METHODS: For the purpose of this work, a cadaveric study was performed on 31 hemi-faces. All dissections were performed bilaterally and comparatively, following steps aiming at simulating, as close as possible, the clinical conditions of a facial palsy rehabilitation by V-VII anastomosis.
RESULTS: For the identification of the masseteric nerve, bony reference points were used, i.e., the temporomandibular joint (TMJ) and the chin point (CT). A virtual axis was drawn between the TMJ and the CT, and the distance [TMJ-MN] determining the smallest length h was then plotted against the distance [TMJ-CT] determining the largest length H, thus allowing the calculation of an h/H proportion ratio (PR) indicating the proximal part of the masseteric nerve from the TMJ. The average length h between the TMJ and the NM was 3.5 cm (± 0.1 cm) from the TMJ, i.e., an average ratio h/H [TMJ-MN]/[TMJ-CT] of 28.1% 4.0 and a median ratio of 28.6% of the distance [TMJ-CT].
CONCLUSIONS: Our study opens new perspectives for facilitating its identification and use, offering practitioners a tool to make V-VII the neurotization procedure less complex, with the eventual prospect of a minimally invasive procedure combining imaging, surgery, and augmented reality.
方法:出于这项工作的目的,对31个半面进行了尸体研究。所有解剖都是双侧和比较的,以下旨在模拟的步骤,尽可能接近,通过V-VII吻合术进行面部麻痹康复的临床状况。
结果:关于咬肌神经的鉴定,使用骨骼参考点,即,颞下颌关节(TMJ)和下巴点(CT)。在TMJ和CT之间绘制了虚拟轴,然后将确定最小长度h的距离[TMJ-MN]与确定最大长度H的距离[TMJ-CT]作图,因此允许计算h/H比例比(PR),该比例表示来自TMJ的咬肌神经的近端部分。TMJ和NM之间的平均长度h为TMJ的3.5厘米(±0.1厘米),即,h/h[TMJ-MN]/[TMJ-CT]的平均比值为28.1%4.0,距离[TMJ-CT]的中值比值为28.6%。
结论:我们的研究为促进其识别和使用开辟了新的视角,为从业者提供了一种工具,使V-VII神经化程序不那么复杂,随着结合成像的微创手术的最终前景,手术,和增强现实。