Yang Hun-Mu, Won Sung-Yoon, Kim Hee-Jin, Hu Kyung-Seok
Department of Anatomy, Dankook University College of Medicine, Cheonan, South Korea.
Department of Occupational Therapy, Semyung University, Jecheon, South Korea.
Surg Radiol Anat. 2015 Nov;37(9):1109-18. doi: 10.1007/s00276-015-1482-z. Epub 2015 May 9.
Various surgical interventions including esthetic surgery, salivary gland excision, and open reduction of fracture have been performed in the area around the mandibular angle and condyle. This study aimed to comprehensively review the anatomy of the neurovascular structures on the angle and condyle with recent anatomic and clinical research.
We provide detailed information about the branching and distributing patterns of the neurovascular structures at the mandibular angle and condyle, with reported data of measurements and proportions from previous anatomical and clinical research. Our report should serve to help practitioners gain a better understanding of the area in order or reduce potential complications during local procedures. Reckless manipulation during mandibular angle reduction could mutilate arterial branches, not only from the facial artery, but also from the external carotid artery. The transverse facial artery and superficial temporal artery could be damaged during approach and incision in the condylar area. The marginal mandibular branch of the facial nerve can be easily damaged during submandibular gland excision or facial rejuvenation treatment. The main trunk of the facial nerve and its upper and lower distinct divisions have been damaged during parotidectomy, rhytidectomy, and open reductions of condylar fractures.
By revisiting the information in the present study, surgeons will be able to more accurately prevent procedure-related complications, such as iatrogenic vascular accidents on the mandibular angle and condyle, complete and partial facial palsy, gustatory sweating (Frey syndrome), and traumatic neuroma after parotidectomy.
包括美容手术、唾液腺切除和骨折切开复位在内的各种外科手术已在下颌角和髁突周围区域进行。本研究旨在结合近期的解剖学和临床研究，全面回顾下颌角和髁突神经血管结构的解剖情况。
我们提供了下颌角和髁突神经血管结构分支和分布模式的详细信息，并引用了先前解剖学和临床研究报告的测量数据和比例。我们的报告应有助于从业者更好地了解该区域，从而减少局部手术期间的潜在并发症。下颌角复位过程中的鲁莽操作可能会损伤动脉分支，不仅是来自面动脉的分支，还有来自颈外动脉的分支。在髁突区域的入路和切口过程中，颞浅动脉和面横动脉可能会受损。面神经下颌缘支在颌下腺切除或面部年轻化治疗过程中很容易受损。在腮腺切除术、除皱术和髁突骨折切开复位过程中，面神经主干及其上下不同分支均有受损情况。
通过回顾本研究中的信息，外科医生将能够更准确地预防与手术相关的并发症，如下颌角和髁突的医源性血管意外、完全性和部分性面瘫、味觉性出汗（弗雷综合征）以及腮腺切除术后的创伤性神经瘤。
