面神经下颌缘支的分支分布及其入肌点位置研究

doi:10.13418/j.issn.1001-165x.2026.5.01

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中国临床解剖学杂志 ›› 2026, Vol. 44 ›› Issue (5) : 499-506. DOI: 10.13418/j.issn.1001-165x.2026.5.01

应用解剖

面神经下颌缘支的分支分布及其入肌点位置研究

周妍^{1, 2#}，邢嘉轩^{1, 3#}，唐炜¹，淳璞¹，王成元⁴，崔忠康⁵，向鸣倩⁵，隋鸿锦^{1, 6}，于胜波¹*

作者信息 +

Study on the distribution characteristics of the mandibular marginal branch of the facial nerve and their entry points into the muscles

Zhou Yan^{1, 2#}, Xing Jiaxuan^{1, 3#}, Tang Wei¹, Chun Pu¹, Wang Chengyuan⁴, Cui Zhongkang⁵, Xiang Mingqian⁵, Sui Hongjin^{1, 6}, Yu Shengbo¹*

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文章历史 +

摘要

目的观察下颌缘支走行、分支类型及进入降口角肌和降下唇肌的情况，为口周微表情对称性调整及临床手术提供解剖学依据。方法通过解剖30侧成年头颈部标本和观察3例P45断层塑化标本，观察下颌缘支与邻近结构位置关系、走行类型、分支点位置以及降口角肌支与降下唇肌支入肌点位置等。结果下颌缘支主干从腮腺前缘（96.7%）或下缘（3.3%）发出后，在咬肌下端以下（30.0%）或表面走行（70.0%），与面动脉呈深面型（23.3%）、浅面型（50.0%）或与之形成血管神经襻（26.7%），随后于下颌缘上方（70.0%）和下颌缘下方走行（30.0%）。下颌缘支分支走行过程可分为单干型、双干型、合干型和假单干型。进入降口角肌的入肌点距咬肌前缘（32.5±10.47） mm、距下颌缘（16.8±5.91） mm；进入降下唇肌的入肌点距咬肌前缘（48.0±7.87） mm、距下颌缘（16.5±6.06） mm。结论下颌缘支分支变异大，存在4种类型，以咬肌前缘和下颌缘可有效定位降口角肌支和降下唇肌支的走行区域性特点，为减少手术损伤风险、提高手术效果提供应用解剖基础。

Abstract

Objective To observe the course, branch type and entry of the marginal mandibular branch (MMB) into the depressor anguli oris muscle and depressor labii inferioris muscle, so as to provide anatomical basis for symmetry adjustment of perioral microexpression and clinical surgery. Methods By dissecting 30 adult head and neck specimens and observing 3 P45 sheet plastination specimens, the relationship between the MMB and adjacent structures, the type of course, the location of branch points, and the entry points of the depressor anguli oris muscle branch and depressor labialis inferior muscle branch were observed. Results The main trunk of the MMB arose from the anterior edge (96.7%) or lower edge (3.3%) of the parotid gland, ran beneath (30.0%) or on the surface (70.0%) of the lower end of the masseter muscle , and lay deep to (23.3%), superficial to (50.0%) form a deep facial type, or formed a neurovascular loop with the facial artery (26.7%). The MMB coursed above the mandibular margin (66.7%) and below the mandibular margin (33.3%). The course of the branches of the MMB could be divided into single-stem type, double-stem type, combined-stem type and pseudo-single-stem type. The entry point of the MMB into the angular ori muscle was (32.5±10.47) mm from the front edge of the masseter muscle and (16.8±5.91) mm from the mandibular edge, the entry point into the depressor labii inferioris muscle was (48.0±7.87) mm from the front edge of the masseter muscle and (16.5±6.06) mm from the mandibular edge. Conclusions The branches of the MMB exhibits significant variation, with four types identified. The course of the depressor anguli oris and depressor labii inferioris branches can be effectively localized based on the anterior border of the masseter and the mandibular border, providing an applied anatomical basis for reducing surgical risks and improving surgical results.

