From the Service de chirurgie maxillofaciale-chirurgie plastique, Centre hospitalier intercommunal; Service de chirurgie maxillofaciale; URDIA, Université Paris Descartes; and Plastic Surgery.
Plast Reconstr Surg. 2019 Mar;143(3):888-899. doi: 10.1097/PRS.0000000000005360.
The marginal mandibular nerve of the facial nerve is frequently injured during corrective and cosmetic surgery. Recent or emerging techniques such as the injection of filler materials, botulinum toxin, allotransplantation of composite tissues of the face, placement of chin implants, and submental cryolipolysis require in-depth knowledge of this nerve. The studies to date are not in agreement regarding the number of branches of the marginal mandibular nerve and its relationship with the vasculature and other nerves.
This study involved 62 half-heads from cadavers.
In 22.6 percent of the cases, the marginal mandibular nerve of the facial nerve was a single branched entity and lateral to the pedicle, with respect to the facial artery and the facial vein. In 16 cases (29 percent), the marginal mandibular nerve had two branches. In 12.9 percent of the cases, the marginal mandibular nerve gave rise to three branches. In 17 cases (35.48 percent), the marginal mandibular nerve gave rise to between four and more than 10 branches, thereby forming a plexus at its end. Analysis of this collection of cases revealed that the marginal mandibular nerve was more consistently lateral to the facial vein than to the facial artery. The marginal mandibular nerve exhibited connections with other branches of the facial nerve and branches of the trigeminal nerve.
The facial vein had a more consistent relationship with the marginal mandibular nerve than the facial artery. This study provides the anatomical bases of substitution, proprioception, and clinical variations in injuries of the marginal mandibular nerve and in their prognosis.
面神经的下颌缘支在正颌和美容手术中经常受伤。最近或新兴的技术，如填充物的注射、肉毒杆菌毒素、面部复合组织同种异体移植、颏植入物的放置和颏下冷冻溶脂，都需要深入了解这根神经。迄今为止，关于下颌缘支的分支数量及其与血管和其他神经的关系，研究结果并不一致。
本研究涉及 62 个尸体半头。
在 22.6%的情况下，面神经的下颌缘支是单一分支的实体，位于面动脉和面静脉的外侧。在 16 例（29%）中，下颌缘支有两个分支。在 12.9%的情况下，下颌缘支有三个分支。在 17 例（35.48%）中，下颌缘支发出四个或更多分支，在其末端形成一个神经丛。对这些病例的分析表明，下颌缘支比面动脉更常位于面静脉的外侧。下颌缘支与面神经的其他分支和三叉神经的分支有联系。
面静脉与下颌缘支的关系比面动脉更一致。本研究为下颌缘支损伤及其预后的替代、本体感觉和临床变异提供了解剖学基础。
