外鼻的血供及临床意义

Blood supply of external nose and its clinical significance

目的:研究外鼻的血液供应,并探讨其临床意义。方法:①38例成人头颅标本,常规解剖并观察外鼻的动脉来源、分支及分布和静脉回流;②10例成人头部铸型标本,观察外鼻的动脉血供和静脉回流;③1例新鲜成人头颅标本,颈外动脉灌注明胶墨汁,切取鼻部皮肤,制成透明标本,观察其皮肤血供的分布和吻合。结果:外鼻的动脉营养主要来源于面动脉及眼动脉分支,包括鼻背动脉、鼻外侧动脉、鼻翼动脉、鼻翼下缘动脉、鼻中隔动脉等。动脉在鼻孔周围呈环形分布。外鼻皮肤的营养由吻合丰富的真皮下动脉网提供,并具一定的方向性。结论:基于鼻背轴型动脉网的存在,可设计以鼻背皮肤（皮下组织）为蒂的鼻中隔软骨粘膜瓣以修复上下睑缺损。井且可以设计以鼻外侧动脉为血管蒂的鼻唇沟岛状皮瓣逆行修复面部缺损。

Objective: To analyse the blood supply and venous return of the external nose and explore its clinical significance.Methods: ①The arterial source, branches and distribution and venous return of external nose were observed on 38 adult cadaveric specimens. ② Blood supply and venous return of external nose were observed on 10 sides cephalic-facial cast specimens. ③The external skin from a fresh adult head specimen was perfused with gelatin china ink and then hyalinized. Results: The blood supply of external nose was basically from branches of the facial artery and ophthalmic artery, including the dorsal nasal artery, lateral artery, naso-alar artery, lowrer naso-alar marginal artery and nasoseptal artery, etc. The distribution of external nose arteries was a circle around the nostrils. The blood supply of the external nasal skin was from the subdermal arterial rete which anastomose richly. Conclusions: Base on the presenec of the axial arterial network, the nasal septal cartilage nucosal flap pedicled with the nasal dorsum skin or subcutaneous tissue can be designed to repair the defect of superior and lower eyelid. The nasolabial fold island flap pedicled with lateral artery can be designed to repair facial defect.