导出引用

周妍, 邢嘉轩, 唐炜, 淳璞, 王成元, 崔忠康, 向鸣倩, 隋鸿锦, 于胜波. 面神经下颌缘支的分支分布及其入肌点位置研究[J]. 中国临床解剖学杂志. 2026, 44(5): 499-506 https://doi.org/10.13418/j.issn.1001-165x.2026.5.01

Zhou Yan, Xing Jiaxuan, Tang Wei, Chun Pu, Wang Chengyuan, Cui Zhongkang, Xiang Mingqian, Sui Hongjin, Yu Shengbo. Study on the distribution characteristics of the mandibular marginal branch of the facial nerve and their entry points into the muscles[J]. Chinese Journal of Clinical Anatomy. 2026, 44(5): 499-506 https://doi.org/10.13418/j.issn.1001-165x.2026.5.01

中图分类号： R322.85

参考文献

[1] 高俊彦, 李明, 吴海平, 等. 面神经下颌缘支和颊支的应用解剖学研究[J]. 长治医学院学报, 2011, (4): 256-258. DOI:10.3969/j.issn.1006-0588.2011.04.005.
Gao JY, Li M, Wu HP, et al. Applied Anatomy Research of the Marginal Mandibular and Buccal Branch of the Facial Nerve[J]. Journal of Changzhi Medical College, 2011, (4): 256-258. DOI:10.3969/j.issn. 1006-0588.2011.04.005.
[2] 易德保, 罗特坚. 面神经下颌缘支的应用解剖[J]. 解剖学研究, 2014, 36 (3): 168-169,175. DOI:10.20021/j.cnki.1671-0770.2014.03.003.
Yi DB, Luo TJ. Applied anatomy of marginal mandibular branch of facial nerve[J]. Anatomy Research, 2014, 36 (3): 168-169,175. DOI: 10.20021/j.cnki.1671-0770.2014.03.003.
[3] Lindsey JT, Jr., Lee JJ, Phan HTP, et al. Defining the Cervical Line in Face-Lift Surgery: A Three-Dimensional Study of the Cervical and Marginal Mandibular Branches of the Facial Nerve[J]. Plast Reconstr Surg, 2023, 152 (5): 977-985. DOI:10.1097/PRS.0000000000010369.
[4] Babuci A, Stratulat S, Zorina Z, et al. Marginal mandibular branch of the facial nerve-anatomical peculiarities and clinical aspects[J]. Folia Morphol, 2025, 84 (3): 565-573. DOI:10.5603/fm.104026.
[5] Gatti AP, Ribeiro MT, Hojaij F. Anatomical variations of the marginal mandibular nerve[J]. Clinics, 2025, 80: 100548. DOI:10.1016/j.clinsp. 2024.100548.
[6] Strantzias P, Botou A, Manoli A, et al. Variation of Marginal Mandibular Nerve in a Caucasian Male Cadaver: A Study Using the Anatomage Table[J]. Cureus, 2019, 11 (11): e6168. DOI:10.7759/cureus.6168.
[7] 王朋晖, 钟树圣, 苏荣彬. 颌下腺表面分离入路对颌下腺良性疾病面神经下颌缘支的保护效果[J]. 实用中西医结合临床, 2022, (9): 43-46. DOI:10.13638/j.issn.1671-4040.2022.09.011.
Wang PH, Zhong SS, Shu RB. Protective effect of submandibular gland surface separation approach on facial nerve mandibular marginal branch in benign submandibular gland diseases[J]. Practical Clinical Journal of Integrated Traditional Chinese and Western Medicine, 2022, (9): 43-46. DOI:10.13638/j.issn.1671-4040.2022.09.011.
[8] Qian W, Zhang Y-K, Lv W, et al. Application of Local Injection of Botulinum Toxin A in Cosmetic Patients with Congenital Drooping Mouth Corner[J]. Aesthetic Plast Surg, 2016, 40(6): 926-930. DOI: 10.1007/s00266-016-0711-0.
[9] 王洁晴. 面神经颧支、下颌缘支入肌点的应用解剖学研究[D]. 大连医科大学, 2008. DOI: 10.7666/d.y1308567.
Wang JQ. Applied anatomy study of localizations of zygomatic branch and marginal mandibular branch and marginal mandibular branch of facial nerve to muscles[D]. Dalian Medical University, 2008. DOI: 10.7666/d.y1308567.
[10]许家洲, 薛黔. 面部表浅肌肉腱膜系统及面神经的定位[J]. 遵义医学院学报, 2013, 36 (6): 521-524. DOI: 1000-2715(2013)06-0521-04.
Xu JZ, Xue Q. The location of superficial musculo aponeurotic system and facial nerve[J]. Journal of zunyi medical university 2013, 36 (6): 521-524. DOI:1000-2715(2013)06-0521-04.
[11]Sindel A, Özalp Ö, Yıldırımyan N, et al. Evaluation of the course of the marginal mandibular branch of the facial nerve: a fresh cadaveric study[J]. Br J Oral Maxillofac Surg, 2021, 59 (2): 179-183. DOI:10.1016/j.bjoms.2020.08.020.
