anatomy of the facial nerve
面神经炎(Facial++Neuritis)[1]
![面神经炎(Facial++Neuritis)[1]](https://img.taocdn.com/s3/m/e96bb7e1551810a6f5248674.png)
面神经炎特点
起病急 发病率高 病程长 疗效明显 后遗症少
流行病学
(Epidemiology)
好发于年轻人 发病率：15－40／10万
患病率:320.3-432.4/10万
病因及发病机理(Etiology & Episode Mechanism)
内在因素：
狭窄的骨性管道 外在因素： 位置较表浅 痉挛 局部血管 缺血、缺氧、水肿 面神经容易受累
减轻水肿 ：皮质激素
地塞米松 10~15mg/天，7－10天 泼尼松(PDN; Prednisone) 1 mg / kg 5 天，以后7日内逐渐减量
急性期治疗原则
(Stage of Acute Therapeutic Principle)
改善循环： 706代血浆、低右 营养神经：B族维生素类、胞二磷胆碱、
(Clinical Situation)
临床特点
无年龄、性别差异
常有面部受凉史 多为单侧 病初耳 后疼痛
临床表现
面部表情肌瘫痪
额部、眼部、鼻部、颊部、口 角、 颈、 诧言改变、进食 味觉改变 听觉改变
膝状神经节综合征
（Ramsay- Hunt Syndrome）
定 位：膝状神经节受累 定 性：带状疱疹病毒感染 临床 表现：面瘫、舌前2/3味觉障碍、 听 觉过敏, 唾液、泪液分泌障 碍，耳内疼痛，外耳道疱疹
痛：面神经管减压术
面神经-副神经吻合术
面神经-膈神经吻合术
面神经-舌下神经吻合
鳄泪
征：环路切断术
鳄泪综合征(Crocodile Tear Syndrome)
面神经炎后,由于长出了新的神经纤维,导致 传至口唇肌肉的神经冲动反而刺激泪腺,结果咀 嚼食物时病人会流泪。
面神经额支的颧弓上定位测量及其临床意义
・应用解剖・面神经额支的颧弓上定位测量及其临床意义姜 平1, 钟世镇2, 徐达传2, 高建华1(1.第一军医大学南方医院整形外科; 第一军医大学解剖学教研室,广东广州510515) 【摘要】目的:研究并定位跨经颧弓的面神经额支行程,为相关外科手术预防额支损伤提供指导。
方法:对16具防腐成人头部标本进行显微解剖,观测跨越颧弓的面神经支的数目和位置。
结果:颧弓下、上缘分别有2.4、2.6支额支跨过,对应的跨区分别在颞骨颧突的关节结节后1.6mm至关节结节前2.7mm之间的区段、耳门上点前24.0mm至耳门上点前33.1mm之间的区段。
结论:面神经额支主要跨经颧弓下缘后、中1/3段,颧弓上缘中1/3段到达额部,针对手术解剖可将颧弓分为“危险区”和“相对危险区”。
【关键词】面神经; 颞支; 额支【中图分类号】R32311;R322185 【文献标识码】A 【文章编号】1001-165X(2003)01-0010-03Applied anatomy of the frontal branch of facial nerve:path across the zygom atic archJ IA N G Ping ,ZHON G S hi2z heng,XU Da2chuan,et al.Depart ment of Plastic S urgery,N anf ang Hospital,First Military Medical U niversity,Guangz hou510515,China【Abstract】Objective:To locate the path of the frontal branch of facial nerve(FB)crossing the zygomaticarch.Methods:Sixteen fixed adult heads specimens were dissected.The number of FB and the site of FB inter2secting lower and upper border of the zygomatic arch were documented.R esults:There were respectively2.4and2.6FB rami crossing the lower and upper border of zygoma,correspondingly the intersecting section werefrom1.6mm posterior to articular tubercle to2.7mm anterior to articular tubercle,and from24.0mm to33.1mm anterior to supra2acoustic pore.Conclusion:The path of FB across the zygomatic arch could be named a’risk zone’and a’relative risk zone’according to surgical dissection.【K ey w ords】facial nerve; frontal branch; zygomatic arch 本研究通过大体解剖和显微解剖,观测面神经额支行程与颧弓的位置关系,并通过颧弓下缘、上缘和骨性标志点对额支进行定位,以期为相关手术预防额支损伤提供应用解剖学基础。
Facial Nerve Palsy
Physical exam:
Topodiagnostics:
