The Great Auricular Nerve: Anatomical Study with Application to Nerve Grafting Procedures
The Great Auricular Nerve: Anatomical Study with Application to Nerve Grafting Procedures
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DOI：
10.1016/j.wneu.2019.01.087
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发表时间：
2019-05-01
影响因子：
2
通讯作者：
Tubbs, R. Shane
中科院分区：
文献类型：
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作者：
Altafulla, Juan;Iwanaga, Joe;Tubbs, R. Shane
背景：在自体神经移植中，腓肠神经和耳大神经是主要用于三叉神经和面神经修复的两条神经。GAN发自第二、第三颈前支，从胸锁乳突部后缘向耳上方和前方发出。方法：使用5具高加索人和1具亚洲人身体头骨的11侧标本(均为新鲜冰冻标本)。男1例，女5例，死亡年龄57~91岁，平均80.3岁。测量耳廓下缘至GAN、GAN至颈外静脉、乳突下缘至GAN，测量耳廓下缘至GAN、耳下缘至GAN、乳突下缘至颈外静脉的平均距离，测量GAN的近、中、远端直径及长度。GaN的平均长度为74.86 mm。其远、中、近端的平均直径分别为1.51、1.38和1.58 mm。结论：GAN是修复面部功能障碍等神经移植的理想选择。在这项研究中，我们回顾了GaN的测量方法、鉴定技术和解剖技术。与手术区域的接近和与GaN移植相关的最小并发症可能有助于提高患者满意度和更好的功能恢复结果。
BACKGROUND: When it comes to autogenous nerve grafting, the sural and great auricular nerve (GAN) are the 2 nerves predominately used for trigeminal and facial nerve repair. Arising from the second and third cervical ventral rami, the GAN emerges from the posterior border of the sternocleidomastoid coursing superiorly and anteriorly toward the ear.METHODS: Eleven sides from 5 Caucasian and 1 Asian cadaveric heads (all fresh-frozen) were used. One man and 5 women were used with an age at death ranging from 57 to 91 years, with a mean of 80.3 years. Measurements were made from the inferior border of the ear to the GAN, the GAN to the external jugular vein, and the inferior border of the mastoid process to the GAN; the proximal, medial, and distal diameters of the GAN and the length of the GAN that was obtained from this exposure were also measured.RESULTS: The mean distance from the inferior border of the mastoid process to the GAN, inferior border of the ear to the GAN, and GAN to the external jugular vein was 27.71, 31.03, and 13.28 mm, respectively. The mean length of the GAN was 74.86 mm. The mean diameter of its distal, middle, and proximal portions was 1.51, 1.38, and 1.58 mm, respectively.CONCLUSIONS: The GAN is an excellent option for use in nerve grafting for repair of, for example, facial dysfunction. In this study, we review our measurements, techniques for identification, and dissecting techniques for the GAN. The proximity to the operative area and minimal complications associated with GAN grafting might contribute to improved patient satisfaction and better outcomes regarding functional restoration.