The Local Anatomy of Oral Maxillo-Facial and Neck
Oral and Maxillofacial Surgery-颌面部
Clinical Manifestation
Intervention
A fractured mandible can block the airway quickly especially if a shattered mandible as the tongue can fall backwards into oropharynx Bandage may provide comfort and initial stabilization Control external bleeding
Clinical manifestation
Periorbital ecchymoses and massive edema At risk for airway obstruction secondary to dissection of hematoma into the palate, pharyngeal walls, or tonsillar pillars Frequently have associated mandibular fractures.
LOGO
Oral and Maxillofacial Surgery
Name: Ai Ni Wa Er Mentor:A Di Li May 17th 2011
Trauma and Facial injuries
1
Epidemiology of facial injuries
(50-70% of all facial fractures ) in facial injuries
Anatomic Classification Condyle 36% Parasymphysis 14% Body 21% Angle 20% Ramus 3% Sports Process 3% Coronoid Symphysis 15%
口腔颌面部感染
经颊脂垫 颊间隙 经神经血管，越下颌切迹
颞下间隙、翼下颌间隙和颞间隙等
咬 肌 间 隙 感 染
感染来源：下颌磨牙的感染； 相邻间隙的感染； 化脓性腮腺炎 临床特点：
严重的张口受限和疼痛
以下颌支及下颌角为中心的肿胀 局限性压痛点：下颌角 凹陷性水肿、穿刺及脓 下颌升支外侧板边缘性骨髓炎
播散、蔓延： 颊间隙、翼下颌间隙、颞下间隙、颞间隙 下颌骨边缘性骨髓炎
扩散： 直接扩散 经面静脉
眶内 内眦静脉
眼静脉
颅内
眶 下 间 隙 感 染
治 疗 早期：局部外敷，全身抗感染 晚期：切开引流 上颌尖牙、前磨牙唇侧 前庭粘膜转折处 炎症控制后，处理病灶牙
颊 间 隙 感 染
Buccal space 广义：位于颊部皮肤与颊粘膜之间，借颊肌分为深浅两间隙。
周界 颧骨下缘
颊 间 隙 感 染
治 疗 晚期：切开引流 下颌龈颊沟，低位
口内 面部
颞 间 隙 感 染
Temporal space 位于颞区，借颞肌分为深浅两间隙 周界 颞下嵴 颧弓
颞浅间隙 颞肌 颞深间隙
颞间隙
通连 颞深间隙
向 下 颞下间隙、咬肌间隙、翼下颌间隙、颊间隙
颞 间 隙 感 染
感染来源： 相邻间隙的感染； 耳部和颞部皮肤感染、损伤 临床特点：肿胀、疼痛和张口受限 凹陷性水肿、压痛、张口受限
血液循环丰富
HIV等
概
临床表现 局
急性期 红、肿、热、痛和功能障 碍、引流区淋巴结肿痛。
述
部
慢性期 炎性浸润块、功能障碍、 窦（瘘）形成。遗留畸形。
脓 金黄色葡萄球菌：黄色、粘稠 全 身 链球菌： 淡黄或淡红色、稀薄或褐色 液 绿脓杆菌： 翠绿色、酸臭、稍粘稠 急性期 慢性期 特 混合感染： 灰白、灰褐色，腐臭 畏寒、发热、头痛、乏力、 持续低热、慢性消耗、营养 性 大肠杆菌： 黄褐色，较稀薄，有粪便臭 食欲下降、休克、昏迷等。 不良、贫血等。 白细胞增高，核左移等。 结核杆菌： 黄绿色、稀薄，可有豆渣样干酪物； Gangrenous stomatitis Fistula
口腔颌面外科学(Oral and maxillofacial surgery )
口腔颌面外科学0102（Oral and maxillofacial surgery 0102）Second section disinfection and sterilizationOral and maxillofacial surgery and other clinical general surgery, must strictly follow the principle of common bacteria and sterile, which exists in the human body and the surrounding environment, there are oral and maxillofacial sinus cavity is a hotbed of parasitism and reproduction of bacteria, after the surgery, the infection is more opportunity. Thorough disinfection and sterilization is an important measure to prevent postoperative infection and cross infection so as to ensure the operation effect and reduce operative complications.Disinfection and sterilization of operation room and surgical equipment(1) disinfection of surgical instruments and dressings1. high pressure steam sterilizer pressure sterilizer has lower exhaust type and pre vacuum pressure sterilizer two kinds. General equipment, cloth, gauze, cotton and rubber can be used. The sterilization effect is reliable, but the pressure and sterilization time of different substances require different.2. boiling disinfection method, this method is simple, easy to use, suitable for heat-resistant, temperature resistant goods, but can make the sharpness of the blade damage. Disinfection time starts from boiling water. Generally need L5 ~ 20 minutes. For patients with hepatitis contaminated instruments and articles, should boil 30 minutes. When adding 2% sodiumbicarbonate, the boiling point is 105 degrees, which can shorten the disinfection time, and the effect is better (metal instruments can be boiled for 5 minutes to meet the sterilization requirements), and can be antirust. 3. dry heat sterilization using electric or infrared oven baking heat sterilization. It is suitable for glass, ceramic and other instruments, and should not be sterilized by high-pressure steam gelatin sponge, Vaseline, grease, liquid paraffin and a variety of powder and other items. Articles that are not resistant to high temperature, such as cotton fabrics, synthetic fibers, plastics and rubber products, cannot be sterilized by this method. The temperature and maintenance time of dry heat sterilization should be determined according to the heat conduction speed, packing size and placing condition of sterilized articles. Generally 160 degrees should last 120 minutes, 170 minutes should last for 90 minutes, 180 minutes should last for 60 minutes.4. chemical disinfection method should be selected with a wide spectrum of sterilization, low toxicity, no irritation, stable performance, no corrosion, fast speed and other advantages of chemical disinfectants.(two) disinfection of special instrumentsElectric drill straight head and electric or pneumatic drill head can be sterilized by high pressure steam or formaldehyde steam (40% formaldehyde lasts 40 minutes). Drilling needle with formaldehyde vapor or immersion disinfection method, it is not suitable for disinfection parts, such as motor three arm, power line can be set to disinfection cloth sleeve isolation.Two. Disinfection of operatorsThe operation of the operation room disinfection including the replacement of clothing, pants, shoes, hats and masks to clean surgery, wash soak, wear gowns and wear rubber gloves and other steps, the principles, methods and requirements of the disinfectant and surgery in exactly the same.Three. Disinfection and sterilization in operation area(1) preoperative preparationPatients for hairdressing, bathing and skin preparation before surgery (with effective disinfection conditions or cosmetic surgery to be shaved). With oral interlinked major surgery, especially for bone grafting, grafting, first oral scaling, filling and removing residual roots, and with Potassium Permanganate 1:5000 or 1:1000 solution chlorhexidine gargle; take the skin and bone area should be 1 days before operation, to thoroughly clean the skin, alcohol after disinfection with sterile dressing.