– Schirmer’s test: – Stapedial reflex: – Taste test: – Submandibular salivery flow test: Warton’s ducts
Anatomy: Surgical landmarks
Middle Ear and Mastoid Surgery:
– Processus chocleariformis – Oval window and horizontal canal – Short process of the incus – Pyramid
Complete vs. incomplete Segmental vs. uniform involvement Unilateral vs. bilateral Cranial nerves assessment Neurologic evaluation Cerebellar signs
Physical exam:
Pons. precentral gyrus. Upper part of the nucleus:
– Upper face – Involuntary emotional movementsLeabharlann Anatomy: Course
Motor fibers originate… Hooks around… Joined by… Facial n. leaves the brainstem… Travels through… Enters the IAC. Then traverse the temporal bone through facial n. canal Leaves the temporal bone through Finally divides into terminal branches.
面神经水平段大血管伴行
面神经水平段及垂直段骨管内大血管伴行一例Large vessel accompany with tympanic segment and vertical portion of facial nerve:a case report我们行颞骨解剖训练时（解剖教研室提供），发现一例标本面神经水平段及垂直段骨管内有较大动、静脉血管伴行，如果在行面神经减压术时遇到此种解剖变异，则很容易损伤血管而导致较严重出血，又因其不易明辨，如用双极电凝等方法止血则可能会造成面神经的严重损伤，遂报告如下。
我们在尸头标本上行面神经减压时，当磨开水平段及垂直段面神经骨管后，发现有暗蓝色条索状物与预计的面神经走行一致（图1）。
继续磨开骨管，经辨认，为与面神经伴行的较大血管，血管水平段下内及垂直段前内的白色条索物方可能为面神经。
经解剖，发现面神经与伴行血管在同一包膜内密不可分，上方至近膝状神经节处，下方至面神经出茎乳孔处，血管神经紧密伴行。
大体观，伴行血管占面神经骨管的2/3左右，呈暗黑蓝色，我们在锥段附近将血管挑开加以验证，可见酱黑色液体溢出，血管占面神经骨管比例有所下降；连续冲水用磨钻进一步开放面神经骨管，血管内容物逐渐溢出，颜色逐渐变白，覆盖的面神经轮廓逐渐清晰显现（图2）。
在面神经出茎乳孔处横形切段神经血管束，显微镜下清晰可见神经与伴行动静脉的关系（图3、4）。
在茎乳孔上方0.5 cm处神经血管束明显膨大呈纺锤形并在此有多个血管分支，其中有三支较明显：一支发自面神经血管束后方，向后走行（图2）；一支发自面神经血管束内面，向内下走行（图5）；还有一支发自面神经血管束前内，向前内下走行（图3）。
自茎乳孔面神经血管束横断处向上逐渐分离面神经血管复合体（包括鼓索及部分锤骨柄、镫骨肌支及镫骨）直至匙突前部横断取下（图6），后行病理切片，证实面神经与血管在同一包膜内伴行（图7）。
图1 暗蓝色条索状物与预计面神经走形一致（3个箭头示） 图2 面神经轮廓逐渐显现，面神经血管束纺锤样膨大后部，可见分支血管向后走行（箭头示） 图3 还有一支血管发自面神经血管束纺锤样膨大部前内，向前内下走行（箭头示），在近面神经出茎乳孔处横形切段神经血管束 图4 显微镜下清晰可见神经与伴行动静脉的关系 图5 面神经血管束内面，可见分支血管向内下走行（箭头示） 图 6取下部分面神经及血管复合体，包括鼓索（短箭头）及部分锤骨柄、镫骨肌支（长箭头）和镫骨图7 病理切片观察，可见神经、血管同一包膜 HE ×40讨论 颞骨内面神经与滋养血管伴行的情况已有较多报道，Minatogawa 等[1]对人颞骨内面神经血供进行研究后指出,脑膜中动脉发出的岩支分布至膝状神经节,茎乳动脉走行于面神经垂直段的前内侧直达上1/3,然后攀绕神经的内侧或外侧上行,到达水平段发出数个小支在面神经膝部与岩支互相吻合成动脉网。
改良面神经额支的体表定位
本研究 通过大体解剖和显微解剖 ，观测 面神经额支的行 程 ，并通过改 良的体表标志 点和连线对 其进行定位 ，为临床 相 关 手 术提 供 更 加 广 泛 、适用 的体 表 定 位 依 据 。
１ 材 料 和 方 法 经 福 尔 马 林 固 定 的 面 部 无 破 损 的成 人 头 部 标 本 ２Ｏ侧 ，
基金项 目：湖南省教育厅基金项 目（编号：０６Ｃ７０７）
图 １ 标 志 点和 标 志 线
测量项 目：（Ｉ）两条标 志线的长度 ：①经耳轮上 点和外眦上 点的连线 （即 线段 ＡＤ）的长度 ；⑦经耳屏上切迹 点和外眦点的连 线（即线段 ＢＣ）的长度；（２） 两条标志线上分 别跨越 的面神经的额 支数 ；（３）两条标志线上 ，额支的最前 分 支 Ｆａ和最后分 支 Ｆｂ与标志线相交点在标志线上的相对位置。如仅 一支额支 则 最 前 分 支 和 最 后 分 支 均 以 此 支 记 ．
ｓｅｇｍｅｎｔ ｓ（１／５－１／２）￣１／９．Ｃｏｎｃｌｕｓｉｏｎ Ｔｈｅ ｄａｎｇｅｒｏｕｓ ａｒｅａ ｗｈｅｒｅ ｔｈｅ ｆｒｏｎｔａｌ ｂｒａｎｃｈ ｏｆ ｆａｃｉａｌ ｎｅｒｖｅ ｓｔｅｐ ｏｖｅｒ ｓｈｏｕｌｄ ｂｅ
