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背景:颌角截骨术中下颌角周围的动脉损伤较常见,但下颌后静脉壁薄,位置较深,也容易受到损伤导致出血,有关下颌后静脉的解剖学研究国内外文献报道甚少。目的:观测下颌后静脉的组成、属支、回流及其与面神经、下颌角等结构的关系。方法:随机选取经甲醛固定的成人尸体20例(40侧),找到并修洁下颌后静脉及其属支,观察测量下颌后静脉的组成、属支、回流及其与面神经、下颌骨等结构的关系。结果与结论:①下颌后静脉起点恒定,其长度平均值为(4.51±2.01)cm,起始部外径平均值为(0.52±0.28)cm,34侧由颞浅静脉和上颌静脉合成,6侧直接起于颞浅静脉。依其回流及走行分为两种类型:一种分为前后支,前支大部分汇入颈内静脉,小部分汇入颈外静脉;后支则与耳后静脉结合汇入颈外静脉;另一种不分前后支,直接与耳后静脉结合汇入颈外静脉。②下颌后静脉的属支及其出现率为面横静脉88%,下颌关节静脉98%,腮腺后静脉95%,耳前静脉58%,茎突静脉43%等。③88%下颌后静脉位于面神经上、下干及其分支的内侧。下颌后静脉与面神经干或其主要分支近于十字形交叉,它们之间多直接相贴。④下颌后静脉及其属支形成的弧形结构紧贴下颌角下缘及后缘行走的占75%,与下颌角最低点有一定距离(平均值为0.58cm)的占25%;在下颌支后缘中下段,100%的下颌后静脉及其属支与下颌支后缘紧密相邻,静脉壁与骨皮质仅隔以菲薄的骨膜。而此处正是下颌角截骨线的位置,无论是剥离还是截骨时都容易损伤该静脉。
BACKGROUND: Artery damage around the mandibular angle is common in mandibular angle osteotomy. However, the posterior mandibular vein is thin and deep. It is also prone to be damaged and lead to hemorrhage. There are few reports on the anatomy of mandibular vena cava at home and abroad. OBJECTIVE: To observe the composition of the posterior mandibular vein, its branches, reflux and its relationship with facial nerve, mandibular angle and other structures. Methods: Twenty cases (40 sides) of adult cadavers fixed by formaldehyde were randomly selected to find and repair the posterior mandibular vein and its branches. The composition, branch and reflow of the posterior mandibular vein and its relationship with facial nerve and mandible Relationship. RESULTS AND CONCLUSION: ① The starting point of the posterior mandibular vein was constant with an average of (4.51 ± 2.01) cm in length and an average of 0.52 ± 0.28 cm in diameter at the beginning. The 34 sides were composed of superficial temporal veins and maxillary veins, 6 Side directly from the superficial temporal vein. According to its reflux and walking divided into two types: one is divided into anterior and posterior branch, most of the anterior branch into the internal jugular vein, a small part of the import of external jugular vein; posterior branch and the posterior vein combined into the external jugular vein; The other regardless of before and after the branch, directly with the ear vein combined into the external jugular vein. The mandibular posterior vein of the genus and its incidence of lateral veins 88%, mandibular articular vein 98%, 95% of the parotid gland vein, 58% of the vestibular vein, styloid process 43%. ③ 88% of the posterior mandibular vein is located in the facial nerve, the next dry and the branches of the medial. Mandibular veins and facial nerve trunk or its main branch near the cross-shaped cross, the more direct contact between them. ④ The mandibular posterior vein and its branches formed arc structure close to the lower edge of the mandibular angle and the trailing edge of walking accounted for 75%, and mandibular angle with the lowest point of a certain distance (average 0.58cm) accounted for 25%; in the mandibular Branch of the middle and lower limbs, 100% of the posterior mandibular vein and its branches and mandibular branch margin closely adjacent to the veins and the cortical bone separated only by the meager periosteum. And here is the location of mandibular angle osteotomy line, both peel or osteotomy are easy to damage the vein.