(two) commonly used disinfection drugs in surgical area1. iodine strong bactericidal, but irritation, so in different parts of different concentration: disinfection of oral maxillofacial and neck were 2%, 1%, 3% of the scalp. After use, iodine should be removed, and iodine allergy should be prohibited.2. chlorhexidine for broad-spectrum disinfectant, little stimulation, it is widely used. Skin disinfection concentration was 0.5%, with 0.5% chlorhexidine alcohol (70% alcohol) disinfection effect is better. The concentration of disinfectant in oral cavity and wound was 0.1%.Iodine 3. aqueous solution containing available iodine 0.5% Iodophor for skin disinfection and hand disinfection, also can lead the oral mucosa before operation, the effect is better than iodine. It has the advantages of complete disinfection, small irritation and shallow coloration.4.75% alcohol is used most frequently, the disinfection is weak, so often have to use up with the iodine iodine removal effect.(three) disinfection methods and scope1. disinfection method should start from the center of the operation area, gradually surrounded by coating, but the infection wound is opposite. No blank should be left when the medicine is coated, and the liquid medicine will be avoided to enter the respiratory tract and the eye. The operations connected with the oral cavity and the operations in multiple surgical districts should be disinfected separately.2. disinfection range, head and neck surgery disinfection range should be 1Ocm outside the surgical area, limbs, trunk need to expand the large 20cm, in order to ensure that there is a sufficient range of safety principle.(four) disinfection towel laying methodThe shape of the oral and maxillofacial region is irregular, and there are cavity, hole crack exists, scalp hair, its surgical towel has a certain degree of difficulty. In general should be put before disinfection after disinfection to sunshade; disinfection towel to prevent pollution of Baotou. The usual methods of spreading towels are as follows:1. Baotou law2. surgical field towel method(1) hole towel laying method(2) triangular surgical field towel method(3) quadrilateral surgical field towel methodThe size and shape of the operation should be adjusted according to the need of operation, and the disinfection area should be larger than the exposed area of the operation field. After the towel was placed around the operation field, the sterilized sheets and large sheets were used to cover the whole body (at least 3~4 layers around the operation area and at least 2 layers at the periphery). Large holes should be aligned to the surgical area. For those who may expand the scope of operation during surgery, disinfection and placement should be considered and prepared to avoid further expansion of disinfection and re placement of towels. After the operation area was paved, the operation area was separated from the anesthesia area with a single sheet.Third basic surgical proceduresOral and maxillofacial surgery commonly used instruments and other surgical instruments are basically the same, the use of the method is basically the same.First, exposureThe sufficient exposure of the surgical field is a prerequisite for the smooth operation of the operation.(1) incision designIn order to ensure the effect of operation and reduce the deformity of scar after operation, the choice of incision in oral and maxillofacial surgery must be considered comprehensively and comprehensively.1. anatomy should take into consideration the location and behavior of the important tissue structures such as nerves, vessels and parotid ducts in the surgical area, and the incisions should be parallel to avoid accidental injury and unnecessary sacrifice.The 2. part of the maxillofacial appearance and functional requirements, should choose the hidden incision site and natural folds, such as jaw, jaw, ear before and after nasolabial etc.. The direction of the incision should be consistent with the direction of the striae (because the direction of the skin tension is consistent with the direction of the striae), so asto obtain the smallest and lightest scar. The incision of the biopsy should be consistent with the incision of the reoperation.3. the length of long and short incisions should be fully exposed in principle.(two) incisionAfter the selection and determination of the incision, the marking mark should be made with methylene blue to ensure its accuracy. The long incision should be marked on both sides of the incision so that it can be sutured. Open, hand tight or fixed skin, knife and tissue surface vertical (vertical knife tip will pierce, moving to the 45 degree angle of skin incision, cut end and the knife in vertical position), accurate, quick, neat, uniform depth to a cut. Pay attention to the layers and cut them by layer (a few cases of reduction surgery). Surgery should be used electric knife or scissors, and plastic surgery without, in order to reduce the scar.(three) postureThe position should be chosen for the exposure of the operation field, and the shoulder and neck surgery should be routinely padded.