascia and parotid gland parenchyma. The facial nerve emerging from the stylomastoid foramen runs across the superficial surface of base of styloid process, passes through the interspace between cartilage of external acoustic meatus and posterior belly of digastric muscle, and enters the parotid gland. The bifurcation of facial nerve trunk is (19.10 ± 3.10)mm from the mastoidale and (39.49 ± 5.78) mm from the mandibular angle. Above the posterior belly of digastric muscle, the posterior auricular artery arises from the posterior wall of the external carotid artery with its main stem running over the superficial surface of facial nerve trunk. In all endoscope-assisted operations, the partial superficial parotidectomy was successful without the need for an additional incision. No major neurovascular damage wasobserved.
A thorough knowledge of the surgical anatomy of retroauricular hairline region and parotid gland region is an essential requirement in performing the safe and feasible EASPRHA.
为耳后发际入路内镜辅助腮腺浅叶部分切除术（EASPRHA）提供解剖学依据，并评估其可行性和安全性。
在15具新鲜人体尸体（30侧）上观察耳后发际区和腮腺区的手术解剖结构。对5具人体尸体（10侧）实施EASPRHA。术后，对相关血管和神经结构进行评估。
耳后发际区位于表浅肌肉腱膜系统和颈浅筋膜之间。枕小神经、耳大神经和颈外静脉位于胸锁乳突肌上部浅面。耳大神经分叉处距耳垂根部（22.85±2.01）mm。腮腺区位于腮腺咬肌筋膜和腮腺实质之间。面神经从茎乳孔穿出后，跨过茎突基部浅面，经外耳道软骨与二腹肌后腹之间的间隙进入腮腺。面神经主干分叉处距乳突尖（19.10±3.10）mm，距下颌角（39.49±5.78）mm。在二腹肌后腹上方，耳后动脉起自颈外动脉后壁，其主干跨过面神经主干浅面。在所有内镜辅助手术中，腮腺浅叶部分切除均成功，无需额外切口。未观察到重大神经血管损伤。
全面了解耳后发际区和腮腺区的手术解剖结构是安全、可行地实施EASPRHA的必要条件。
