上颌动脉翼腭段的应用解剖

Clinical anatomy of the pterygopalatine segment of the maxillary artery

目的研究上颌动脉翼腭段的走行及分支规律,为翼腭窝内动脉结扎、肿瘤切除和颅面外科手术提供解剖学依据。方法采用3种手术入路解剖21具成人尸头,观测上颌动脉翼腭段及分支的行程、管径、长度和毗邻关系。结果上颌动脉翼腭段行于上颌骨颞下面后上区内,分为5型:Y型26.19%、中间型33.33%、T型21.43%、M型11.90%和其他型7.14%。上颌动脉翼腭段外径为(2.61±0.39)mm,总长为(19.44±3.62)mm;其分支有上牙槽后动脉、眶下动脉、圆孔动脉、翼管动脉、腭降动脉、蝶腭动脉、腭鞘动脉,分支走行变异常见;颞深前动脉可作为确定上颌动脉翼腭段的参考标志。结论熟悉上颌动脉的分支、分型及走行对指导翼腭窝区手术及降低术后并发症具有重要意义。

Objective To explore anatomical feature of the pterygopalatine segment of the maxillary artery, in order to provide the anatomic basis for ligating the maxillary artery, resecting tumors and craniofacial surgery. Methods Twenty-one adult cadaveric heads were dissected via three surgical approaches. The course, diameter, length, branches and patterns of the pterygopalatine segment of the maxillary artery were observed. Results The pterygopalatine segment of the maxillary artery was located in the superior posterior part of the intratemporal surface. The pterygopalatine segment of the maxillary artery was classified into five types： Y type （26.19%） , intermediate type （33.33 % ） , T type （21.43%） , M type（ 11.90% ） and other type（7.14% ）. The diameter and length of the pterygopalatine part of the maxillary artery were （2.61 ± 0.39） mm and （ 19.44± 3.62 ） mm. It sent off seven branches which were the posterior superior alveolar artery, the infraorbital artery, the foramen rotundum artery, the pterygoid canal artery, the descending palatine artery, the sphenopalatine artery and the palatine vaginal artery. However, the variability of branches was common. The anterior deep temporal artery served as a reference landmark to localize the pterygopalatine segment of the maxillary artery. Conclusion It is important to be familiar with the pathway, the type and branch patterns of the pterygopalatine segment of the maxillary artery for guiding surgery approach to the pterygopalatine fossa and reducing postoperative complications.