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目的:探讨膈神经移位与面神经干吻合的解剖学基础。方法:解剖11具22侧成年尸体头颈部,观察并测量:①膈神经根与面神经总干腮腺区分叉处之间的距离;②膈神经干在颈部可利用长度;③面神经总干腮腺区分叉处游离至水平半规管下缘可利用长度,面神经总干腮腺区分叉处游离至水平半规管下缘较游离至茎乳孔处增加的面神经干可利用长度;④面神经总干腮腺区分叉处至水平半规管下方切断处膈神经干及面神经干神经移位后并列放置重合长度。结果:①膈神经根与面神经总干腮腺区分叉处之间的距离为(7.2±0.9)cm。②膈神经起点至锁骨下静脉上缘平面为(7.2±1.6)cm。③面神经总干腮腺区分叉处至水平半规管下方切断处的长度2.7~3.5 cm,较面神经干自茎乳孔下方切断增加1.0~1.5 cm。④神经移位后重合长度为0.4~1.8 cm。结论:在锁骨下静脉上缘平面切断20侧标本膈神经可与自乳突内切取的面神经干无张力吻合,两侧膈神经不能与自乳突内切取的面神经干无张力吻合。
Objective: To investigate the anatomic basis of phrenic nerve transposition and facial nerve stem anastomosis. Methods: The head and neck of 11 adult cadavers with 11 sides were dissected and observed. The distance between phrenic nerve roots and the total parotid gland of the facial nerve was calculated. The available length of the phrenic nerve in the neck was measured. Parotid Division fork at the free to the level of the lower edge of the semicircular canal can be used length, facial parotidectomy parotid free fork to the lower edge of the horizontal semicircular canal free to stem milk hole increased facial nerve trunk available length; ④ facial parotidectomy parotid gland area Bifurcation to the level below the semicircular canal at the cut off phrenic nerve trunk and facial nerve dry shift after the parallel placement of overlap length. Results: ① The distance between phrenic nerve root and facial parotid gland division fork was (7.2 ± 0.9) cm. ② The origin of phrenic nerve to the superior margin of subclavian vein was (7.2 ± 1.6) cm. ③ Facial parotid gland division of the fork to the level below the semicircular canal at the cut off the length of 2.7 ~ 3.5 cm, than the facial nerve stem cut from the hole below the increase of 1.0 to 1.5 cm. ④ nerve shift coincidence length of 0.4 ~ 1.8 cm. CONCLUSION: The phrenic nerve of the 20 sides of the subclavian vein can be cut off from the upper edge of the subclavian vein without tension with the facial nerve stem cut from the mastoid. The bilateral phrenic nerve can not fit with the facial nerve cut from the mastoid.