ｇｅｔ ｏｕｔ ｏｆ ｔｈｅ ｗａｙ ｉｎ ｔｈｅ ｆａｃｅ ｌｉｆｔｉｎｇ． Ｋｅｙ ｗ ｏｒｄｓ：ｆａｃｉａｌ ｎｅｒｖ ｅ；ｆｒｏｎｔａｌ ｂｒａｎｃｈ；ｓｕｄａｃｅ ｍａｒｋｓ
（Ｄｅｐａｒｔｍｅｎｔ ｏｆ Ａｎａｔｏｍｙ，Ｕｎｉｖｅｒｓｉｔｙ ｏｆ Ｓｏｕｔｈ Ｃｈｉｎａ，Ｈｅｎｇｙａｎｇ ４２１００１，Ｈｕｎａｎ，Ｃｈｉｎａ）
Ａｂｓｔｒａｃｔ＝ Ｏｂｊｅｃｔｉｖｅ Ｔｏ ｐｏｓｉｔｉｏｎ ｔｈｅ ｆｒｏｎｔａｌ ｂｒａｎｃｈ ｏｆ ｆａｃｉａｌ ｎｅｒｖｅ ｓｕｒ ｆａｃｅ ｍａｒｋｓ ｔｈｒｏｕｇｈ ｔｈｅ ｎｅｗ ｗａｙ医学 ２００８年 ５月第 １７卷第 ５期 Ｃｈｉｎｅｓｅ Ｊｏｕｒｎａｌ ｏｆ Ａｅｓｔｈｅｔｉｃ Ｍｅｄｉｃｉｎｅ．Ｍａｙ．２００８．Ｖｏ１．１７．Ｎｏ．５
十二对脑神经 知识点英语
十二对脑神经知识点英语The Twelve Cranial Nerves: A Comprehensive Overview.The cranial nerves are twelve pairs of nerves that emerge directly from the brain, innervating various structures in the head and neck. They play a crucial role in sensory perception, motor function, and autonomic regulation. Understanding the anatomy and functions of these nerves is essential for a comprehensive understanding of neurology.Classification of Cranial Nerves.The cranial nerves are classified into two main types: sensory and motor. Sensory nerves transmit sensory information from the periphery to the brain, while motor nerves carry motor commands from the brain to muscles and glands.Sensory Cranial Nerves.Olfactory Nerve (CN I): Responsible for the sense of smell.Optic Nerve (CN II): Transmits visual information from the retina to the brain.Oculomotor Nerve (CN III): Innervates muscles responsible for eye movements, pupillary constriction, and eyelid closure.Trochlear Nerve (CN IV): Innervates the superior oblique muscle of the eye, controlling downward and outward eye movements.Trigeminal Nerve (CN V): Provides sensory innervation to the face, including the skin, teeth, and mucous membranes. It also innervates the muscles of mastication.Abducens Nerve (CN VI): Innervates the lateral rectus muscle of the eye, controlling outward eye movements.Facial Nerve (CN VII): Innervates the muscles offacial expression, lacrimal glands, and taste buds on the anterior two-thirds of the tongue.Vestibulocochlear Nerve (CN VIII): Transmits auditory and vestibular information from the inner ear to the brain.Motor Cranial Nerves.Hypoglossal Nerve (CN XII): Innervates the muscles of the tongue, controlling its movements for speech and swallowing.Glossopharyngeal Nerve (CN IX): Innervates the muscles of the pharynx and soft palate, plays a role in swallowing, and provides taste sensation to the posterior third of the tongue.Vagus Nerve (CN X): The longest cranial nerve, it innervates structures throughout the thorax and