颏下逆行岛状皮瓣修复眼窝缺损的解剖学研究

Anatomic Study of the Reversed Submental Island Flap in the Reconstruction of Orbital Cavity Defects

目的:探讨颏下逆行岛状皮瓣修复眼窝缺损的可行性及手术操作要点。方法:解剖20具甲醛溶液固定、颈总动脉灌注红色乳胶的头颈部标本及2具灌注亚甲蓝的新鲜头颈部标本,测量相关标志点之间的距离,观察面部相关血管之间的吻合情况,观察面神经在面部的分布特点。结果:下眼睑(自睑缘正中算起)至口角平面及下颌骨与面动脉交点的距离分别为(68.80±5.70)mm和(103.70±8.20)mm,面动、静脉之间的距离为(9.60±2.73)mm;面动、静脉与面部相关血管之间有丰富吻合;面神经跨越面静脉处集中于口角及以上平面。结论:颏下逆行岛状皮瓣修复眼窝缺损具有可行性,皮瓣旋转点宜选择在下颌骨以上、口角以下平面,皮瓣蒂宽宜在(9.60±2.73)mm左右。

Objective：To study the practice and procedures on the reconstruction of orbital cavity deformity with reversed submental island flap.Methods：Applied anatomy were carried out on twenty cadavers with 40 sides of the head and neck which were fixed by formalin and fused by red emulsion,2 additional fresh cadavers which were fused by methylene blue were dissected,observed,and measured.Results：The distance from the lower eyelid to the angular oris plane and the crossing point of mandible and facial artery were（68.80±5.70） mm and（103.70±8.20） mm respectively,the distance between facial artery and vein was（9.60±2.73） mm.There were rich anastomoses between both facial arteries and veins.The branches of facial nerve spanned facial vein on the angular oris plane or above it.Conclusion：There is anatomic feasibility for the reconstruction of orbital cavity defect with reversed submental island flap.The reversing point of the flap ought to be in the position between the angular oris and the mandible plane.