逆行颞顶筋膜瓣的解剖与临床应用

Anatomical study of the reversed-flow temporoparietal fascial flap and its clinical application

目的 :探讨逆行颞顶筋膜瓣临床应用的可行性。方法 :①在 12侧成人头颅标本上 ,对颞顶筋膜的形态和血供进行巨微解剖观测。②分别以颞浅动脉的额支或顶支或额、顶支双蒂设计逆行颞顶筋膜瓣应用于临床修复头颅深度软组织缺损。结果 :①颞顶筋膜主要由颞浅动脉供血 ,额支与顶支是颞浅动脉的终末分支 ,颞浅动脉经额支、顶支与耳后动脉、枕动脉、眶上动脉、滑车上动脉及对侧颞浅动脉有丰富吻合。颞浅静脉由静脉额支和静脉顶支汇合而成 ,动、静脉额支及动、静脉顶支基本伴行。②临床应用 6例逆行颞顶筋膜瓣均获成功。结论 :逆行颞顶筋膜瓣供血可靠 ,具有采取方便、供区隐蔽等优点 ,适用于额、顶、枕等处深度软组织缺损的修复。

Objective: To investigate the feasibility of the clini cal applicatio n of reversed-flow temporoparietal fascial flap (RFTPFF). Methods: ①The morpho logy and blood supply of temporopartietal fascia (TPF) were observed on 12 sides adult head specimens.② The reversed-flow fascial flaps pedicled with frontal branch (FB) or parietal branch (PB) of the superficial temporal artery (STA) or double branches have been used in six patients.Results: ①TPF was mainly supplye d by STA.The FB and PB are the terminal branches of the STA.By FB and PB, the ST A have abundant anastomosis with supraorbital artery (SOA), supratrochlear arter y (STCA), occipital artery (OA), posterior auricular artery (PAA) and opposite S TA. The superficial temporal vein (STV) was mainly formed by the union of a fron tal and a parietal venous branch (FB and PVB) which approximately accompanied t he corresponding branch of the artery.②All of the fascial flaps used in the cli nical cases have survived well.Conclusion: THe blood-su pply to RFTPFF is reliab le.The flap is easy to be obtained, and donor site can be well disguised by hair growth.So, the RFTPFF is suitable for repairing deep-degree soft tissue defect in the fronto-parieto-temporal region.