(four) lightingGood lighting can increase the clarity of the surgical field, and is conducive to accurate operation and avoiding accidentalinjury, which is particularly necessary in the operation of important tissue structures and the mouth and pharynx cavity.Two. HemostasisHemostasis plays an important role in reducing blood loss, keeping the operation field clear, preventing important tissue injury, ensuring the safety of operation and wound healing after operation. The hemostatic methods commonly used in surgery are as follows:(1) hemostasis by clamping and ligationThis method is of the most basic and the most commonly used hemostatic methods, namely the bleeding point visible rapidly and accurately with hemostatic clamp forceps.(two) blocking hemostasisThis method is the most obvious and reliable method for hemostasis in clinic, that is, clamping, ligation and suture ligation are used to block the blood flow of the famous vessels or the larger vessels in the operation area, so as to achieve the purpose of regional hemostasis.Hemostasis of 1. well known or thicker vessels2. ligation of external carotid artery3. regional blocking hemostasis(three) hemostasis by compressionBy using external force to oppress the local, the lumen of the small vessel can be occluded so as to achieve the effect of hemostasis.(four) hemostasis by drugsHemostatic drugs can be divided into two categories: systemic and topical drugs.1. hemostatic drugs are mainly used in patients with coagulation disorders or as auxiliary drugs in a large number of blood transfusion, in order to enhance the clotting mechanism, commonly used drugs have hemostatic aromatic acid, hemostatic sensitivity, etc..2. local medication hemostasis, blood oozing can use gelatin sponge, starch sponge, hemostatic powder and other drugs. When the medicine is used, the medicine is first applied on the bleeding surface, then the saline gauze is pressed for a short time, and then the hemostatic effect can be achieved. In order to reduce intraoperative bleeding, local injection of 1:1000 is also necessary. Epinephrine procaine or physiological saline, can also be directly compressed hemostasis with adrenaline gauze.(five) hemostasis by coagulation(six) low temperature hemostasis(seven) hemostasis by DepressurizationThree. DissectionDissection is an important means to expose the anatomical part of the tissue, protect the normal and important tissues, and remove the diseased tissue. Dissection should be carried out in the normal tissue level, that is, the operation level is clear and layer by layer is cut in.(1) sharp separationUsed for fine level dissection or separation of adhesive solid scar tissue. The instruments used are sharp surgical knives and surgical scissors. This method of tissue injury, the motion requirements of delicate and accurate, in general should be under direct vision.(two) blunt separationSeparation of normal muscle and loose connective tissue and removal of benign tumor. Mainly to the forceps can also use, handle, finger, gauze. This method is safe, but it has great damage to the tissue.Separation of the two methods, in operation often alternation and combination, but either way, should prevent violent and accidental injury, and should pay attention to the rhythm and speed wound protection operation, avoid long time exposure and dry necrosis.Four, knotKnotting is one of the most important basic skills in surgical operation, and it is one of the most basic technical operations. It is mainly used for ligation of blood vessels and sutures.。
48种SCI口腔医学杂志简介
48种SCI口腔医学杂志简介1. 国际口腔修复学杂志INT J PROSTHODONT（The International Journal of Prosthodontics，ISSN：0893-2174，IF：2003年为1.113），双月刊，国际口腔修复医师学院、国际颌面修复学会官方刊物。
由Quintessence Pub. Co.出版发行,可上该公司网站订阅获取印刷版。
网址：,主编：George Zarb。
2. 口腔修复杂志J Oral Rehabil（Journal of Oral Rehabilitation，ISSN：0305-182X，IF：2003年为0.643），月刊，创刊于1974年，由Blackwell Scientific Publications出版发行，可上该杂志网站订阅获取电子版。
网址：。
主编：Peter Svensson, Royal Dental College,Faculty of Health Sciences,University of Aarhus,Vennelyst Boulevard 9,DK-8000 Aarhus C,Denmark,Tel: +45 8942 4212, Fax: +45 8942 4297, Editorial Assistant：JanetMikkelsen,E-mail:************.dk。
3. 修复牙科学杂志J Prosthet Dent（The Journal of Prosthetic Dentistry，ISSN：0022-3913，IF：2003年为0.527），月刊，创刊于1951年，由Elsevier公司出版发行。
可上该杂志网站订阅获取电子版。
网址：/science/journal/00223913。
主编：Carol A. Lefebvre。
4. 社区牙科学和口腔流行病学Community Dent Oral Epidemiol（Community Dentistry and Oral Epidemiology，ISSN：0301-5661，IF：2003年为1.100），双月刊，创刊于1973年，由Blackwell Scientific Publications出版发行，可上该杂志网站订阅获取电子版，网址：/loi/com。
The Local Anatomy of Oral Maxillo-Facial and Neck
甚至伤及食管。
4.勿切第一气管软骨环，以免术后发生喉
部狭窄。
5.切开不应低于第5气管软骨环，以免引起 无名动脉等损伤。
Submandibular area
• Boundaries • Constructures
三.颌下区
（一）境界
（二）内容
1.颌下腺
2.颌下淋巴结 3.面前静脉
4.颌外动脉
5.颌下神经节
• 1.丝状乳头 • 2.菌状乳头 • 3.轮廓乳头
• 4.叶状乳头
• 舌后1/3粘膜无舌乳头，但有结节状淋巴 组织，称舌扁桃体。
（二） 舌腹
标志
1舌系带 2伞襞 3舌下肉阜 4舌下襞
（三）舌的淋巴管
1.舌尖淋巴管
大部分至颏下淋巴结，小部分至颈肩胛舌骨
肌淋巴结。 2.舌体边缘或外侧淋巴管 部分至颌下淋巴结，另一部分至颈深上淋巴 结。
6.舌神经、颌下腺导管和舌下神经 三者位于颌下腺深面，在舌骨舌肌的浅 面，自上而下依此排列： 舌神经、颌下腺导管、舌下神经。
舌神经与颌下腺导管关系密切，从解剖关 系上可作以下鉴别： 1.联系 舌神经连于颌下神经节，导管则 直接发自颌下腺。 2.位置 在舌骨舌肌表面，舌神经位于导 管的上方。 3.形态 舌神经比颌下腺导管粗而略扁， 且坚韧。
3）线距测量（硬组织）
• 前全面高 (Anterior total facial height,ATFH) • 前上面高 (Anterior upper facial height ,AUFH) • 前下面高 (Anterior lower facial height, ALFH)
3.临床应用
• 上颌骨水平位置 • 上颌骨垂直位置 • 下颌骨水平位置
口腔颌面外科题库
一、名解：1、oral and maxillofacial surgery(口腔颌面外科学) P12、local anesthesia (局部麻醉) P173、block anesthesia （阻滞麻醉）P214、osseointegration （骨结合）P985、infection （感染）P1286、pericoronitis （智齿冠周炎）7、furuncle （疖）P1608、Lefort Ⅱ型骨折P1869、Precancerous lesion （癌前病损）P23610、precancerous condition （癌前状态）P23711、junctional nevus （交界痣）P24712、Sjogren syndrome （舍格伦综合征）P28913、Dislocation of condyle （颞下颌关节脱位）P31614、Ankylosis of temporomandibular joint （颞下颌关节强直）P31915、Trigeminal neuralgia （三叉神经痛）P33416、Bell palsy （贝尔麻痹）P35117、Facial spasm （面肌痉挛）18、Dento-maxillofacial deformities （牙颌面畸型）P42219、Axial falp （轴型皮瓣）P45820、岛状皮瓣P458二、填空1、重度张口受限是指上、下切牙切缘间距不足横指，约cm以内。
