新鲜冷冻越南尸体中颏神经的骨外解剖：经前庭入路经口腔内镜甲状腺切除术中前庭切口与穿刺器放置的解剖学考量
Extraosseous mental nerve anatomy in fresh-frozen Vietnamese cadavers: anatomical considerations for vestibular incisions and trocar placement in transoral endoscopic thyroidectomy via the vestibular approach.
文献信息
| PMID | 42778775 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Quang Nguyen Xuan |
| 作者单位 | Hanoi Medical University, Hanoi, Vietnam. |
| 期刊 | Surgical and radiologic anatomy : SRA |
| SCI 分区 | Q2 |
| IF | 1.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 经前庭入路经口腔内镜甲状腺切除术（TOETVA）可提供极佳的美容效果，但会引入与颏神经相关的特定解剖学挑战。尽管颏孔的位置已被广泛研究，但关于颏神经骨外走行、分支模式及层次关系的详细信息仍有限。本研究旨在描述新鲜冷冻越南尸体中颏神经的骨外解剖，并提供与TOETVA前庭切口规划和穿刺器放置相关的解剖学信息。
方法： 对15具新鲜冷冻越南成年尸体进行描述性解剖学研究，共提供30条颏神经用于分析。系统解剖颏孔及骨外颏神经分支。记录形态学参数、分支模式以及神经分支与周围软组织层次之间的关系。
结果： 颏孔最常位于与第二前磨牙对齐的位置（50.0%）。颏神经在出颏孔后早期即发生分支，至第一分支点的平均距离为3.17±2.55 mm。分支模式表现出相当大的变异性，观察到Hu分类的全部五种类型，46.7%的尸体存在两侧不对称。出颏孔后，颏神经始终位于骨膜浅面。在所有标本中，角支和下唇侧支均走行于口轮匝肌深面，而颏支最常相对于颏肌走行于浅面。
结论： 颏神经在出颏孔后表现出早期骨外分支和一致的层次解剖关系。这些发现为TOETVA前庭切口规划和穿刺器放置提供了重要的解剖学信息。
英文摘要
BACKGROUND: Transoral endoscopic thyroidectomy via the vestibular approach (TOETVA) provides excellent cosmetic outcomes but introduces specific anatomical challenges related to the mental nerve. Although the location of the mental foramen has been extensively studied, detailed information regarding the extraosseous course, branching pattern, and layer-based relationships of the mental nerve remains limited. This study aimed to characterize the extraosseous anatomy of the mental nerve in fresh-frozen Vietnamese cadavers and provide anatomical information relevant to vestibular incision planning and trocar placement in TOETVA.
METHODS: A descriptive anatomical study was performed on 15 fresh-frozen Vietnamese adult cadavers, providing 30 mental nerves for analysis. The mental foramen and extraosseous mental nerve branches were dissected systematically. Morphometric parameters, branching patterns, and relationships between nerve branches and surrounding soft tissue layers were recorded.
RESULTS: The mental foramen was most commonly located in line with the second premolar (50.0%). The mental nerve divided early after exiting the foramen, with a mean distance to the first branching point of 3.17 ± 2.55 mm. Branching patterns showed considerable variability, with all five Hu classification types observed and side-to-side asymmetry present in 46.7% of cadavers. After exiting the foramen, the mental nerve was consistently superficial to the periosteum. The angular and lateral inferior labial branches coursed deep to the orbicularis oris muscle in all specimens, while the mental branch most commonly followed a superficial course relative to the mentalis muscle.
CONCLUSION: The mental nerve demonstrates early extraosseous branching and consistent layer-based anatomical relationships after exiting the mental foramen. These findings provide important anatomical information relevant to vestibular incision planning and trocar placement in TOETVA.