Xu Yuanzhi, Nunez Maximiliano Alberto, Mohyeldin Ahmed, Fernandez-Miranda Juan C, Cohen-Gadol Aaron A
Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Department of Neurosurgery, Stanford Hospital, Stanford, California, United States.
J Neurol Surg B Skull Base. 2021 Dec 14;83(4):430-434. doi: 10.1055/s-0041-1739237. eCollection 2022 Aug.
Understanding the anatomic features of the zygomatic nerve is critical for performing the endoscopic transmaxillary approach properly. Injury to the zygomatic nerve can result in facial numbness and corneal problems. To evaluate the surgical anatomy of the zygomatic nerve and its segments from an endoscopic endonasal perspective for clinical implications of performing the endoscopic transmaxillary approach. The origin, course, length, and segments of the zygomatic nerve were studied in four specimens from an endonasal perspective. The zygomatic nerve arises 4.1 ± 1.7 mm from the foramen rotundum of the maxillary nerve in the superolateral pterygopalatine fossa (PPF). According to its anatomic region in endonasal endoscopic surgery, we divided the zygomatic nerve into two segments: the PPF segment, from origin to the point of entry under Muller's muscle, which runs superolaterally to the inferior orbital fissure (IOF) (length, 4.6 ± 1.3 mm), and the IOF segment, starting at the entry point in Muller's muscle and terminating at the exit point in the IOF, which travels between Muller's muscle and the great wing of the sphenoid bone (length, 19.6 ± 3.6 mm). In the transmaxillary approach, the zygomatic nerve is a critical landmark in the superolateral PPF. The zygomatic nerve travels in the PPF and the IOF; better visualization and preservation of this nerve during endonasal endoscopic surgery are crucial for successful outcomes.
了解颧神经的解剖特征对于正确实施内镜经上颌窦入路手术至关重要。颧神经损伤可导致面部麻木和角膜问题。
为了从鼻内镜鼻内视角评估颧神经及其各节段的手术解剖结构，以探讨内镜经上颌窦入路手术的临床意义。
从鼻内视角对四个标本中的颧神经的起源、走行、长度和节段进行了研究。
颧神经起源于翼腭窝（PPF）上颌神经圆孔上方4.1±1.7mm处。根据其在鼻内镜手术中的解剖区域，我们将颧神经分为两段：翼腭窝段，从起源至进入米勒肌下方的点，该段向上外侧走行至眶下裂（IOF）（长度为4.6±1.3mm）；眶下裂段，始于进入米勒肌的点，止于眶下裂的出口点，该段走行于米勒肌与蝶骨大翼之间（长度为19.6±3.6mm）。在经上颌窦入路手术中，颧神经是翼腭窝上外侧的关键标志。
颧神经走行于翼腭窝和眶下裂；在鼻内镜手术中更好地显露和保留该神经对于手术成功至关重要。
