颞肌的血供研究

Blood supply in temporalis

目的研究颞肌动脉血供情况.方法选用10具成人新鲜头颅标本,将其标本浸泡在10%的甲醛溶液中,于颈总动脉中灌注1:1的乳胶与硫酸钡的混合液,将头颅标本去除颞区的皮肤与皮下组织后将颞肌取下,在2.5 mA 40 kV的牙片机下摄颞肌血供X线片,并对其血供来源动脉进行观察分析.结果供应颞肌的主要动脉有3条:颞深前动脉,供应颞肌前份,约占全部颞肌的11%～25%,平均为17%;颞深后动脉,供应颞肌中份,约占全部颞肌的27%～50%,平均为38%;颞肌内动脉,为颞浅动脉的分支,供应颞肌的后份,约占全部颞肌的30%～58%,平均为45%.结论研究结果给以提示,在制备颞肌瓣来修复口腔颌面部缺损时,可根据其血供动脉分支来源制备3个不同的组织瓣,即前颞肌瓣、中颞肌瓣和后颞肌瓣或反向颞肌瓣.

Objective To investigate the arteries supplying the temporalis. Methods Ten cadavers were examined after embalming with a fluid containing 10% formaldehyde. For detailed examination of the supplying arteries of the temporalis, a mixture of latex and barium sulfate in a ratio of 1 ： 1 was injected into both carotid arteries of 10 fresh cadavers. The skin and soft tissue were removed from the temporal and lateral regions of the head, and the superficial temporal artery was dissected. As soon as the origin of the medial temporal artery was identified, the zygomatic arch was cut and lifted. The maxillary artery with its branches of the infratemporal region was carefully dissected. After identification of all vessels of the infratemporal region, the temporalis was removed, and then radiographic examination of the injected arteries was performed using 2.5 mA and 40 kV. The injected arteries were clearly identified on the radiographic images, and the area supplied by each artery was determined. Planimetric evaluation of these areas was performed. Results In all specimens, three arteries supplying the temporalis were identified： the anterior deep temporal artery that supplied the anterior part between 11% and 25% of the temporalis with a mean of 17%, the posterior deep temporal artery that supplied the central part of 27% to 50% of the lateral aspect of the temporalis, with a mean of 38% and a branch of the superficial temporal artery, the medial temporal artery, which supplied the posterior part and in 25% the posterior and the upper part of the temporalis, resulting in 30% to 58% of the muscle＇s lateral aspect, with a mean of 45%. Conclusion According to a detailed description of the arterial supply of the temporalis, two different pedicled flaps using the anterior or central part of the temporalis can be selectively used for reconstructive surgery.