2、对唇、颊、舌、口底和下颌下区病变触诊检查时可使用检查。
3、利多卡因麻醉时一次的最大剂量是mg。
4、下牙槽神经阻滞麻醉口内注射时的标志点有和。
5、糖尿病病人拔牙时，要求血糖控制在mmol/L.6、牙挺的工作原理包括原理，原理和原理7、下颌支前缘与第二磨牙远中面之间的间隙不大，不能容纳第三磨牙牙冠的阻生齿在临床分类中归第类。
8、阻生齿拔除术中阻力分析一般包括阻力、阻力和阻力。
口腔解剖学英语
口腔解剖学英语Oral Anatomy: A Comprehensive GuideIntroductionOral anatomy is a crucial field of study within dentistry and plays a significant role in understanding the structure and function of the oral cavity. In this article, we will delve into the key aspects of oral anatomy and explore the terminology commonly used in the field. Though primarily focusing on the English language, this comprehensive guide aims to provide a solid foundation for students and professionals alike.1. Introduction to Oral AnatomyThe oral cavity is the starting point of the digestive system and is responsible for functions such as mastication, swallowing, and speech. It comprises various structures, including the lips, teeth, tongue, palatal mucosa, tonsils, and salivary glands. Familiarizing oneself with the names and locations of these structures is vital to understanding oral anatomy.2. The TeethThe teeth, often referred to as dentition, are vital components of the oral cavity. They serve multiple functions, including chewing, speaking, and enhancing facial aesthetics. Human beings typically have two sets of teeth: primary (baby) teeth and permanent teeth. Understanding the different types of teeth, such as incisors, canines, premolars, and molars, is essential in dental diagnosis and treatment planning.3. The Tongue and Its StructuresThe tongue is a muscular organ located in the oral cavity and is responsible for essential functions such as taste perception, swallowing, and speech. It consists of several structures, including the papillae, taste buds, lingual frenulum, and intrinsic and extrinsic muscles. A thorough understanding of these structures aids in diagnosing and treating conditions such as tongue tie and taste disorders.4. The Palate and Its ComponentsThe palate forms the roof of the oral cavity and is divided into the hard palate (anterior) and the soft palate (posterior). The hard palate aids in the process of mastication, while the soft palate plays a crucial role in swallowing and speech. Knowledge of the various structures, such as the uvula and palatine rugae, is essential in assessing conditions like cleft palate and snoring.5. Salivary GlandsSalivary glands are responsible for producing saliva, which lubricates the oral cavity, aids in digestion, and helps prevent tooth decay. Major salivary glands include the parotid glands, submandibular glands, and sublingual glands. Understanding their location and function is vital when diagnosing and managing conditions such as salivary gland stones and Sjogren's syndrome.6. The Temporomandibular Joint (TMJ)The TMJ connects the mandible (lower jaw) to the temporal bone of the skull, allowing for the movement required during chewing and speaking. Disorders of the TMJ, such as temporomandibular joint dysfunction (TMD),can cause pain and difficulty in jaw movement. Proper understanding of the TMJ's anatomy helps dentists provide appropriate treatment for such conditions.ConclusionA sound knowledge of oral anatomy is essential for dental professionals to provide effective oral healthcare. This comprehensive guide serves as a stepping stone in understanding key structures within the oral cavity, aiding in accurate diagnosis and treatment planning. Continuous study and exploration of oral anatomy will enable dental professionals to deliver optimal care to their patients, promoting overall oral health and well-being.。
口腔颌面部感染
参考内容：
颌下间隙
面神经下颌缘支
咬肌、翼颌间隙
腮腺、面N下颌缘支
眶下间隙
眶下NAV、面NAV
舌下间隙
舌N、颌下腺导管、舌下腺小管、舌下A、舌下N
咽旁间隙
切口在翼颌皱襞内侧仅达黏膜下
茎突前 有 咽升AV 、 面A 的扁桃体支
茎突后 有颈内AV、舌咽N、迷走N、副N、舌下N、颈交感干
【病因】 【临床表现】
52%发病率
【治疗】 1. 冠周冲洗上药
2. 龈瓣盲袋切除
冠周炎冲洗针头
冠周炎冲洗
【并发症】
感染蔓延途径
1. 沿外斜线 ＃36或＃46 根尖感染或瘘管 2. 向外前方沿颊肌和咬肌间 颊间隙感染 3. 沿升支外侧向后 咬肌间隙感染 4. 沿升支内侧向后
扁桃体周围脓肿、咽旁间隙感染、 翼颌间隙感染
咽旁间隙感染
【治疗要点】
小儿 ： 穿刺 、抽脓、注药 成人脓肿切排切口：
五、口底蜂窝织炎
cellulitis of the floor of mouth
【局解】
【感染来源】
1.牙源性感染 2.其它感染 3.其它间隙感染扩散 4.继发感染
【临床表现】
口底诸间隙弥漫性肿胀， 舌体抬高， 双侧颈上份肿胀 （下颌下缘消失呈牛颈状） 化脓性多见 腐败坏死性严重Ludwig’s angina
氯霉素几乎对所有的厌氧菌包括脆弱类杆菌在内均有效， 但缺点是有骨髓抑制的危险性。
甲硝唑对厌氧感染有效，此药价格便宜，即使长期使用也 无严重并发症。
林可霉素的抗菌谱与青霉素G相仿，如病人对青霉素过敏 时可选用。氯林可霉素对厌氧菌感染的疗效优于林可霉素， 但它和林可霉素一样，有时会引起致命的假膜性结肠炎。
48种SCI口腔医学杂志简介
http://202.113.49.23/help/SCI_Web/SCI_1.swf... ...http://202.113.49.23/help/SCI_Web/SCI_8.swfSCI 1-4匿名提取文件连接htp:///SCI 5-8匿名提取文件连接htp:///952950590342950548种SCI口腔医学杂志简介1. 国际口腔修复学杂志INT J PROSTHODONT（The International Journal of Prosthodontics，ISSN：0893-2174，IF：2003年为1.113），双月刊，国际口腔修复医师学院、国际颌面修复学会官方刊物。
由Quintessence Pub. Co.出版发行,可上该公司网站订阅获取印刷版。
网址：,主编：George Zarb。
2. 口腔修复杂志J Oral Rehabil（Journal of Oral Rehabilitation，ISSN：0305-182X，IF：2003年为0.643），月刊，创刊于1974年，由Blackwell Scientific Publications出版发行，可上该杂志网站订阅获取电子版。
网址：。
主编：Peter Svensson, Royal Dental College,Faculty of Health Sciences,University of Aarhus,Vennelyst Boulevard 9,DK-8000 Aarhus C,Denmark,Tel: +45 8942 4212, Fax: +45 8942 4297, Editorial Assistant：JanetMikkelsen,E-mail:************.dk。
3. 修复牙科学杂志J Prosthet Dent（The Journal of Prosthetic Dentistry，ISSN：0022-3913，IF：2003年为0.527），月刊，创刊于1951年，由Elsevier公司出版发行。
Local Anesthesia Techniques In Oral And Maxillofacial Surgery英文精品课件
Sean M. Healy, D.D.S.
Oral and Maxillofacial Surgery
Francis B. Quinn, M.D.
