摘要
目的为颏下逆行带蒂岛状皮瓣修复颜面部皮肤软组织缺损的可行性及手术操作提供解剖学依据。方法解剖20例40侧福尔马林固定、颈总动脉灌注红色乳胶的成人头颈标本及4例灌注汞溴红、2例灌注亚甲蓝的新鲜成人头颈标本,测量相关动脉的外径及相关标志点之间的距离(以±s表示);观察两侧面动脉之间、面动脉与颞浅动脉及眼动脉终未之间的吻合情况,观察面动、静脉的行程要点及其与面神经各分支之间的位置关系,观察面静脉与相关静脉之间的吻合情况。结果颏下动脉、上唇动脉、下唇动脉起点处的外径(±s,以下同)分别为(1.42±0.30)mm、(1.34±0.35)mm、(1.34±0.27)mm。下唇动脉起点至颏下动脉起点直线距离为(35.19±9.18)mm,实际距离为(50.13±13.79)mm;上唇动脉起点至颏下动脉起点直线距离为(64.99±5.24)mm,实际距离为(92.09±8.73)mm。双侧面动脉之间、面动脉与颞浅动脉及眼动脉终末之间有丰富的吻合。在下颌缘水平,面动、静脉相贴伴行,面神经下颌缘支跨过其浅面;在下颌缘水平以上,面静脉行于面动脉后外约1 cm 处,面神经颊支经面静脉表面于面动、静脉之间入表情肌。面静脉通过内眦静脉与眼静脉、面深静脉与上颌静脉之间有良好的交通。结论以颏下逆行带蒂岛状皮瓣修复颜面部皮肤软组织缺损在解剖上具有可行性,建议皮瓣的旋转点选择在口角或口角以下平面。
Objective To provide anatomic data for clinical use of reversed submental island flap in reconstruction of buccal and facial defects. Methods Twenty cadavers with 40 sides of head and neck which were fixed by formalin and perfused by red emulsion, 6 fresh cadavers which were perfused by coloring agent were dissected, observed and measured. Results The diameter of the submental artery, the superior lip artery and the inferior lip artery at their origins were respectively （ 1.42 ± 0. 30） mm （x^- ± s, same at below）, （ 1.34 ±0. 35） mm and （ 1.34 ±0. 27） mm respectively. The realistic distance from the origin of inferior and superior lip arteries to the origin of submental artery were （50. 13 ± 13.79） mm and （92. 09 ± 8.73 ） mm, respectively. However, the straight distances from the origin of inferior and superior lip arteries to the origin of submental artery were （ 35.19 ± 9. 18） mm, （64.99 ± 5.24） mm, respectively. There were rich anastomoses between both facial arteries, and the facial arteries also anastomosed richly with the ophthalmic artery and the superficial temporal artery. On the marginal mandibular plane, the facial vein ran closely with the artery, the marginal mandibular branch of the facial nerve crossed superficially to the facial blood vessels ; superior to this plane, the vein ran 1 cm behind the artery. The buccal branches of the facial nerve crossed superficially to the facial vein and ran into the muscles behind or across the facial artery. The facial vein anastomosed richly with the ophthalmic vein and the maxillary vein. Conclusion There is anatomic feasibility for the reconstruction of buccal and facial defects by using pedicled submental reversed island flap. The reversing point of the flap ought to be at the cheilion plane or inferiorly.
出处
《中华耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2007年第4期268-272,共5页
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
关键词
颏
外科皮瓣
解剖学
局部
Chin
Surgical flaps
Anatomy, regional
