背景:关于面神经干(FNT)方向通过茎乳孔后的变异性的知识对于颌面外科医生具有重要的临床意义,耳鼻喉科医师,肿瘤学家,整形和美容手术专家。我们研究的目的是建立FNT方向的变化及其依赖于分支模式的特性,性别,人体测量类型和头部侧面。
方法:在成年尸体(59男/16女)的75个解剖半面上研究了FNT的方向及其分支模式,和FNT长度的形态计量学,进行了宽度和分叉角。
结果:建立了7种面神经分支模式:I型-18.7%,II型-14.7%,III型-20%,IV型-14.6%,V型-5.3%,VI型-18.7%,和NI型-8%(奇异类型)。在73.3%的病例中,FNT呈下降方向;上升的FNT-9.3%(包括5.3%的非常短的弥漫性分支干和1.3%的拱形FNT);水平FNT-10.7%;数量变异-6.7%。下降的FNT的男女比例为69.5%/87.4%;上升-10.2%/6.3%;水平-11.9%/6.3%;数量变异-8.4%(仅男性)。下降FNT的右/左比率为62.9%/82.5%;上升-11.4%/7.5%;水平-11.4%/10%;数字变体-14.3%(仅在右侧)。头膜型(MCT)/短脑型(BCT)/头脑型(DCT)中FNT下降的比率分别为70.6%/100%/66.7%;上升-12.1%/0%/0%;水平-12.1/0%/11.1%。MCT的数值变化-5.2%,DCT-22.2%。MCT/BCT/DCT中FNT的平均数分别为1.07/1.0/1.22。
结论:FNT的特征是三个主要方向:下降,上升和水平的,取决于分支模式,性别,头部的形状和侧面。
BACKGROUND: Knowledge concerning variability of the facial nerve trunk (FNT) direction after its exit through the stylomastoid foramen is of a great clinical significance for maxillofacial surgeons, otorhinolaryngologists, oncologists, specialists in plastic and aesthetic surgery. The aim of our study was to establish the variation of the FNT direction and its
peculiarities depending on the branching pattern, gender, anthropometric type and side of the head.
METHODS: The direction of the FNT and its branching pattern were studied on 75 dissected hemifaces of adult formalised cadavers (59 male/ /16 female), and the morphometry of the FNT length, width and bifurcation angle was carried out.
RESULTS: Seven branching patterns of the facial nerve were established: type I - 18.7%, type II - 14.7%, type III - 20%, type IV - 14.6%, type V - 5.3%, type VI - 18.7%, and type NI - 8% (bizarre types). The FNT had a descending direction in 73.3% of cases; ascending FNT - 9.3% (including 5.3% of very short diffuse branching trunks and 1.3% of arch-shaped FNT); horizontal FNT - 10.7%; number variants - 6.7%. The male/female ratio of the descending FNT was 69.5%/87.4%; ascending - 10.2%/6.3%; horizontal - 11.9%/6.3%; number variants - 8.4% (only in male). The right/left ratio of the descending FNT was 62.9%/82.5%; ascending - 11.4%/7.5%; horizontal - 11.4%/10%; number variants - 14.3% (only on the right side). The ratio of the descending FNT in mesocephalic type (MCT)/brachycephalic type (BCT)/dolichocephalic type (DCT) was respectively 70.6%/100%/66.7%; ascending - 12.1%/0%/0%; horizontal - 12.1/0%/11.1%. Numerical variants in MCT - 5.2%, in DCT - 22.2%. The mean number of FNT in MCT/BCT/DCT was respectively 1.07/1.0/1.22.
CONCLUSIONS: Three main directions are characteristic of the FNT: the descending, ascending and horizontal ones, which vary depending on the branching pattern, gender, shape and side of the head.