Otolaryngology – Head and Neck Surgery
Local Anesthetics:
• Role:
– Decrease intraoperative and postoperative pain
– Decrease amount of general anesthetics used in the OR
– Increase patients cooperation – Diagnostic testing/examination
– Inter-cranial – Pterygopalatine – Infraorbital – Facial
Maxillary Division (V2):
• Branches:
– Within the cranium- middle meningeal nerve providing sensory innervation to the dura mater
pterygoids
• Mylohyoid • Anterior belly of the digastric • Tensor tympani • Tensor veli palatini
Maxillary Division (V2):
• Exits the cranium via foramen rotundum of the
口腔外颌 英文版
口腔颌面外科是oral and maxillofacial surgery department广西医科大学口腔颌面外科是学院的旗舰与重点学科，它是中国口腔颌面外科新兴力量发展的代表。
数十年的发展，奠定了颌面外科影响广西乃至区域口腔学界的地位。
科室在周诺院长的领导下，医疗、教学、科研全面发展，科研、医疗实力雄厚，是一个在国内外口腔医学领域有着一定影响和知名度的学科，为广西和全国口腔医学临床事业的发展做出了巨大的贡献。
科室发展迅速，规模完善，分设一个门诊与两个病区，共计有椅位20张，病床72张。
专业器械有来复锯等全套微型器械、stryker动力系统及beanair动力系统等。
同时旗下设正颌中心与种植牙中心两个临床亚科室。
我科现有医师28位，其中正高级职称6位，副高级职称8位，其中具有博士学位7位，硕士学位11位，梯队结构合理，技术力量整齐，学术水平高，科研能力强，符合现代化学科的模式。
科室是一个团结合作，努力向上的集体。
老师做榜样，认真勤教侮，青年敬师长，刻苦学技术，奋发图强，共同组建一个注重学习、争作奉献、能出成果的学科。
科室业务开展齐全，技术水平先进，可独立开展常规临床技术项目，全面涵盖肿瘤、创伤、畸形、整形等颌面外科领域。
院长周诺教授于上个世纪率先开展的正颌外科技术在全国名列前茅，积累了丰富的经验和理论。
肿瘤外科则熟练掌握了带蒂游离皮瓣、肌皮瓣修复技术。
唇胯裂的综合序列治疗造福了数以千记的广大区内外患者和家庭。
口腔颌面外科主要有三个稳定的研究方向：牙颌面畸形治疗、口腔颌面部肿瘤综合治疗、口腔颌面部整形修复。
近五年获得国家自然科学基金资助项目8项，省部级项目19项。
研究成果获中华口腔医学会口腔医学研究创新奖1项，广西科技进步二等奖2项。
发表论文于SCI杂志3篇，核心期刊41篇。
在教学上科室承担了临床医学院五年制本科，口腔医学院五年制本科和硕士的教学任务，并招收东盟国家留学生。
近五年共培养硕士研究生63人，博士研究生5人，派出参加国家级继续医学教育18人次，共接受进修医师31人。
《口腔颌面外科杂志》官方微信开通
口腔颌面外科杂志2019年12月第29卷第6期Journal of Oral and Maxillofacial Surgery Vol.29No.6December 熏2019的一个不足之处。
总之,我们的研究表明,利用颞骨鼓部骨面引导显露面神经主干在临床上是一种可行的方法,具有安全、可靠和快捷的特点。
参考文献:[1]Nadershah M,Salama A.Removal of parotid,sub ⁃mandibular,and sublingual glands[J].Oral Maxillofac Surg Clin North Am,2012,24(2):295⁃305.[2]皮昕.口腔解剖生理学[M].7版.北京:人民卫生出版社,2012.[3]Isaacson B.Anatomy and surgical approach of the ear and temporal bone[J].Head Neck Pathol,2018,12(3):321⁃327.[4]O'Regan B,Bharadwaj G,Bhopal S,et al.Facial nerve morbidity after retrograde nerve dissection in parotid surgery for benign disease:a 10⁃year prospective observa ⁃tional study of 136cases [J].Br J Oral Maxillofac Surg,2007,45(2):101⁃107.[5]Mahmmood VH.Buccal branch as a guide for superficial parotidectomy[J].J Craniofac Surg,2012,23(5):e447⁃e449.[6]Huang G,Yan G,Wei X,et al.Superficial parotidectomy versus partial superficial parotidectomy in treating benign parotid tumors[J].Oncol Lett,2015,9(2):887⁃890.[7]Mehle ME,Kraus DH,Wood BG,et al.Facial nerve mor ⁃bidity following parotid surgery for benign disease:the Cleveland Clinic Foundation experience[J].Laryngoscope,1993,103(4):386⁃388.[8]Kim DY,Park GC,Cho YW,et al.Partial superficial parotidectomy via retroauricular hairline incision [J].Clin Exp Otorhinolaryngol,2014,7(2):119⁃122.[9]Swanson JW,Yu JW,Taylor JA,et al.The retroauricularapproach to the facial nerve trunk [J].J Craniofac Surg,2017,28(2):347⁃351.[10]Blau I,Vaisbuch Y,Marom A.A new method for tracingthe facial nerve trunk using the posterior auricular nerve [J].Clin Anat,2019,32(3):453⁃457.[11]O'Brien JX,Rozen WM,Ting JW,et al.A simplified land ⁃mark for the facial nerve trunk in parotidectomy:the ster ⁃nocleidomastoid origin [J].J Plast Reconstr Aesthet Surg,2012,65(6):832⁃833.《口腔颌面外科杂志》官方微信开通《口腔颌面外科杂志》已开通了官方微信公众号。
口腔颌面外科绪论
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概 念 （Concept)
• 口腔器官 （牙、牙槽骨、唇、颊、舌、腭、咽） • 面部软组织 （神经、血管、皮肤、肌肉） • 颌骨 （上颌骨、下颌骨、颧骨） • 颞下颌关节 • 涎腺 • 颈部
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疾 病 （disease）
• 感 染 infection • 损 伤 injure • 肿 瘤 tumor
with free pectoralis major myocu编ta辑nepoptus flap
13
恶性肿瘤侵及颅后凹的颅颌联合根治术
Radical resection (including posterio编r b辑opnpyt skull base) and reconstruction
14
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新教学园区
• 教学楼总建筑面积5500㎡ • 口腔模拟操作椅位60台，模拟诊室配备椅位15台
