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目的:根据颈筋膜解剖特点,改进传统的先天性肌性斜颈的手术方法。方法:选取经福尔马林固定,颈部无肉眼病变的成人尸体标本12具。沿锁骨切开皮肤、颈阔肌,向上在颈筋膜浅层浅面(封套筋膜)进行仔细分离,观察封套筋膜和颈阔肌的相互关系,粘连程度。以锁骨上方1.5cm水平为中心,在胸锁乳突肌内缘内侧0.5cm纵行剪开封套筋膜约3cm,在胸锁乳突肌后鞘深面进行分离达胸锁乳突肌外侧,感觉分离的难易程度,观察封套筋膜和颈动脉鞘的完整性。结果:封套筋膜在颈前完整、致密,将胸锁乳突肌完整套封,颈阔肌与封套筋膜可以轻易地完整分离;在颈中下部胸锁乳突肌后鞘与颈动脉鞘也无粘连,各自独立,很容易完整分离。结论:依据胸锁乳突肌前后筋膜鞘的结构特点,可以将先天性肌性斜颈传统手术加以改进,提高疗效。
Objective: To improve the traditional surgical method of congenital muscular torticollis according to the anatomical features of the cervical fascia. METHODS: Twelve adult cadaver specimens with formalin-fixed and non-gross neck lesions were selected. Cut the skin along the clavicle, platysma, upward in the superficial cervical fascia (fascia fasciculus) were carefully separated to observe the relationship between the envelope fascia and platysma, degree of adhesion. To the top of the supraclavicular 1.5cm level, within the inner edge of the sternocleidomastoid muscle 0.5cm longitudinal cut open the fascia about 3cm, in the sternocleidomastoid muscle deep sheath isolated from the lateral sternocleidomastoid muscle lateral, Feel the ease of separation and observe the integrity of the cuff and carotid sheath. Results: The fascia fascia was intact and dense at the neck. The sternocleidomastoid muscle was completely closed and the platysma and the fascia were easily separated completely. The posterior sternocleidomastoid sheath and carotid sheath Also no adhesion, independent, it is easy to complete separation. Conclusion: According to the structural characteristics of the fascia sheath before and after the sternocleidomastoid muscle, the traditional surgical treatment of congenital muscular torticollis can be improved to improve the curative effect.