PDF(Pubmed)
Abstract：
BACKGROUND: Anatomical preservation and functional integrity of the facial nerve (FN) are the main concerns of parotid surgery. Even though a variety of anatomical landmarks have been proposed and widely utilized, temporal or permanent postoperative FN palsy is still a significant comorbidity of parotid surgery. Therefore, the literature must fully elucidate the consistency of the anatomical relationship between the FN and the retromandibular vein (RMV).
METHODS: We conducted a cadaveric study of 24 hemifaces to map the relationship between the FN and the RMV. Three distinct patterns were identified. Fourteen of the hemifaces were males, and 10 were females. Thirteen cadaveric dissections were performed on the right side and 11 on the left side.
RESULTS: Our study found three distinct patterns and proposed a classification system. Type I (66.7%) is when the nerve lies exclusively lateral to the RMV. Type II (29.2%) is when the FN lies superficial to the RMV, but its mandibular branch lies deep to the anterior branch of the RMV, and type III (4.1%) is when the FN lies exclusively medial to the RMV.
CONCLUSIONS: The FN and RMV relationship is not constant, and surgeons should be aware of every anatomical variation. Especially in cases where the FN is estimated to lie more in-depth to the level of the RMV, a retrograde approach may be required to avoid a FN injury.
METHODS: We conducted a cadaveric study of 24 hemifaces to map the relationship between the FN and the RMV. Three distinct patterns were identified. Fourteen of the hemifaces were males, and 10 were females. Thirteen cadaveric dissections were performed on the right side and 11 on the left side.
RESULTS: Our study found three distinct patterns and proposed a classification system. Type I (66.7%) is when the nerve lies exclusively lateral to the RMV. Type II (29.2%) is when the FN lies superficial to the RMV, but its mandibular branch lies deep to the anterior branch of the RMV, and type III (4.1%) is when the FN lies exclusively medial to the RMV.
CONCLUSIONS: The FN and RMV relationship is not constant, and surgeons should be aware of every anatomical variation. Especially in cases where the FN is estimated to lie more in-depth to the level of the RMV, a retrograde approach may be required to avoid a FN injury.
摘要：
背景：面神经（FN）的解剖保存和功能完整性是腮腺手术的主要关注点。尽管已经提出并广泛使用了各种解剖标志，暂时性或永久性术后FN麻痹仍然是腮腺手术的重要合并症。因此,文献必须充分阐明FN与下颌后静脉（RMV）之间的解剖关系的一致性。
方法：我们对24个半面进行了尸体研究，以绘制FN和RMV之间的关系。确定了三种不同的模式。十四个半脸是男性，还有10个是女性。在右侧进行了13例尸体解剖，在左侧进行了11例尸体解剖。
结果：我们的研究发现了三种不同的模式，并提出了一个分类系统。I型（66.7％）是神经仅位于RMV的外侧。II型(29.2%)是当FN位于RMV表面时，但是它的下颌分支位于RMV的前支深处，III型（4.1％）是当FN仅位于RMV中间时。
结论：FN和RMV关系不是恒定的，外科医生应该意识到每一个解剖变化。特别是在FN估计比RMV更深入的情况下，可能需要逆行入路以避免FN损伤。
方法：我们对24个半面进行了尸体研究，以绘制FN和RMV之间的关系。确定了三种不同的模式。十四个半脸是男性，还有10个是女性。在右侧进行了13例尸体解剖，在左侧进行了11例尸体解剖。
结果：我们的研究发现了三种不同的模式，并提出了一个分类系统。I型（66.7％）是神经仅位于RMV的外侧。II型(29.2%)是当FN位于RMV表面时，但是它的下颌分支位于RMV的前支深处，III型（4.1％）是当FN仅位于RMV中间时。
结论：FN和RMV关系不是恒定的，外科医生应该意识到每一个解剖变化。特别是在FN估计比RMV更深入的情况下，可能需要逆行入路以避免FN损伤。