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生物样本库建设
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基因测序仪
口腔生物工程实验室
细胞培养室
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硬组织切片系63统
口腔微生物实验室
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上海生物材料研究测试中心
全自动病理设备
图像分析系统
头颈部恶性肿瘤侵犯高位颈动脉的切除与重建 Carotid artery resection and reconstruction
Recurrent parotid carcinoma involving the carotid artery, radical resection and carotid
（Dental Surgery Section） （Dental Surgeon）
探究应用颈椎骨龄定量分期法(QCVM)观察骨性Ⅱ类错
探究应用颈椎骨龄定量分期法 (QCVM)观察骨性Ⅱ类错畸形青少年患者上气道生长发育特点情况摘要：目的：研究颈椎骨龄定量分期法（QCVM）观察骨性Ⅱ类错 畸形青少年患者上气道生长发育的特点。
方法：作者选择我院在2019年1月至2021年6月期间收治的120例骨性Ⅱ类错 畸形青少年患者作为本次研究的对象，通过颈椎骨龄定量分期法将患者分成四期，分别为：Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期，然后通过X线头颅定位侧位片，比较不同颈椎骨龄分期的骨性Ⅱ类错 畸形患者的上气道特点以及周围组织特点。
结果：Ⅱ期患者的SNA、SNB、PNS-R、PNS-UPW高于Ⅰ期患者，差异无统计学意义（P＜0.05）；Ⅲ期患者的U-MPM高于Ⅱ期和Ⅰ期患者，差异有统计学意义（P＜0.05）；其余几项，四期比较，差异无统计学意义（P＞0.05）。
结论：颈椎骨龄定量分期法对骨性Ⅱ类错 畸形青少年患者的上下颌骨、上气道生长发育潜力进行评估，评估效果良好，能够指导此类患者做早期矫治，值得推广。
关键词：颈椎骨龄定量分期法、骨性Ⅱ类错 畸形、上气道、生长发育骨性Ⅱ类错畸形属于常见的错 畸形疾病，主要发生在恒牙期的青少年人群中，骨性Ⅱ类错畸形一般包括：矢状向、垂直向、水平向骨骼结构，其和牙弓之间的关系不协调，矢状向上，一般会表现为下颌后缩[1]。
目前，已有相关性研究表明：骨性Ⅱ类下颌后缩和上气道狭窄之间具有密切的联系[2]。
临床中，一般会采用功能矫治器治疗患者，使患者的下颌骨生长得到促进，进而对患者的面型进行改善，同时，又能够将上气道容积大大增加。
那么，治疗时机的选择对于患者的治疗也是十分重要的。
骨龄能够对患者颅面不生长发育进行有效预测，临床中也将骨龄作为颈椎疾病的诊断标准之一。
通过在正畸治疗前的头颅侧位片中，观察颈椎骨形态，能够有效防止对患者的手腕骨片造成二次伤害。
21世纪初，国内学者林久祥，陈莉莉等[3]创立了颈椎骨龄定量分期法(uantitative cervical vertebral maturationQCVM)，该方法能够定量分析患者的骨龄，从而对治疗时机进行有效评估[4]。
口腔颌面部肿瘤根治同期血管化组织瓣修复术的临床疗效观察
第30卷 第3期 中国现代医学杂志 Vol. 30 No.3 2020年 2月 China Journal of Modern Medicine Feb . 2020收稿日期：2019-07-09*基金项目：江苏高校优势学科建设工程资助项目（No ：2014-37）DOI: 10.3969/j.issn.1005-8982.2020.03.012文章编号： 1005-8982（2020）03-0059-05口腔颌面部肿瘤根治同期血管化组织瓣修复术的临床疗效观察*李怀奇，叶金海，丁旭，刘莉，武和明[南京医科大学附属口腔医院（南京医科大学口腔疾病研究江苏省重点实验室）口腔颌面外科，江苏 南京 210029]摘要：目的 观察和探讨口腔颌面部肿瘤根治同期血管化组织瓣修复术的临床效果。
方法 选取2015年8月—2017年2月南京医科大学附属口腔医院64例口腔颌面部肿瘤患者。
根据患者病情选择气管插管静脉复合麻醉方法；术中严密观察患者的生命体征，实施综合措施，减少手术时间及出血量；根据不同组织瓣修复术，将其分成股前外侧皮瓣组、小腿内侧皮瓣组、前臂皮瓣组及游离腓骨瓣组，对比各组患者手术治疗效果、术后功能及生存质量情况。
结果 患者体内组织瓣的存活率为95.31%（61/64），所有患者在住院治疗期间无死亡发生等恶性事件，顺利出院。
麻醉前后经皮血氧饱和度（SpO 2）、血压（BP）、平均动脉血压（MAP）及中心静脉压（CVP）比较，差异有统计学意义（P <0.05），均有不同程度改善。
各组血管吻合时间、术后皮瓣危象率及术后皮瓣成活率比较，差异无统计学意义（P >0.05）；各组患者间吐字发音和咀嚼吞咽功能恢复情况比较，差异无统计学意义（P >0.05）；各组患者术后总体生存质量评分比较，差异无统计学意义（P >0.05），各组患者术后均取得较满意效果。
结论 口腔额面部肿瘤类型较多，病情复杂，合理适宜且有针对性的血管化组织瓣对口腔颌面部肿瘤修复有显著的临床效果，口腔功能恢复好，提高患者术后生活质量。
口腔颌面部感染
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口腔专业英语考试重点(李树波)
课堂听写句子：1.This tooth have three four root anals,each canal appears to be quite small and curved and therefore,it takes time to clean out each canal thoroughly这颗牙齿有三四个根管，每个根管小且弯曲因此完全清干净要一定的时间。
（课本P9页倒数第四段里）2.your gums are very inflamed,swollen,and bleeding.so I suggest\recommend that you need to see the hygienist to have your teeth and gums cleaned.你的牙龈有炎症，肿胀且流血。
因此，首先建议洁牙。
课本各章节：（下面各章节下划线加粗的标记词为课堂听预约Have a check-up检查Chew on咀嚼take some radiographs 拍X片the initial consultation fee初诊费book up 预定cancellation删除surgery 手术recommend 推荐牙科检查carry out 执行，实施go through 仔细阅读，审查proceed to 继续instrument 器械cavity （复数cavities）龋洞filling 充填物crown(+s)牙冠gum牙龈take a set of x-ray films 拍一套X线片in the upper right side 右上部位be hurt 疼痛on and off 断断续续dental surgery 牙科诊所molar 磨牙premolar前磨牙put a filling充填high blood pressure高血压under the care of a medical doctor在药师的监护下apart from 除了……之外=besideswisdom teeth=the third molar 智齿check on 核实the lower right side右下部位（边）general health 全身健康questionnaire问卷eruption .n.（牙）萌出erupte.vt.萌出swollen肿胀jaw 颌骨have a x-ray film=have the x-ray taken拍X光片premolar 前磨牙molar磨牙上前牙In the upper left side 上左边Affect the nerve 累及神经Hygienist 洁牙员Stain 染色、污渍Tartar 牙垢\牙结石Dental floss牙线Tooth-coloured material牙齿光固化材料Dental decay 龋病Root canal treatment 根管治疗Full crown 全冠Extensive treatment 广泛的治疗Eliminate the disease 消除疾病Back teeth 后牙Be restored 修复Denture 假牙Bridge 固定桥Implant 种植体Breakdown of the treatment 分期付款cleanse、clean 洁治麻醉Numbness .n.