背景:耳颞部神经是与面神经连通的周围神经之一。然而,人们对这些通信的功能知之甚少。这些通信如何形成和相互联系的细节仍不清楚。此外,用于在手术期间定位这些通信的可靠解剖标志尚未得到充分描述。
方法:对10具柔软防腐尸体的20个外侧半面进行显微解剖,以研究面-耳-颞神经的沟通,重点是确定其功能。在下颌后间隙中发现了耳颞神经,并追踪到其末端。遵循交通分支,并观察与周围结构的解剖关系。
结果:耳颞神经悬挂在下颌支后面的致密的下颌后筋膜中的上颌动脉上方。它形成一个结,扇出,在矢状面的所有方向上提供多个分支。卑鄙的,它连接上颌周围动脉丛,而微小的分支在颞下颌关节的前部供应。较大的分支主要与面神经颞面部分支的分支相通,耳支向后进入耳软骨的筋膜。颞部分支和偶尔的zy部分支向上出现,分布在颞顶筋膜内。耳颞神经通过两种类型的交流形成腮腺下颌后丛。它发送一到三个分支,以在颞面部分区的分支区域连接面神经的zu和颊分支。它还与颞浅动脉和上颌动脉的动脉丛连通。该神经丛沿着面神经的分支和面横动脉的动脉周围神经丛向前延伸,作为腮腺周围导管自主神经丛,在腮腺的两个主要分区的环路内供应腮腺导管的分支。
结论:在一些标本中,由耳颞神经产生的单个皮肤骨分支,腮腺内与颌骨和面神经的颊干通讯,下颌后与颞上颌浅动脉丛的通讯,两个主要面部分区的环路之间的导管周围自主神经丛导致以下建议:耳颞神经的这些通信将分泌运动传递到面神经的zy和颊分支。
方法:本期刊要求作者为每个提交的证据分配一个级别,该级别的证据适用于循证医学排名。这不包括评论文章,书评,和有关基础科学的手稿,动物研究,尸体研究,和实验研究。对于这些循证医学评级的完整描述,请参阅目录或在线作者说明www。springer.com/00266.
BACKGROUND: The auriculotemporal nerve is one of the peripheral nerves that communicates with the facial nerve. However, the function of these communications is poorly understood. Details of how these communications form and connect with each other are still unclear. In addition, a reliable anatomical landmark for locating these communications during surgery has not been sufficiently described.
METHODS: Microdissection was performed on 20 lateral hemifaces of 10 soft-embalmed cadavers to investigate facial-auriculotemporal nerve communications with emphasis on determining their function. The auriculotemporal nerve was identified in the retromandibular space and traced towards its terminations. The communicating branches were followed and the anatomical relationships to surrounding structures observed.
RESULTS: The auriculotemporal nerve is suspended above the maxillary artery in the dense retromandibular fascia behind the mandibular ramus. It forms a knot and fans out, providing multiple branches in all directions in the sagittal plane. Inferiorly, it connects the maxillary periarterial plexus, while minute branches supply the temporomandibular joint anteriorly. The larger branches mainly communicate with the branches of the temporofacial division of the facial nerve, and the auricular branches enter the fascia of the auricular cartilage posteriorly. The temporal branches and occasionally the zygomatic branches arise superiorly to distribute within the temporoparietal fascia. The auriculotemporal nerve forms the parotid retromandibular plexus through two types of communication. It sends one to three branches to join the zygomatic and buccal branches of the facial nerve at the branching area of the temporofacial division. It also communicates with the periarterial plexus of the superficial temporal and maxillary arteries. This plexus continues anteriorly along the branches of the facial nerve and the periarterial plexus of the transverse facial artery as the parotid periductal autonomic plexus, supplying the branches of the parotid duct within the loop of the two main divisions of the parotid gland.
CONCLUSIONS: A single cutaneous zygomatic branch arising from the auriculotemporal nerve in some specimens, the intraparotid communications with the zygomatic and the buccal trunks of the facial nerve, the retromandibular communications with the superficial temporal-maxillary periarterial plexuses, and the periductal autonomic plexus between the loop of the two main facial divisions lead to the suggestion that these communications of the auriculotemporal nerve convey the secretomotor to the zygomatic and buccal branches of the facial nerve.
METHODS: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.