[12]Marolt C, Freed B, Coker C, et al. Key Anatomical Clarifications for the Marginal Mandibular Branch of the Facial Nerve: Clinical Significance for the Plastic Surgeon[J]. Aesthet Surg J, 2021, 41 (11): 1223-1228. DOI:10.1093/asj/sjaa368.
[13]丛源, 刘静雯, 孙晓旭, 等. 鼻唇沟区面动脉分支的应用解剖学研究[J]. 局解手术学杂志, 2024, 33 (10): 882-886. DOI:10.11659/jjssx. 11E023040.
Cong Y, Liu JW, Sun XX, et al. Applied anatomical study of facial artery branches in the nasolabial groove area[J]. Journal of Regional Anatomy and Operative Surgery, 2024, 33 (10): 882-886. DOI: 10.11659/jjssx.11E023040.
[14]王得利, 张大伟, 赵微. 面神经下颌缘支的应用解剖与颌面外科的关系[J]. 牡丹江医学院学报, 2009, 30 (1): 1-3. DOI:10.3969/j.issn.1001-7550.2009.01.001.
Wang DL, Zhang DW, Zhao W. The Association Between Maxillofacial Surgery And Facial Nerve Marginal Mandibular Branch of Applied Anatomy[J]. Journal of Mudanjiang Medical University, 2009, 30 (1): 1-3. DOI:10.3969/j.issn.1001-7550.2009.01.001.
[15]Marcuzzo AV, Šuran-Brunelli AN, Dal Cin E, et al. Surgical Anatomy of the Marginal Mandibular Nerve: A Systematic Review and Meta-Analysis[J]. Clin Anat, 2020, 33 (5): 739-750. DOI:10.1002/ca.23497.
[16]董博, 王学东. 面神经下颌缘支的应用解剖[J]. 局解手术学杂志, 2008, 17 (3): 177-178. DOI:10.3969/j.issn.1672-5042.2008.03.014.
Dong B, Wang XD. Applied anatomy of the marginal mandibular branch of the facial nerve[J]. Journal of Regional Anatomy and Operative Surgery, 2008, 17 (3): 177-178. DOI:10.3969/j.issn.1672-5042.2008.03.014.
[17] 孙宇. 面神经下颌缘支的应用解剖学研究[D]. 延边大学, 2009. DOI: 10.7666/d.D01177075.
Sun Y. Anatomosurgical Research of the MarginalMandibular Branch of the Facial Nerve[D]. Yanbian University, 2009. DOI:10.7666/d.D0 1177075.
[18]王晓敏, 李慧, 陈德尚, 等. 高位咽旁间隙良性肿瘤的手术治疗[J]. 临床耳鼻咽喉头颈外科杂志, 2018, 32 (23): 1804-1809. DOI:10.13201/j.issn.1001-1781.2018.23.009.
Wang HM, Li H, Chen DS, et al. The surgical management of upper parapharyngeal regions[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2018, 32 (23): 1804-1809. DOI:10.13201/j.issn.1001-1781.2018.23.009.
[19] 和子晴. 基于解剖研究的降口角肌肉毒毒素注射方法探索[D]. 南华大学, 2024. DOI:10.27234/d.cnki.gnhuu.2024.000686.
He ZQ. Exploration of the Injection of Botulinum Neurotoxins in the Depressor Anguli Oris Based on Anatomical studie[D]. University of South China, 2024. DOI:10.27234/d.cnki.gnhuu.2024.000686.
[20]Krag AE, Dumestre D, Hembd A, et al. Topographic and Neural Anatomy of the Depressor Anguli Oris Muscle and Implications for Treatment of Synkinetic Facial Paralysis[J]. Plast Reconstr Surg, 2021, 147 (2): 268e-278e. DOI:10.1097/PRS.0000000000007593.
[21]孙诗竹, 于胜波, 隋鸿锦. P45断层塑化技术在应用解剖学研究中的应用[J]. 中国临床解剖学杂志, 2021, 39 (2): 240-243. DOI: 10.13418/j.issn.1001-165x.2021.02.026.
Sun SZ, Yu SB, Sui HJ. Application of the P45 sectional plastination technique in applied anatomic study[J]. Chinese Journal of Clinical Anatomy, 2021, 39 (2): 240-243. DOI:10.13418/j.issn.1001-165x. 2021.02.026.
[22]马希达, 淳璞, 赵士磊, 等. 基于P45断层塑化技术和硬组织切片技术的纵隔薄膜性结构的组织学研究[J]. 中国临床解剖学杂志, 2025, 43(5):520-528. DOI:10.13418/j.issn.1001-165x.2025.5.04.
Ma XD, Chun P, Zhao SL, et al. Histological study of mediastinal membranous structures based on plastination 45 sectional plastination technique and hard tissue sectioning technique[J]. Chinese Journal of Clinical Anatomy, 2025, 43(5):520-528. DOI:10.13418/j.issn.1001-165x.2025.5.04.
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