麻醉Paste 膏剂The gums go a bit numb 牙龈有点麻Have a quick rinse 漱口Cheek 颊Splash 飞溅Suck out 吸出来Silver amalgam 银汞合金Resin material 树脂材料Apply some pressure 施加些压力（去腐质时用到）Saliva 唾液Salivary ejector 吸唾器Suction tip吸头Close together on your back teeth 咬一咬后牙（调牙合时用到）Occlusion and articulation （牙合）与关节The biting surfaces 咬合面Sticky areas 易卡住的区域Sealing the tooth over with a plastic resin 用树脂来覆盖（封闭）牙齿Durable 耐用的Cavity preparation洞形制备牙龈缘Oral hygiene instructions 口腔卫生指导Tartar deposits 牙垢Ultrasonic scaler 超声洁治器Hand instrumentsPolish 抛光Inflam 发炎Inflammation 炎症Bleeding 流血Toot-hpaste 牙膏Fluoride 氟Dental floss 牙线Tricky 难用的Sore 酸痛Abrasive 研磨作用Tooth-paste containing fluoride含氟牙膏Upper left molar 上左磨牙Put a filling in the cavity 充填龋洞Painkillers 止痛药Numb up the tooth 麻醉牙齿Local anaesthetic injection 局部麻醉注射Rubber dam 橡皮障Taking some painkillers 吃些止痛药The nerve is expose 牙髓暴露A post and core 桩和核（桩核）In the region of 在….区域Fracture off （修复体等）断裂Denture 义齿Bridge固定桥Extract the tooth =pull out the tooth 拨牙Give(have) a local anaesthetic 局麻Lost appetite没有胃口Glucose 葡萄糖Boost your blood sugar 提高血糖Faint 虚脱Squeeze the socket 挤压牙槽窝Gauze pad 纱布愈合Prescribe 开处方Erupte 萌出Put to sleep 催眠Remove some bone 移动骨组织Suture 缝合Haemostasis 止血Drill 钻Upper central incisor上中切牙Permanent bridge 永久固定桥Permanent cement 永久粘接剂cementum 水门汀adjacent teeth 邻接牙Porcelain tooth 烤瓷牙Fuse onto熔接到…..上面Be cemented onto 粘接到….上Take some impressions 取印模Pour some plaster 灌注石膏Temporary crown临时冠Emergency 急诊Prepare 2 supporting teeth 备2个基牙Have a heavy bite 咬合重Rock 摇动Vibration 振动Ulcer 溃疡Rub against your gums 摩擦你的牙龈Jaw 下颌，颌，颚 Palate 腭Dental plaque 牙菌斑Pellicle formation 获得性薄膜 Gingival crevicular fluid GCF 龈沟液 Streptococcus mutans 变形链球菌 Secret 分泌 Saliva 唾液Salivary glands 唾液腺 Parotid gland 腮腺Submandibular gland 下颌下腺 Sublingual gland 舌下腺 Buffering action 缓冲作用 Inorganic phosphates 无机磷酸盐 Buffering capacity 缓冲功能 Inorganic 无机的Bicarbonate 重碳酸盐离子句子P33 第一段Saliva is secreted by the three major salivary glands ,the parotid gland , submandibular gland , and the sublingual ,and by the very numerous minor salivary glands classified as lingual glands (on the tongue), buccal and labial glands (in the cheeks and lips) , palatine glands (in the palate ), and glossopalatine glands ( on the glossopalatine folds).唾液是由三大主要唾液腺分泌的，包括腮腺，下颌下腺和舌下腺。
医学英语口腔词汇汇总
医学英语口腔词汇汇总口腔科，医学学科分类之一。
主要口腔科疾病包括：口腔颌面部皮样、表皮颌下间隙感染、颌面部淋巴管瘤、齿状突发育畸形、上颌窦恶性肿瘤、颌骨造釉细胞瘤、慢性筛窦炎、下颌后缩、四环素牙、舌白斑等疾病。
为大家推荐医学英语口腔词汇汇总如下：Alveolarbone 牙槽骨carcinoma of maxillary sinus上颌窦癌carcinoma of tongue 舌癌cellulitis of the floor of the mouth口底蜂窝织炎cementum 牙骨质dental arch 牙弓dental crown 牙冠dental defect 牙体缺损dental necrosis 牙坏死dental sac 牙囊dentin 牙本质enamel 牙釉质endodontics 牙体牙髓病学extraction 拔牙术fascial space infection 间隙感染fluoride 氟化物fracture of maxillary 上颌骨骨折gum， gingiva 牙龈herpetic stomatitis 疱疹性口炎infraorbital space 眶下间隙jaw 颌骨leukoplakia 白斑lichen planus 扁平苔藓local anesthesia 局麻mucous cyst 粘液囊肿odontoclasis 牙折oral candidiasis 口腔念珠菌病oral hygiene 口腔卫生oral pathology 口腔病理学oral surgery 口腔外科orthodontics 正畸学osteomyelitis of the jaws 颌骨骨髓炎pediatric dentistry 口腔儿科学periodontal ligament 牙周韧带periodontal membrane 牙周膜periodontics 牙周病学prosthodontics 修复学pterygomandibular space 翼颌间隙public-health dentistry 口腔预防医学pulp exposure 牙髓暴露pulpectomy 牙骨摘除术pulpitis 牙髓炎pyogenic osteomyelitis 化脓性骨髓炎radiation osteomyelitis 放射性骨髓炎radicular syst 根端囊肿recurrent aphthae 复发性口疮root canal therapy 根管治疗root of tooth 牙根sublingual gland syst 舌下腺囊肿sublingual space 舌下间隙submasseteric space 嚼肌间隙submaxillary space 颌下间隙tartar 牙石temporomandibular joint 颞颌关节thrush 鹅口疮tooth decay 龋齿tooth replantation 牙再植术。
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5. 皮下组织中有表情肌，手术或创伤处理 时应注意表情肌的缝合，以避免影响表 情肌功能。
The area of the parotid gland and masseter muscle
• Boundaries • Constructures
三.腮腺咬肌区
（一）境界
（二）内容 1.腮腺
腮腺鞘的特点
