颞浅动脉在耳前区分支的应用解剖研究

发布时间：2018-06-28 19:47

本文选题：皮瓣 + 耳前区　；参考：《第二军医大学》2010年硕士论文

【摘要】： 研究目的：观察颞浅动脉在耳前区的分支情况,为提高耳前区局部皮瓣的成活率和长宽比提供解剖学支持,并指导临床应用。研究方法：①观察范围：后界为过耳屏点的垂线,前界为耳屏点前方3cm的垂线。上界为耳屏点上方3cm的水平线,下界为耳屏点下方7cm的水平线。②用乳胶灌注10%甲醛溶液固定的头部标本10具,进行大体解剖,观察颞浅动脉在耳前区分支的起始位置、走行方向及分布区域。③用死亡6小时以内的新鲜尸体头部标本2具制作透明标本(面部软组织全层透明),测量颞浅动脉在耳前区分支的分布面积。研究结果：耳前区皮肤及皮下组织的血液主要由颞浅动脉及其分支,如颧眶动脉、颞浅动脉耳屏前皮支、面横动脉等供应。颧弓上方区域主要由颧眶动脉供应。颧弓下方区域由下颌角与外眦点的连线分成两部分：后上方由颞浅动脉耳屏前皮支和颧眶动脉主干向下的分支供应,前下方由面横动脉的小分支供应。以上动脉及其分支之间有丰富的吻合。颧眶动脉大多数起源于颞浅动脉的主干,起始点距耳屏点约7mm,沿颧弓上缘向眶外侧前行,走行中分为上下两支,分别供应上睑和下睑的眼轮匝肌。颧眶动脉主干在走行过程中,分别向上方和下方发出小的分支,供应相邻的皮肤及皮下组织。颞浅动脉在耳屏前有恒定的皮支发出。该皮支出现率100%,起始点位于耳屏点下方38.17±3.26(mm),起始点直径0.61±0.27(mm)。该动脉在腮腺后方向上走行,于耳屏前穿出SMAS层,穿出点在耳屏点前下方13.15±1.56(mm),穿出点处的血管直径平均0.53±0.12(mm)。该皮支穿出SMAS层后分成2-3支,与过耳屏点的垂线成约30。角向下分布于腮腺浅面的皮下组织及皮肤,分布范围为18.64±2.32(cm2),并与面横动脉、颧眶动脉、面动脉等动脉的分支有丰富的吻合。颞浅动脉耳屏前皮支在以往的文献中未见详细描述。该动脉属于颞浅动脉的分支,起始点直径约0.6mm,在血供类型上,属于动脉皮支。因该动脉恒定地于耳屏前穿出SMAS供应耳屏前及其下方的皮肤及皮下组织,故我们称其为颞浅动脉耳屏前皮支。面横动脉在耳前区主要走行于SMAS深面,行至耳前区前下方时发出分支垂直穿过SMAS层次,然后逐级分支,形成数个终末支供应皮肤及皮下组织,这些终末支供应范围较小,相互之间吻合丰富。结论：耳前区皮肤及皮下组织的血液主要由颞浅动脉及其分支颧眶动脉、颞浅动脉耳屏前皮支、面横动脉等供应,上述动脉之间吻合丰富。其中,颞浅动脉耳屏前皮支在以往的文献中未见详细描述。该皮支出现率高,SMAS穿出点位置恒定,供应范围较大,临床上利用该皮支可在耳前区形成半岛状轴型皮瓣或岛状皮瓣,用以修复周围组织缺损。
[Abstract]:Objective: to observe the branches of superficial temporal artery in preauricular region and to provide anatomical support for improving the survival rate and aspect ratio of the local flap. Methods: the range of observation: the posterior boundary is the perpendicular line of the trapezoid point and the front boundary is the perpendicular line of 3cm in front of the auricular point. The upper boundary was the horizontal line of 3cm above the auricular point, and the lower boundary was the horizontal line .2 of 7cm below the auricular point. 10 head specimens fixed with 10% formaldehyde solution were perfused with latex. The initial position of the branches of the superficial temporal artery in the preauricular region was observed. In the direction and distribution area, 2 fresh cadaveric head specimens within 6 hours of death were used to make transparent specimens (the whole layer of facial soft tissue transparency), and the distribution area of superficial temporal artery branches in the preauricular region was measured. Results: the blood of skin and subcutaneous tissue in preauricular area was mainly supplied by superficial temporal artery and its branches, such as zygomatic-orbital artery, anterior cutaneous branch of superficial temporal artery and transverse facial artery. The area above the zygomatic arch is mainly supplied by the zygomatic-orbital artery. The area below the zygomatic arch is divided into two parts by the line between the mandibular angle and the outer canthus: the anterior cutaneous branch of the superficial temporal artery and the main branch of the zygomatic-orbital artery are supplied from the anterior cutaneous branch of the superficial temporal artery and the main branch of the zygomatic-orbital artery, and the inferior part is supplied by the small branch of the transverse facial artery. There is abundant anastomosis between the above arteries and their branches. Most of the zygomatic-orbital arteries originated from the main trunk of the superficial temporal artery, and the starting point was about 7 mm from the point of the auricle, and along the superior edge of the zygomatic arch to the lateral side of the orbit, there were two branches in the middle of the line, supplying the orbicularis oculi muscle of the upper eyelid and the lower eyelid, respectively. The zygomatic-orbital artery sends out small branches to the upper and lower, supplying adjacent skin and subcutaneous tissue. The superficial temporal artery has a constant cutaneous branch in front of the auricle. The appearance rate of the cutaneous branch is 100%, and the starting point is 38.17 卤3.26 (mm), below the auricular point. The diameter of the starting point is 0.61 卤0.27 (mm). The artery runs upwards behind the parotid gland and penetrates the SMAS layer in front of the tragus. The average diameter of the vessel at the point of perforation of 13.15 卤1.56 (mm), in front of the auricular point is 0. 53 卤0. 12 (mm). The skin branch is divided into 2-3 branches after the SMAS layer is perforated, which is about 30% of the vertical line across the auricular point. The angle was distributed downwards in the subcutaneous tissue and skin of the superficial parotid gland, with a range of 18.64 卤2.32 (cm2), with abundant anastomosis with the branches of the transverse facial artery, the zygomatic-orbital artery and the facial artery. The anterior cutaneous branch of the superficial temporal artery is not described in detail in previous literature. The artery is a branch of the superficial temporal artery with a diameter of about 0.6 mm and belongs to the cutaneous branch of the artery in the type of blood supply. SMAS is used to supply the skin and subcutaneous tissue before and below the auricle, so we call it the cutaneous branch of the superficial temporal artery. The transverse facial artery mainly runs in the anterior ear area on the deep side of the SMAS. When it reaches the anterior and inferior preauricular area, it sends out branches perpendicular to the SMAS layer, then branches step by step, forming several terminal branches to supply the skin and subcutaneous tissue, and the supply range of these terminal branches is relatively small. There is a rich correspondence between each other. Conclusion: the blood of the skin and subcutaneous tissue in the preauricular area is mainly supplied by the superficial temporal artery and its branches, zygomatic-orbital artery, the anterior cutaneous branch of the superficial temporal artery and the transverse facial artery, and the anastomosis between the above arteries is abundant. Among them, the superficial temporal artery was not described in detail in previous literature. The location of the perforating point of SMAS is constant and the supply range is large. The skin branch can be used to form a peninsular axial flap or island flap in the preauricular area to repair the peripheral tissue defects.
【学位授予单位】：第二军医大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R322

【参考文献】