【 文献重点摘要 】
 

Background: The motor innervation of the lower orbicularis oculi has not been clearly established. There is a discrepancy between anatomical descriptions and clinical outcomes of the motor innervation of the pretarsal orbicularis oculi muscle. Therefore, the purposes of this study were to identify every motor and sensory nerve of the lower eyelid, and to reveal the detailed motor nerve pathways toward the medial canthal area.

Methods: Fresh cadaver dissections were performed on 50 hemifaces under a surgical microscope. Submuscular and intramuscular nerves of the lower eyelid were identified, and the pathways of facial nerves that ran toward the medial canthus were traced.

Results: Vertical submuscular nerves at the lower eyelid originated from the infraorbital foramen, indicating that all were sensory nerves. The zygomatic branch of the facial nerve traveled obliquely through the anterior cheek and supplied the orbicularis oculi of the lower eyelid and the medial portion of the upper eyelid. Its route was defined as a clinically useful line, the medial orbicularis motor line. In addition, the nerve innervating the pretarsal orbicularis oculi arose at the superomedial preseptal area and extended horizontally and laterally. Interestingly, the angular nerve appeared not to innervate the palpebral orbicularis oculi.

Conclusions: In the lower eyelid, the vertical sensory and the oblique motor nerve supplies are independent and clearly distinguished in aspect of their own routes. The medial orbicularis motor line represents the motor route to the medial portion of the orbicularis oculi. These results might provide valuable knowledge about surgical anatomy for safe lower blepharoplasty with or without midface lift.

背景：眼轮匝肌下部的运动神经支配尚不清楚。睑前轮匝肌运动神经支配的解剖学描述与临床结果之间存在差异。因此，本研究的目的是识别下眼睑的每一条运动神经和感觉神经，并揭示通向内斜角区的详细运动神经通路。

方法：在手术显微镜下对50侧新鲜身体进行解剖。确定了下眼睑的肌下神经和肌内神经，并追踪了面神经向内眼角的路径。

结果：下睑垂直肌下神经起源于眶下孔，均为感觉神经。面神经颧支斜行于前颊部，分布于下睑眼轮匝肌和上睑内侧。其入路被定义为一条临床有用的线，即内侧眼轮匝肌运动线。此外，支配睑前眼轮匝肌的神经起于隔前上内侧区，并向水平和外侧延伸。有趣的是，角神经似乎没有支配眼睑轮匝肌。

结论：下睑的垂直感觉神经和斜行运动神经供应是独立的，在各自的路径上有明显的区别。内侧眼轮匝肌运动线代表通向眼轮匝肌内侧部分的运动路线。这些结果可能为安全的下睑成形术提供有价值的外科解剖学知识，包括面中部提升术和非提升术。