中国临床解剖学杂志 ›› 2020, Vol. 38 ›› Issue (2): 123-126.doi: 10.13418/j.issn.1001-165x.2020.02.002

• 穿支皮瓣 • 上一篇    下一篇

面动脉穿支蒂颊黏膜瓣重建泪道的解剖学基础

卫旭东1, 凌能本1, 李小静2, 宁金龙2    

  1. 1.肥西县人民医院骨科,  安徽   肥西    231200;    2.安徽医科大学第一附属医院整形外科,  合肥   230022 
  • 收稿日期:2019-12-30 出版日期:2020-03-25 发布日期:2020-03-30
  • 通讯作者: 李小静,教授,博士生导师,E-mail:lixiaojing5@163.com
  • 作者简介:卫旭东(1990-),硕士,研究方向:骨、关节、软组织损伤与修复,Tel:15155966655,E-mail:weixudong1990@163.com
  • 基金资助:
    安徽省科技攻关项目(1604a0802078)

Anatomical study of the buccal mucosal flap based on the facial artery perforator for reconstruction of lacrimal duct

WEI Xu-dong1, LIN Neng-ben1, LI Xiao-jing2, NING Jin-long2   

  1. 1. Department of Orthopedics, Feixi People's Hospital, Feixi 231200, Anhui Province, China; 2. Department of Plastic Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
  • Received:2019-12-30 Online:2020-03-25 Published:2020-03-30

摘要: 目的 为面动脉穿支蒂颊黏膜瓣重建泪道提供解剖基础。 方法 在10个20侧动脉内灌注红色乳胶的成人头标本上解剖观测:①面动脉穿支的起源、分支与分布;②颊动脉的起源、分支与分布;③面动脉与颊动脉的吻合。另在1侧新鲜标本上进行摹拟手术设计。  结果 颊黏膜的血供为多源性,主要由面动脉、颊动脉和上牙槽后动脉发出的穿支供养。①面动脉自颈外动脉发出,行至咬肌前缘越过下颌骨底达面部后,再斜向内上至内眦处与鼻背动脉吻合,沿途除发出分支营养颈、面部相应区域外,在口角外侧(1.10±0.31)cm 处分出1~3支颊支,支配颊肌与颊黏膜前中部,并与颊动脉颊支、上牙槽后动脉颊支形成吻合;②颊动脉发自上颌动脉的翼肌段,行于颞肌下部深面前下方向,沿途发支分布于颊黏膜后中部,并与面动脉穿支相互吻合。当上颌动脉分出颊支细短时,则由粗大的上牙槽后动脉颊支(占5%)代偿。   结论 颊黏膜瓣血供丰富,可形成以面动脉穿支为蒂颊黏膜瓣转位重建泪道。

关键词: 面动脉,  颊动脉,  颊黏膜瓣,  泪道

Abstract: Objective To provide anatomical basis for reconstructing the lacrimal duct by the buccal mucosa flap based on the facial artery perforator. Methods 20 sides of 10 adult head specimens were perfused with red latex and were dissociated to observe the following contents: ①The origin, branches and distribution of the facial artery perforators; ②The origin, branches and distribution of the buccal artery. ③The anastomosis of the facial artery and the buccal artery. In addition, mimic operation design was performed on one side of the fresh specimen. Results The blood supply of the buccal mucosa was multi-source, which was mainly composed of the perforating branches from the facial artery, buccal artery and posterior superior alveolar artery. ① The facial artery commonly arose from the external carotid artery, then crossed over the mandibular bone at the front edge of the masseter muscle and arrived at the face, and finally ran obliquely towards the medial canthus to anastomose with the dorsal nasal artery. The facial artery sent out several branches to nourish the neck region and face region on its way. It also sent out 1~3 buccal branches at (1.10 ± 0.31) cm lateral to the angulus oris, innervating the buccal muscle and the front-middle part of mucosa and anastomosing with the buccal branches of buccal artery and the buccal branches of the posterior superior alveolar artery; ②The buccal artery originated from the pterygoid segment of the maxillary artery and ran anteriorly and inferiorly under the deep surface of the temporal muscle. It sent out branches, which distributed at the postero-middle part of the buccal mucosa, and anastomosed with the perforators of the facial artery. When the maxillary artery sent out thin and short buccal branches, the thick posterior superior alveolar artery buccal branches with a 5% occurrence rate  compensated them. Conclusions The buccal mucosal flap based on the facial artery perforator is abundant in blood supply and may become a supplement for the reconstruction of the lacrimal duct.

Key words: Facial artery,  ,  , Buccal artery,  Buccal mucosa flap,  Lacrimal duct

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