四 腭 分为前 2/3 的硬腭和后 1/3 的软腭两部分。 （一）硬腭的表面标志 1.腭中缝 2.切牙乳头（腭乳头） 3.腭皱襞 4.上颌硬区和上颌隆突 5.腭大孔 6.蝶骨翼突钩 7.腭小凹
（二）硬腭软组织的特点 1.粘膜下层前部含有少量脂肪，无腺体； 后部则有较多的腭腺。 2.硬腭的骨膜与粘膜下层附着紧密，而与 骨面附着则不太紧密。 3.粘骨膜不易移动，能耐受磨擦和咀嚼压 力。 （三）软腭的肌群
• Coordination
• The features of The maxillo-facial soft tissue
二.颌面部软组织的特点 1. 皮肤薄而柔软，皮下组织疏松，易于 伸展移动。但鼻翼与颏部皮肤与皮下组
织结合紧密，不易伸展。
2.富于皮脂腺、毛囊和汗腺。
3.血管密集，血运丰富。
4.有皮肤皱纹，走向有一定的规律。
10.颈外静脉
11.副神经
12.胸膜顶
（三）颈筋膜
1.颈浅筋膜 2.颈深筋膜浅层
形成完整的封套包绕部
3. 颈深筋膜中层
上连舌骨，两侧至肩胛
舌骨肌外缘，向下附着于锁骨和胸骨柄 的后缘，并包被舌骨下肌群。
4. 颈脏器筋膜
包被颈部脏器，如喉、气
管、甲状腺、咽及食管等。
5.椎前筋膜（颈深筋膜深层）
Cervical part of trachea
（一）口腔的境界 境界及分部 （二）口腔前庭的表面标志 定义 1.口腔前庭沟（唇颊龈沟） 2.上、下唇系带 3.颊系带
4.腮腺导管口 5.磨牙后区 由磨牙后三角和磨牙后垫组成。 6.翼下颌皱襞 7.舌系带
Lip
• The boundaries of lip • Superficial anatomy of lip • Layers of lip
• The blood vessels 、lymphatic vessels and
nerves
二 唇
（一）唇的境界 （二）表面标志 （三）唇的解剖层次 1.皮肤 2.浅筋膜 比较疏松。 3.肌层 主要为口轮匝肌。 4.粘膜下层 有粘液腺和上、下唇动脉。 5.粘膜 有粘液腺开口。
（四）唇的血管、淋巴管及神经 1. 主要血供为颌外动脉的分支上、下 唇动脉，静脉血经面前静脉回流。 2.淋巴管很丰富 3. 唇的感觉神经来自上、下颌神经的 分支，运动则由面神经支配。
6.舌神经、颌下腺导管和舌下神经 三者位于颌下腺深面，在舌骨舌肌的浅 面，自上而下依此排列： 舌神经、颌下腺导管、舌下神经。
舌神经与颌下腺导管关系密切，从解剖关 系上可作以下鉴别： 1. 联系 舌神经连于颌下神经节，导管则 直接发自颌下腺。 2. 位置 在舌骨舌肌表面，舌神经位于导 管的上方。 3. 形态 舌神经比颌下腺导管粗而略扁， 且坚韧。
4.舌下动脉
The Local Anatomy of MaxilloFacial Area
第二节 颌面部局部解剖
一、颌面部表面标志及软组织特点
（一） 表面解剖标志 鼻根、鼻尖和鼻背 鼻底和鼻前孔 鼻小柱和鼻翼 鼻面沟 唇面沟 鼻唇沟
鼻唇沟 鼻下点 口裂 口角 颏唇沟 颏前点 颏下点 耳屏
体表投影 眶下孔、颏孔、腮腺导管、面神经出 茎乳孔的位置
• Boundaries and constructures
• Attention of tracheotony
二.气管颈段
（一）气管颈段前方的层次 （二）气管切开的注意点 1. 采取头正中后仰位，以免伤及颈总动脉， 并使气管位置变浅。
2. 一般在第 3 ～ 5 气管软骨环的范围内切开。
3. 切开时注意深度，以免伤及气管后壁，
3.舌中央淋巴管 汇入颈深上淋巴结，亦有汇入颌下淋巴 结者。 4.舌根淋巴管
汇入两侧颈深上淋巴结。
The floor of the mouth
• Boundaries • Constructures
六 口底舌下区
（一）境界
（二）内容
1.舌下腺及颌下腺深部
2.颌下腺导管及舌神经
3.舌下神经及其伴行静脉
2)
软组织标志点（略）
2.常用X线头影测量平面、角及线 距
1) 测量平面（硬组织） 前颅底平面(SN.SN plane) 眼耳平面(FH.Frankfortt horizontal plane)
牙合平面(OP.Occlusal plane)
2)
角度测量（硬组织）
• SAN角 • SNB角 • ANB角 • NA-PgA角(Angle of convexity,颌凸角）
1) • • • • 硬组织标志点 蝶鞍点(S.Sella) 鼻根点(N.Nasion) 耳点(P.Porion) 眶点(O.Orbitale)
• 翼上颌裂点(Ptm.pterygommaxillary fissure) • 前鼻点(ANS.Anterior nasal spine) • 后鼻点(A.Subspinale) • 下牙槽座点(B.Supramental) • 颏前点(Pg.Pogonion) • 颏下点(Me.Menton)
支、腮腺导管、面神经下颊支及下颌缘
支。
（4）腮腺浅叶下端神经血管的排列从前向 后依次为面神经下颌缘支、面神经颈支、 面后静脉 （5）腮腺深叶面的神经血管腮腺深叶的深 面与茎突诸肌及深部血管神经包括颈内 动、静脉和第Ⅸ～Ⅻ对脑神经
2.咬肌
位于腮腺咬肌筋膜的深面。
Lateral deep face
下以翼内肌附着于下颌支处为界。
（五）颞下颌间隙
位于翼颌间隙上方。前界上颌骨后面，后 界茎突及茎突诸肌，内界蝶骨翼突外侧板， 外界下颌支上份及颧弓，上界蝶骨大翼的 颞下面和颞下嵴，下以翼外肌下缘平面为 界。
（六）颞间隙 位于颞区，借颧弓与颞下嵴的平面和颞下 间隙分界，可分为颞浅间隙和颞深间隙两 部分。
甚至伤及食管。
4. 勿切第一气管软骨环，以免术后发生喉
部狭窄。
5.切开不应低于第5气管软骨环，以免引起 无名动脉等损伤。
Submandibular area
• Boundaries • Constructures
三.颌下区
（一）境界
（二）内容
1.颌下腺
2.颌下淋巴结 3.面前静脉
4.颌外动脉
5.颌下神经节
Bucca
• Boundaries • Layers and constructures
三、颊 （一）境界 （二）层次 1.皮肤。 2.皮下组织 3.颊筋膜 4.颊肌。 5.粘膜下层 含有粘液腺。 6.粘膜 有腮腺导管的开口。
Palate
• Superficial anatomy • The features of hard and soft palate • The muscles of soft palate
3）线距测量（硬组织）
• 前全面高 (Anterior total facial height,ATFH) • 前上面高 (Anterior upper facial height ,AUFH) • 前下面高 (Anterior lower facial height, ALFH)
3.临床应用
• 上颌骨水平位置 • 上颌骨垂直位置 • 下颌骨水平位置
四、面侧深区
（一）境界 （二）内容 1.翼丛 2.颌内动脉 3.翼外肌 4.下颌神经及其分支
Space
• Infraorbital space • Buccal space • Massetric space
• Pterygomandibular space
• Infratemporal space
第三节
颈部局部解剖
一概述 （一）颈部境界和分区 1.以斜方肌前缘为界
2.以胸锁乳突肌前、后缘为界
1）颈前三角 2）胸锁乳突肌区 3）颈后三角
（二）体表标志和体表头影 1.舌骨 2.甲状软骨
3.环状软骨
4.气管颈段（略）
5.胸锁乳突肌 6.锁骨上窝
7.胸骨上窝
8.颈总动脉和颈外动脉
9.锁骨下动脉
• 1.丝状乳头 • 2.菌状乳头 • 3.轮廓乳头
• 4.叶状乳头
• 舌后1/3粘膜无舌乳头，但有结节状淋巴 组织，称舌扁桃体。
（二） 舌腹
标志
1舌系带 2伞襞 3舌下肉阜 4舌下襞
（三）舌的淋巴管
1.舌尖淋巴管
大部分至颏下淋巴结，小部分至颈肩胛舌骨
肌淋巴结。 2.舌体边缘或外侧淋巴管 部分至颌下淋巴结，另一部分至颈深上淋巴 结。
腮腺与神经血管的关系
（1）腮腺内神经血管纵行的有：颞浅动静
脉、耳颞神经、面后静脉、颈外动。
横行的有：面神经、颌内动静脉及面横动
脉。
（2）腮腺浅叶上缘神经血管排列 从后向前依次为颞浅静脉、耳颞神经、 颞浅动脉、面神经颧支和颞支
（3）腮腺浅叶前缘结构从上到下依次排列
为面横动脉、面神经颧支、面神经上颊
（二）面部比例
（三）对称
（四）美容角
鼻额角
鼻面角
鼻唇角
鼻颏角
颏颈角
（五）X线头影测量
(cephalometric radiography)
是将X线头颅定位照相所得的影像转描于 描图纸上，显示各标志点并构成线、角、 面进行测量分析，用于正颌外科、口腔正 畸科及研究颅面生长发育。
1.常用X线头影测量标志点
（七）咽旁间隙（咽侧间隙） 位于翼内肌，腮腺深叶与咽侧壁之间，上 达颅底，下至舌骨平面，前界翼下颌韧带， 后界椎前筋膜