顏面神經位於後頜支靜脈內側之罕見變異

A Rare Variation of the Facial Nerve Medial to the Retromandibular Vein

李元淳(Yuan-Chen Lee) ； 李佳茹(Chia-Ru Li) ； 侯昭祥(Chu-Siang Haw) ； 許信德(Hsin-Te Hsu) ； 蔡青劭(Stella Chin-Shaw Tsai)

《台灣耳鼻喉頭頸外科雜誌》 43卷4期 (2008/08) Pp. 102-105

https://doi.org/10.6286/2008.43.4.102

摘要

所有頭頸部腫瘤中腮腺腫瘤只佔了3%，其中80%是良性，而最常見的類型是多形性腺瘤。治療方法是以手術切除爲主。然而多形性腺瘤有復發的機會，且有可能轉變爲惡性腫瘤，手術中爲確實徹底清除腫瘤，通常執行淺葉或深葉腮腺切除。一般腮腺切除手術時，爲了摘除腫瘤及保留顏面神經的完整，對手術者經常是一大挑戰。因此在手術時，常會參考一些重要的解剖位置，包括顏面神經位在耳屏指標下約1至1.5cm，及顏面神經與後頜支靜脈的相關位置等。本文提出一良性混合瘤病例，其顏面神經上下分支都位於後頜支靜脈的下方，不同於一般的位於後頜支靜脈的上方，實屬罕見。

關鍵字

顏面神經 ； 後頜支靜脈

並列摘要

Comprising less than 3% of all head and neck neoplasms, eighty per cent of salivary gland tumors present as benign tumors, and the most common histopathological diagnosis is pleomorphic adenoma. The treatment of choice is surgery. As pleomorphic adenoma has a tendency to recur, as well as a potential for transformation into malignancy, thorough removal of the tumor via superficial and/or deep parotidectomy is warranted. It is a technical challenge to surgeons to excise the tumor and preserve the integrity of the facial nerve in parotid gland surgeries. Often, important anatomical landmarks will be chosen as reference points, including the landmark about 1 to 1.5 cm beneath the tragal point, and the anatomical relationship between the facial nerve and the retromandibular vein. In this report, we present a rare case of benign pleomorphic adenoma, in which both the upper and lower divisions of the facial nerve are located below the retromandibular vein, in contrast to the usual location of the facial nerve above the retromandibular vein.

並列關鍵字

facial nerve ； retromandibular vein