Kitamura Seiichiro
Faculty of Health Sciences, Morinomiya University of Medical Sciences, 1-26-16 Nankokita, Suminoe-ku, Osaka-shi, Osaka, 559-8611, Japan.
Anat Sci Int. 2018 Jan;93(1):1-13. doi: 10.1007/s12565-017-0394-x. Epub 2017 Feb 28.
This review provides an overview of comprehensive knowledge regarding the anatomy of the fasciae and fascial spaces of the maxillofacial and the anterior neck regions, principally from the standpoint of oral surgery, whose descriptions have long been puzzling and descriptively much too complex. The maxillofacial and the anterior neck regions are divided into four portions: the portions superficial and deep to the superficial layer of the deep cervical fascia (SfDCF) including its rostral extension to the face, the intermediate portion sandwiched by the splitting SfDCF, and the superficial portion peculiar to the face where the deep structures open on the body surface to form the oral cavity. Different fascial spaces are contained in each of the portions, although the spaces belonging to the portion of the same depth communicate freely with each other. The spaces of the superficial portions are adjacent to the oral cavity and constitute the starting point of deep infections from that cavity. The spaces of the intermediate portion lie around the mandible and occupy the position connecting the superficial and deep portions. Among these spaces, the submandibular and prestyloid spaces play an important role as relay stations conveying the infections into the deep portion. The spaces of the deep portion lie near the cervical viscera and communicate inferiorly with the superior mediastinum, among which the poststyloid space plays a role as a reception center of the infections and conveys the infections into the superior mediastinum particularly by way of the retrovisceral space and the carotid sheath.
本综述主要从口腔外科的角度，对颌面部和颈部前部区域的筋膜及筋膜间隙的解剖学综合知识进行概述，长期以来，这些区域的描述一直令人困惑且过于复杂。颌面部和颈部前部区域分为四个部分：颈深筋膜浅层（SfDCF）浅面和深面的部分，包括其向面部的延伸；被分开的SfDCF夹在中间的部分；以及面部特有的浅部，深部结构在体表开口形成口腔。每个部分都包含不同的筋膜间隙，尽管同一深度部分的间隙彼此自由连通。浅部的间隙与口腔相邻，是口腔深部感染的起始点。中间部分的间隙位于下颌骨周围，占据连接浅部和深部的位置。在这些间隙中，下颌下间隙和茎突前间隙作为将感染传递至深部的中继站发挥重要作用。深部的间隙位于颈部脏器附近，向下与上纵隔相通，其中茎突后间隙作为感染接收中心，尤其通过内脏后间隙和颈动脉鞘将感染传递至上纵隔。