abdomen, including the heart, lungs, digestive system, and vocal cords.Accessory Nerve (CN XI): Innervates the sternocleidomastoid and trapezius muscles, controlling head and neck movements.Autonomic Cranial Nerves.The vagus nerve and glossopharyngeal nerve are considered autonomic cranial nerves, as they contain both sensory and motor fibers involved in regulating involuntary functions such as heart rate, digestion, and salivation.Innervation Territories.Each cranial nerve supplies a specific region of the head and neck, known as its innervation territory. Knowledge of these territories is essential for diagnosing and treating neurological conditions.Clinical Significance.Damage to the cranial nerves can result in a wide rangeof neurological symptoms, depending on the affected nerve. Examples include:Olfactory nerve: Loss of smell (anosmia)。
05---三叉神经Trigeminal Nerve
The ophthalmic nerve— V1 division
The ophthalmic nerve courses in the wall of the cavernous sinus, just below the fourth nerve and lateral to the sixth nerve（眼神 经穿入海绵窦外侧壁，在滑车神经和展神经外下方走行）. This can be seen as a craniocaudal ovoid nerve, which is much larger than the adjacent fourth and sixth nerves. This nerve can only be depicted in a reliable way on coronal contrast-enhanced high-resolution T1W images through the cavernous sinus（眼神 经在增强后的高分辨T1WI冠状位上可以看到）. The nerve then leaves the skull through the SOF and enters the orbit, where it divides into a frontal, lacrimal, and nasociliary nerve providing sensory innervation to the globe, nose, forehead, and scalp（眼
Trigeminal nuclei— intra-axial segment
The spinal nucleus is a caudal extension of the PSN and descends from the level of the lower pons down to spinal cord level C3 （三叉神经脊束
面神经 前庭蜗神经 中英文
②Weber test
place the tuning fork base down in the centre of the forehead , ask to compare the sound (BC) of both side
• louder in affected side Weber(+)：conductive deafness • louder in unaffected side Weber(-)：sensorineural deafness
(2) Vestibular nerve前庭神经
look
for nystagmus(眼震) ice water caloric test（冷热水试验）
thank you
geniculate ganglion syndrome (膝状神经节)
in/above the stapedius nerve （镫骨肌神经） in/above chorda tympani nerve (股索神经) •outside stylomastoid foramen
(茎乳孔)
clinical features
nystagmus（眼震）
Examination
(1) Cochlear nerve耳蜗神经
rough estimate：soud of watch，tuning fork（ 音叉） • Vigorously rub your fingers together very near to each ear, ask the patient if the sound was the same in both ears.
