磨牙后管(后磨牙孔)。概述和病例报告]。

Thomas von Arx, Michael M Bornstein, Peter Werder, Dieter Bosshardt
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引用次数: 0

摘要

一位19岁的女病人被推荐去拔掉她的智齿。全景x线片显示双侧下颌骨后磨牙管。由于后磨牙管在解剖学教科书中被忽视,并且在科学出版物中很少有文献记载,因此该病例促使我们在患者知情同意的情况下进行进一步的诊断检查。在手术切除患者右下智齿期间,进行了有限锥束计算机断层扫描,并对磨牙后孔出现的软组织束进行了活检。根据文献,组织学显示髓鞘神经纤维,小动脉和小静脉。关于磨牙后管的文献资料有限,这条骨管可能传递异常的颊神经。此外,感觉神经纤维从上进入磨牙后管并分支到下颌磨牙,可以逃避在下颌孔处的阻滞麻醉。这些罕见的解剖特征可能解释了为什么磨牙后管的元素会导致下颌阻滞麻醉失败或术后颊神经供应区的敏感性改变。
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[The retromolar canal (foramen retromolare). Overview and case report].

A 19-year old female patient was referred for removal of her wisdom teeth. The panoramic radiograph showed bilateral retromolar canals in the mandible. Since the retromolar canal is neglected in anatomical textbooks and is rarely documented in scientific publications, the case prompted us to perform further diagnostic examinations with informed consent by the patient. A limited cone beam computed tomography was made and, during the surgical removal of the patient's lower right wisdom tooth, a biopsy of the soft tissue bundle emerging from the retromolar foramen was taken. In accordance with the literature, the histology revealed myelinated nerve fibers, small arteries and venules. The limited data available in the literature about the retromolar canal report that this bony canal may convey an aberrant buccal nerve. In addition, sensory nerve fibers entering the retromolar canal from above and branching to the mandibular molars may evade a block anesthesia at the mandibular foramen. These rare anatomic features may explain why the elements of the retromolar canal account for failures of mandibular block anesthesia or postsurgical sensitivity changes in the supply area of the buccal nerve.

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