二腹肌前腹-下颌骨膜瓣修复喉气管应用解剖学研究

Periosteal flap of anterovent of digastric muscle-mandible to renovate laryngotracheal stenosis:an applied anatomical study

目的 为临床上较为棘手喉气管狭窄提供新的修复方法。方法 研究２３具（４６侧）福尔马林固定的头颈部标本的二腹肌前腹的形态学特征并测量其相关的解剖结构。结果 二腹肌前腹以（３０．４°±３．５°）的角度起于下颌骨二腹肌窝内，其长度为（４．８±０．７），颏下动脉二腹肌血管支在距颏下动脉起始点（２．４±０．７）ｃｍ发出，下颌舌骨神经伴随血供入肌，该肌附着骨膜面积为６９．６～１５５．４（１１１．６±２８．２）ｍｍ＾２。结论 根据颏下动脉皮瓣和胸锁乳突肌锁骨骨膜瓣的制备方法和二腹肌前腹相关的解剖学数据，设计以二腹肌前腹和颏下动脉为蒂的下颌骨骨膜瓣修复喉气管，有良好的解剖学条件。

Objective To explore a new surgical approach for the renovation of laryngotracheal stenosis. Methods the anatomical structures of the anteroventral portion of the digastric muscle along with the blood supply, innervation and periosteal coverage of the mandibular were investigated by observing 23(46 sides) cadaver. Results The anteroventral portion of the digastric muscle rise from the fossae digastrica at the angle of 30.4°±3.5°. Its length was (4.8+0.7) cm and the periosteal coverage averaged (111.6+28.2) mm2. The puncta of rami digastricus stats (2.4+0.7) cm from the arteriae submentalis. Mylohyoid nerve together with rami digastricus enters the muscular tissue. Conclusion Designed with reference to sternocleidomastoid clavicular periosteal flap, the periosteal flap of the anterovent of the digastric muscle-mandible may offer a new way for largngotracheal renouation.