ii. Sensory : test for taste/ask patient about taste
下颌骨周围重要软组织结构及下颌神经管的解剖-人体解剖学论文-基础医学论文-医学论文
下颌骨周围重要软组织结构及下颌神经管的解剖-人体解剖学论文-基础医学论文-医学论文——文章均为WORD文档，下载后可直接编辑使用亦可打印——摘要：目的精细解剖下颌角周围软组织结构及下颌神经管, 为下颌角肥大整形术提供解剖学参考。
方法20例大体标本, 观察及测量面动静脉、面神经下颌缘支及咬肌区的血管和神经。
据下颌骨表面骨性标志定位5条径线, 测量该5条径线上下颌神经管在下颌骨中的位置。
计算各软组织结构和下颌神经管的安全范围。
结果面动脉距下颌角点为23. 1836. 28 mm, 距咬肌前缘为-9. 519. 27 mm。
面静脉距离下颌角点为17. 7932. 03mm。
面神经下颌缘支贴近下颌角部及下颌骨下缘走行, 距离下颌角点为-8. 5710. 70 mm, 而咬肌前缘下颌缘支距下颌骨下缘为-8. 8311. 06 mm。
咬肌的血供主要有面动脉咬肌支、颈外动脉咬肌支、上颌动脉咬肌支及面横动脉咬肌支这四大来源。
咬肌神经多与咬肌动脉伴行进入咬肌。
下颌神经管在5个截面中距离下颌骨外侧点分别大于10. 50 mm、14. 72 mm、15. 60 mm、8. 53 mm、6. 74 mm。
结论在剥离下颌角区软组织时, 注意对咬肌前缘面动脉、面神经下颌缘支及下颌角点附近面神经下颌缘支的保护。
去除咬肌的最佳层次为咬肌深层中份最厚点及中下份。
而在截骨或劈骨时, 根据下颌神经管的安全范围, 可在下颌骨颊侧骨板快速画出一条指导性的安全线。
关键词：下颌角肥大; 下颌神经管; 截骨; 解剖学; 成人;Abstract：Objective To dissect soft tissue structure around the mandibular angle and the mandibular nerve canal accurately, as to provide anatomical reference for the mandibular angle hypertrophy operation. Methods Twenty formalin-fixed adult head-and-neck specimens were observed and measured for facial arteries and veins, the marginal mandibular branch of the facial nerves, and the vessels and nerves of masseter muscle. Five lines positioned according to the characteristic structures of the mandible were used for themeasurement of mandibular nerve canal. The safety range of the soft tissue structure and the mandibular nerve canal, external carotid artery, maxillary artery, and transverse facial artery were calculated. Results The distance between the facial artery and the mandibular angle is 23. 18-36.28 mm. Facial artery to the anterior margin of masseter muscle is-9. 51-9.27 mm. Separation between the facial vein and the mandibular angle is 17. 79-32. 03 mm. The marginal mandibular branch of the facial nerve is close to the mandibular angle and the lower edge of the mandible, measurements showed a distance of-8. 57-10. 70 mm towards mandibular angle. At anterior masseter muscle, separation between mandibular branches and the lower edge of the mandible is-8. 83-11. 06 mm. The four major sources of masseter arteries are the masseter branch of the facial artery, external carotid artery, maxillary artery, and transverse facial artery. The masseter nerve entered the masseter muscle alongside with the masseter artery. In the five cross sections, the disctance from mandibular nerve canal to the lateral mandibular point is more than 10. 50 mm, 14. 72 mm, 15. 60 mm, 8. 53 mm and 6. 