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背景:颞肌筋膜法动力性矫正晚期面神经麻痹(以下简称面瘫)的手术中,存在颞肌血管神经定位困难的问题。为明确颞肌的精细解剖而设计了此次实验。目的:通过分组进行人类颞肌的血管神经分束研究,以阐明颞肌动力修复晚期面瘫的显微解剖应用基础。设计:随机对照的研究。单位:南方医科大学南方医院整形外科及解剖教研室。对象:收集2000年自愿遗体捐助的20具24h内死亡的新鲜尸体头部标本,其中男性12具,女性8具,年龄在16～50岁,平均30岁,死因均为感染或肿瘤等疾病,随机分为4组。方法:分别用氧化铅、墨汁或甲基丙烯酸树脂进行血管灌注,并进行神经显微解剖染色,结果拍摄照片,在计算机中进行图像叠加,从而形成血管神经的分束构筑图。主要观察指标:①颞肌形态。②颞肌前动脉、颞深后动脉及颞中动脉直径、长度和分布面积百分比。③颞深前神经、颞深后神经及颞中神经直径、长度和分布面积百分比。④颞肌静脉的分布。⑤颞肌神经血管的分束。结果:颞肌具有可利用的、有独立神经血管支配的三个肌肉分区,互相之间有丰富的吻合支。结论:晚期面瘫眼、鼻和口部畸形的动力矫正可选用对应的颞肌神经血管束一期完成。
BACKGROUND: Temporal myofascial dynamic correction of advanced facial paralysis (hereinafter referred to as facial paralysis) surgery, there is the problem of temporomandibular vascular nerve localization difficulties. This experiment was designed to clarify the fine anatomy of the temporalis muscle. OBJECTIVE: To study the micro-anatomical application of temporomandibular motion in the repair of advanced facial paralysis by grouping the vascular nerve splitting of human temporalis muscle. Design: A Randomized Controlled Study. Unit: Southern Hospital of Southern Medical University, Department of Plastic Surgery and Anatomy. PARTICIPANTS: Twenty new dead head samples collected within 24 hours from donations of voluntary remains were collected from 2000, including 12 males and 8 females, aged from 16 to 50 years old, with an average of 30 years of age. All of the deaths were caused by infections or tumors. Randomly divided into 4 groups. Methods: Vascular perfusion was performed with lead oxide, ink or methacrylic resin, respectively, and neuromicroscopic dissection was performed. Results were taken and images were superimposed on a computer to form a vascular bundle. MAIN OUTCOME MEASURES: ① temporal muscle morphology. ② temporal anterior artery, deep temporal artery and temporal artery diameter, length and distribution area percentage. ③ temporal deep anterior nerve, deep temporal nerve and temporal nerve diameter, length and distribution area percentage. ④ temporal muscle vein distribution. ⑤ temporal muscle neurovascular bundle. RESULTS: The temporalis muscle had three muscle segments that were available and had independent neurovascular dominance and rich anastomosis between each other. CONCLUSION: The dynamic correction of ocular, nasal and oral deformities in late facial paralysis can be performed in one phase with the corresponding temporal muscle neurovascular bundle.