【 文献重点摘要 】

BACKGROUND

The supratrochlear nerve (STN) is relatively superficial and therefore vulnerable to iatrogenic injury.

OBJECTIVE

To elucidate the course of STN with reference to the lacrimal caruncle, with the aim of preventing nerve injury during surgery in the forehead region.

MATERIALS AND METHODS

Thirty-four hemifaces from 18 Korean cadavers were dissected. The vertical line through the apex of lacrimal caruncle and the horizontal line through the supraorbital margin were used as horizontal and vertical reference lines, respectively. The course of STN in the frontal view and the point at which it pierced the overlaying musculature were examined.

RESULTS

After exiting the corrugator muscle cushion, the STN enters the subcutaneous plane by piercing the frontalis muscle. These piercing points occurred at mean horizontal and vertical distances relative to the medial branch of the STN of 9.2 and 9.6 mm, respectively; the corresponding distances for the lateral branch of the STN were 1.1 and 15.3 mm, respectively.

CONCLUSION

When performing surgery in the medial forehead region, the surgeon must ensure that the dissection plane of forehead tissue is more superficial: superiorly within 1.5 cm from the supraorbital margin and medially within 1.0 cm from the vertical line through the apex of lacrimal caruncle.

背景

滑车上神经(STN)相对较浅，易受医源性损伤。

目的

以泪肉为参照，阐明STN的病程，以预防额部手术中神经损伤的发生。

材料与方法

解剖18具韩国人身体的34个半面。以通过泪肉尖的垂直线和通过眶上缘的水平线分别作为水平参考线和垂直参考线。观察STN在正位的走行及其穿透上覆肌层的位置。

结果

STN离开皱肌垫后，通过穿刺额肌进入皮下平面。这些穿刺点相对于STN内侧支的平均水平距离为9.2 mm，相对于STN内侧支的垂直距离为9.6 mm，相对于STN外侧支的相应距离分别为1.1 mm和15.3 mm。

结论

额部内侧区手术时，必须确保额部组织的剥离平面较浅：距眶上缘1.5 cm以内，距垂直线内侧1.0 cm至泪肉肉尖。