74 mm, respectively. Conclusion Attention should be paid, when undermining soft tissue in the mandibular angle, three main structures specifically the facial artery and the marginal mandibular branch of facial nerve located at the anterior aspect of mandibular muscle, and the mandibular marginal branch of the facial nerve located at the mandibular angle areprerogative. Layers removed from the masseter muscle are best done at the thickestregion of the middle inferior aspect. A guide safety line can be drawn quickly during osteotomy on the buccal bone palate of the mandible based on the safety range of mandibular nerve canal.Keyword：Mandibular angle hypertrophy; Mandibular nerve canal; Osteotomy; Anatomy; Adult;下颌角肥大俗称方型脸。
面神经解剖在腮腺手术中的临床意义
面神经解剖在腮腺手术中的临床意义目的：探讨面神经解剖在腮腺肿瘤切除术中的意义。
方法：回顾性分折1998~2005年我科施行腮腺肿瘤切除术101例。
面神经解剖86例（85.1%，86/101）。
面神经总干解剖15例，面神经下颌缘支解剖71例。
3例恶性肿瘤和12例小腺瘤未行面神经解剖。
腮腺局部切除12例，腮腺浅叶切除74例，腮腺全切除15例。
结果：全组术后随访9～33个月，无肿瘤复发病例。
4例术后腮腺瘘，7～10 d痊愈。
1例永久性面瘫。
无术后出血、感染等并发症。
结论：面神经解剖有助于完整切除腮腺肿瘤和防止面神经医原性损伤。
美蓝染色可在术中有效识别面神经。
[Abstract] Objective:To study the signification of facial nerve anatomy during parotid operation. Methods:This paper was to summarize and analyze retrospectively the clinical experience of 101 cases with the parotid-tumor who were performed operation from 1998 to 2005. Of these 101 cases, facial nerve were anatomized in 86 cases(85.1%,86/101)，including facial nerve con-caudex anatomy in 15 cases, ramus marginal mandibulae nervous facial anatomy in 71 cases. M alignant tumor in 3 cases and little adenoid tumor in 12 cases weren’t facial nerve anatomy. Based on demand of the treatment, parotid local excision in 12 cases, parotid superficial-lobe excision in 74 cases and parotid total excision in 15 cases were performed. Results: Followed-up all of patients for 9～33 months, postoperatively, no one recurrence. Fistula of parotid gland occurred in 4 cases and 7~10 days were healed through changing dressing and permanence facial palsy in 1 cases and no post-operative complications such as blooding or infection were observed. Conclusion:It is one of effective measures in parotid operations with facial nerve anatomy for preventing facial nerve iatrogenic damage. Methylene blue is helpful to discriminate facial nerve.[Key words] Facial nerve；Anatomy；Parotid tumor；Surgery腮腺部分或全切除術是治疗腮腺肿瘤的主要方法，因腮腺肿瘤与面神经关系密切，而术中面神经损伤是常见并发症。
五官英语作文
In the realm of human anatomy,the facial features known as the five senses play a crucial role in our daily interactions and experiences.These features include the eyes, ears,nose,mouth,and tongue,each serving distinct functions that contribute to our perception of the world around us.Eyes:The Windows to the SoulThe eyes are often referred to as the windows to the soul.They are the primary organs for vision,allowing us to perceive our surroundings through the sense of sight.They