摘要
目的为颏下动脉穿支皮瓣的设计和安全切取提供解剖学基础。方法应用红色乳胶灌注新鲜尸体标本2具;使用改良了的明胶--氧化铅血管造影技术,灌注新鲜尸体标本8具。后者中的2具尸体,使用螺旋CT进行扫描并通过相应的软件存储扫描得到的图像,并三维重建。然后,对10具尸体层次解剖追踪颏下区外径≥0.5 mm的穿支,测量其走行、分支、分布情况并拍摄X线片。同时应用ScionImage软件对颏下动脉营养区域的表面积进行计算。结果颈前区和下颌前区皮肤和肌肉的营养主要通过:甲状腺上动脉、舌动脉、颏下动脉、颏动脉、面动脉等几个主要动脉的穿支供应。颏下动脉从面动脉起始处的直径为(1.7±0.4)mm,沿途发出(1.8±0.6)支穿支营养颏下区的皮肤。颏下动脉营养皮肤的范围为(45±10.2)cm2。其最大的一个穿支出现于二腹肌前腹内侧缘的后面。同时,面动脉、颏下动脉、舌下动脉的穿支之间存在丰富的吻合。结论本文阐述了颏下皮瓣的解剖学基础,并结合重建的三维可视化模型对皮瓣血供和皮瓣设计提供了依据。
Objective To provide algorithmic morphological data that enables safe elevation of the submental artery perforator flap.Methods Two fresh unfixed corpses underwent whole body latex injection;eight fresh cadavers were injected with a modified lead oxide-gelatin mixture.Two of them were selected for three-dimensional reconstruction using a spiral computed tomography scanner and specialized volume-rendering software.Ten specimens were dissected by layers.Angiography and photography were used to document the precise course,size,location,and type of individual perforators in the submental region.The surface areas of cutaneous territories and perforator zones were measured and calculate with Photoshop and Scion Image.Results The skin and muscles on the anterior neck and mandible are nourished by several arterial perforators： lingual artery,the superior thyroid artery,the submental artery,mental artery,and the facial artery.The diameter of the submental artery was（1.7±0.4）mm at its origin from the facial artery.It sends（1.8± 0.6） perforators to the skin on its course toward the chin.The average size of the territory supplied was（45± 10.2）cm2.Its largest perforating branch arised behind the medial border of the anterior belly of the digastrics muscle.There were multiple anastomosis between perforators from the submental artery,facial artery,and sublingual artery.Conclusions This study clarifies the anatomy of the submental flap and provides a three dimensional understanding to this important head and neck donor site.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2010年第6期603-605,610,共4页
Chinese Journal of Clinical Anatomy
基金
国家自然科学基金资助项目(30871308)
浙江省教育厅重点科研项目(20071000)
关键词
穿支皮瓣
颏下动脉
血管造影
三维重建
数字解剖学
Perforator flap
Submental artery
Angiography
3D-reconstruction
Digital anatomy
作者简介
丁茂超（1982-），男，湖北黄冈人，在读硕士，主要从事临床应用解剖学研究，E-mail：dingmaochao008@163．com
【通讯作者】唐茂林，教授，博士生导师，E-mail：mltang001@hotmail．com.Tel（0577）86689965
