Gosain A K, Sewall S R, Yousif N J
Division of Plastic and Reconstructive Surgery, Medical College of Wisconsin, Milwaukee, USA.
Plast Reconstr Surg. 1997 Apr;99(5):1224-33; discussion 1234-6. doi: 10.1097/00006534-199704001-00003.
A thorough examination of the temporal branch of the facial nerve was performed to characterize precisely the number of rami crossing the zygomatic arch and their location with respect to bone and soft-tissue landmarks. Fresh cadaver dissection was performed in 12 facial halves, dissecting the facial nerve superiorly from the stylomastoid foramen to identify all branches crossing the zygomatic arch. There were a median of three (range two to four) rami of the temporal branch crossing the lower aspect of the zygomatic arch, with distinct anterior and posterior divisions identified in each dissection. In 8 of the 12 dissections, one or more separate middle divisions of the nerve also were seen at the inferior aspect of the zygomatic arch. Superior to the zygomatic arch, frequent interconnections were noted between all divisions of the temporal branch, but no connections were noted to other branches of the facial nerve. Previous descriptions of the course of the temporal branch based on soft-tissue landmarks most closely correlated with nerve rami that were found in the present study to be located within the anterior division of the nerve. On crossing the inferior aspect of the zygomatic arch, the anterior and middle divisions of the temporal branch were located a median of 12 and 4 mm anterior to the articular eminence, respectively; the posterior division ranged in location from 10 mm posterior to 7 mm anterior to the articular eminence. The range over which rami of the temporal branch crossed the inferior aspect of the zygomatic arch was equally divided anterior and posterior to the articular eminence and covered up to 50 percent of the total length of the zygomatic arch. The present study confirms that the temporal branch is not a single nerve branch but consists of multiple rami that cross the zygomatic arch anywhere for over half the length of its inferior border. Techniques for localizing the nerve based on reference points from two soft-tissue landmarks are therefore unreliable.
对面神经颞支进行了全面检查，以精确确定越过颧弓的分支数量及其相对于骨骼和软组织标志的位置。对12侧面部进行了新鲜尸体解剖，从茎乳孔向上解剖面神经，以识别所有越过颧弓的分支。颞支越过颧弓下缘的分支数量中位数为3支（范围为2至4支），每次解剖中均识别出明显的前支和后支。在12次解剖中的8次中，在颧弓下缘还可见到一支或多支单独的中间支。在颧弓上方，颞支的所有分支之间有频繁的相互连接，但未发现与面神经其他分支有连接。以往基于软组织标志对面神经颞支走行的描述与本研究中发现的位于神经前支内的神经分支最为相关。颞支的前支和中间支在越过颧弓下缘时，分别位于关节结节前方中位数为12毫米和4毫米处；后支的位置范围是从关节结节后方10毫米到前方7毫米。颞支分支越过颧弓下缘的范围在关节结节前后平均分布，覆盖颧弓总长度的50%。本研究证实，颞支不是单一神经分支，而是由多个分支组成，这些分支在颧弓下缘的任何位置越过颧弓，长度超过其下缘的一半。因此，基于两个软组织标志的参考点来定位神经的技术是不可靠的。