detect light and color,enabling us to appreciate the beauty of nature,read,and recognize faces. The eyes are composed of various parts,including the cornea,iris,pupil,lens,and retina, each with a specific role in the process of vision.Ears:The Receivers of SoundEars are the organs of hearing and balance.They capture sound waves and convert them into electrical signals that the brain interprets as sound.The ear is divided into three parts: the outer ear,middle ear,and inner ear.The outer ear collects sound waves,the middle ear amplifies them,and the inner ear,specifically the cochlea,translates them into nerve impulses.Nose:The Sense of SmellThe nose is responsible for the sense of smell,which is closely linked to the sense of taste. It contains olfactory receptors that detect different odors and send signals to the brain, allowing us to enjoy the aroma of food and beverages,and also to detect potentially harmful substances.The nose also plays a role in respiration,helping to filter,warm,and humidify the air we breathe.Mouth:The Gateway for Speech and TasteThe mouth is a multifunctional organ that serves as the entry point for food and the source of speech.It contains the tongue,teeth,and palate,which work together to facilitate chewing,tasting,and articulating words.The tongue,in particular,is covered with taste buds that can detect sweet,sour,salty,bitter,and umami flavors. Tongue:The Taster and ArticulatorThe tongue is a muscular organ that plays a central role in both the gustatory and speech functions.It moves food around the mouth for chewing and mixing with saliva,which aids in digestion.The tongues flexibility and muscle control are also essential for clear speech,as it shapes the mouth to produce different sounds.The Interconnectedness of the SensesWhile each of the five senses operates independently,they are interconnected in waysthat enhance our overall sensory experience.For example,the sense of smell can intensify the flavors we taste,and the sense of sight can influence our perception of taste as well.The integration of these senses allows us to have a rich and complex understanding of the world.In conclusion,the five senses are integral to our existence,providing us with the means to navigate,communicate,and enjoy life.They are a testament to the complexity and wonder of human biology,and their proper functioning is essential for a high quality of life.。
面部支持韧带的解剖学进展
面部支持韧带的解剖学进展李秀琪【摘要】面部支持韧带主要包括颧弓韧带、下颌骨韧带、颈阔肌-耳韧带和颈阔肌-皮肤前韧带.面部支持韧带作为浅表肌腱膜系统(SMAS)和真皮与深筋膜和骨膜的锚定点,起支持、固定其相应区域面部的皮肤和皮下软组织,维持正常的解剖位置的作用.支持韧带与血管神经关系密切,掌握支持韧带的解剖可以避免除皱术中损伤血管神经.此外,支持韧带的松解对于提升面部下垂组织至关重要,掌握支持韧带的解剖非常必要.【期刊名称】《医学综述》【年(卷),期】2014(020)017【总页数】3页(P3178-3180)【关键词】面部支持韧带;除皱术;面部老化【作者】李秀琪【作者单位】中国医学科学院整形外科医院面颈美容中心,北京100144【正文语种】中文【中图分类】R602面部支持韧带与手指的Grayson韧带和Creland韧带的功能相似，是皮肤和浅表肌腱膜系统(superficial musculoaponeurotis system,SMAS)与周围组织结构的固定装置。
