以枕动脉为蒂颅骨外板骨(膜)瓣枕颈融合术的应用解剖

Applied anatomy of cranial outer table bone flap pedicled with the occipital artery for occipitocervical fusion

目的：为带枕血管蒂的颅骨（ 膜） 瓣转位枕颈融合术提供解剖学基础。方法：在４０ 侧经动脉灌注乳胶的成人尸体标本和８ 例头颈铸型标本（５ 例保留骨骼） 上，对枕动脉的走行、分支及分布进行观测，并在标本上进行模拟术式设计。结果：枕动脉从颈外动脉发出后经颞骨枕动脉沟向后上迂曲走行至项部浅出，其浅出点位于枕外隆凸下方１ ．０ ±０ ．１ ｃｍ ，中线外侧３ ．５ ±０ ．２ ｃｍ ，浅出点处外径２ ．１ ±０ ．１ ｍ ｍ ，浅出后向上走行于浅筋膜和帽状腱膜之间，分支营养头部（ 包括枕部、耳后、后颅顶） 大约２／５ 区域的软组织，骨膜和颅骨外板，枕动脉深段至分支处可游离长度为８ ｃｍ 以上。结论：以枕动脉为蒂颅骨外板骨（ 膜） 瓣转位行枕颈融合的术式具有可行性。

To provide anatomic basis of cranial outer table flap pedicled with the occipital artery for occipitocervical fusion.Methods:The course,branches and distribution of the occipital artery were observed on 40 adult cadavers perfused with latex and 8 cephalocervical vascular castings(5 castings preserved bones).The operation was imitated on 2 cadavers.Results:The occipital artery originated from the external carotid artery.It ran through the occipital artery channel of temporal bone and perforated to the nucha.The perforaing point is 1.0±0.1 cm inferior to the external occipital protuberance and 3.5±0.2 cm lateral to the median plane.Its external diameter at the point of penetration into the subcutaneous tissue is 2.1±0.2 mm.The occipital artery ran upward between superficial fascia and galea aponeurotica and gave off branches to nourish the soft tissue(the occiput,opisthotic region,opisthotic and calvaria),pericranium and cranial outer table.Conclusion:Cranial outer table flap pedicled with the occipital artery could be used in occipitocervical fusion.