Furnas[1](1989)首次提出了面部支持韧带并详细描述了颧弓韧带、下颌骨韧带、颈阔肌-耳韧带和颈阔肌-皮肤前韧带,分为真性韧带和假性韧带两种。
真性韧带起于骨膜，假性韧带起于浅筋膜或SMAS，都止于皮肤。
面部支持韧带支撑面部软组织在其正常解剖位置，抵抗重力变化[2]。
经过近年来的探索研究，面部支持韧带的概念和理论不断地完善。
1 真性韧带起于骨膜止于皮肤的称为真性韧带，主要包括：眼轮匝肌支持韧带(orbicularis retaining ligament,ORL)、颧弓韧带、颊上颌韧带上颌部、下颌骨韧带[3]。
1.1 颧弓韧带McGregor最先指出腮腺筋膜的前界与颊部皮肤之间存在纤维黏结，将其命名为“McGregor′s Patch”，后被证实为颧弓韧带[2-3]。
Furnas[1]进一步详细描述了颧弓韧带。
Mendelson等[4]提出颧弓韧带作为颧弓前隙的下界是非常重要的结构。
Facial-Anatomy--面部解剖-02-
颊肌
起点 上颌骨和下颌骨牙槽突
止点 口轮匝肌
作用 收紧脸颊和维持口内压力
颊肌
图片：DVD of 3D HEAD & NECK ANATOMY
腮腺
外观：略呈楔形，底向外略呈三 角，尖向内对咽侧壁。质软，色 淡黄，外有腮腺鞘包被。
位置：下颌后窝 上界——外耳道和颧弓 下界——下颌角的后下方 后界——颞骨乳突和胸锁 乳突肌前缘 前界——咬肌前缘
眶上切迹/眶上孔
位置：眶上缘内、中1/3交界处，距正中线约2.5cm 神经：眶上神经 （属感觉神经）
三叉神经→眼神经→额神经→眶上神经 血管：眶上动脉、眶上静脉
张淑琴主编《美容整形临床应用解剖学第2版》
眶下孔
位置：眶下缘中点下方0.5～0.8cm处，或由鼻尖到 眼外角连线的中点处
神经：眶下神经 （属感觉神经） 三叉神经→上颌神经→眶下神经
• 他们由5个主要骨骼构成：
– 额骨 – 鼻骨 – 颧骨 – 上颌骨 – 下颌骨
冠状缝 蝶骨 额骨
眶上切迹 （孔） 眉间 颧骨 鼻骨 上颌骨 牙槽 下颌骨
颅骨
顶骨
颞骨
人字缝 外耳道 枕骨 枕外隆凸 颧弓
额骨
眉间 眶上切迹
上颌骨
鼻骨 眶面 顴突 牙槽
面颌骨
眶面 顴弓 颧突 眶下孔 下颌支
颏孔 下颌体
皮肤及皮下组织的分层
表皮 真皮
皮下组织
肌肉
骨骼
角质层 透明层 颗粒层 棘细胞层
基底层
面部皮下组织
• 皮下组织
– 连接神经，肌肉和血管。 – 皮下层由含结缔组织和脂肪的网状组织构成。 – 皮下脂肪储存有助于维持脸型。 – 皮下层以下是SMAS（Superficial Muscular Aponeurotic
腮腺与面神经颧支的应用解剖学研究
腮腺与面神经颧支的应用解剖学研究摘要】目的：探讨腮腺叶间导管转移治疗干眼病的解剖学基础。
方法：对10具（20侧）成人尸体标本头面部腮腺区进行局部解剖，观察腮腺第1叶间导管与面神经颧支的关系，测量两者的相关数据。
结果腮腺浅部第1叶间导管在距腮腺乳头（25.49±2.76）mm处注入腮腺导管，第1叶间导管长度为（37.63±1.24）ｍｍ，注入腮腺导管处的外径（0.54±0.16）ｍｍ。
腮腺浅部第１叶间导管与面神经颧支的解剖关系是面神经颧支位于叶间导管的浅层，两者逆向而行。
在眼眶外侧缘的垂直线上叶间导管和面神经颧支距离腮腺导管分别为（9.82±1.35）ｍｍ和（6.51±1.30）mm。
结论：第1叶间导管转位治疗干眼病是临床较理想的术式。
【关键词】腮腺；叶间导管；面神经颧支；干眼病【中图分类号】R361 【文献标识码】A 【文章编号】1007-8231（2017）01-0059-02Applied anatomy of the parotid gland and zygomatic branch of facial nerveCHEN Zhi-qiang, WU Gui-long, YUAN En-jian, LEI ZHen.Changsha Medical University 421001, China【Abstract】Objective To explore the anatomic basis of treatment of dry eyewith the transfer of the parotid gland .Method The first interlobar duct of parotid gland and zygomatic branch of facial nerve of 10 (20 sides) adult cadaveric head and face of parotid gland were dissected and observed , and the datameasured.Results Zygomatic branch of facial nerve and parotid gland first interlobar duct reverse. Conclusion The treatment of dry eye disease with first leaf catheter translocation is an ideal surgical procedure.【Key words】Parotid gland;Leaf catheter;Zygomatic branch of facial nerve;Dry eye干眼病又称干燥性角膜炎，是由于眼部或全身多种原因引起的眼腺细胞分泌减少的常见眼病，此病会导致视力下降，重症者致盲率较高，至今没有较好的治疗方法。
面神经(Facial nerve) 28页PPT文档共30页文档
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