摘要
目的 为在修复腭裂时正确地设计和切取腭部组织瓣 ,保证其存活和肌肉恢复功能 ,对软腭血供进行了解剖学研究。方法 对 14例头颈标本做了腭部动脉的解剖学观察 ,10例胎儿标本做了造影 ,6例胎儿头标本做了组织学连续切片观察。结果 证实软腭血供具有多源性 ,主要来源于腭升动脉。该动脉前、后支均是肌粘膜穿支血管。供应软腭的其他动脉均为直接粘膜支 ,包括腭小动脉、咽升动脉腭支和扁桃体动脉。供应软腭的血管在粘膜下及肌筋膜层形成丰富的相互吻合的血管网。腭裂时 ,腭升动脉腭支随腭帆提肌向前外移位。结论 保护好腭部动脉 ,特别是腭升动脉在软腭内的分支 ,对腭裂手术的设计、伤口愈合及术后功能的恢复都十分重要。
Objective\ The correct design of a myomucosal or mucosal flap of the soft palate in the surgical procedure for cleft palate and velopharyngeal incompetence should be made with a thorough knowledge of the arterial supply for the soft palate,which is an important premise for functional rehabilitation of the soft palate postoperatively.Methods\ Anatomical dissection was undertaken in 14 cadavers (10 normal adults,2 normal newborns and 2 newborns with cleft lip & palate).The arteriography and histological studies have been used in 10 newborn and 6 aborted fetuses.Results\ The results showed that the arterial supply of the soft palate is multi\|original and the principal artery is the ascending palatal artery.Its anterior and posterior branches are myomucosal perforators.The other vessels to supply the soft palate are direct mucosal branches,which include the lesser palatine artery,the palatal branch of the ascending pharyngeal artery and the tonsillar artery.All above arteries anastomose under the mucosal,muscular and fascial layers in the soft palate.In cleft cases,all arteries in the soft palate are displaced anterior\|laterally because of the deformities of the palatal muscles and bone structure.Conclusions\ This study supports the facts that the major blood supply of the soft palate comes from ascending palatine artery and the generous arterial anastomosis of the velum allows it to tolerate the proper dissection during palatoplasty.We believe that decreasing the damage of the intrapalatal vascular supply by carefully dissection around the hamulus is very important to prevent wound break down,muscular fibrosis,flap failure,and also is the basis of design for surgical procedure and postoperative functional recovery in cleft palate patients.\;
出处
《中华整形外科杂志》
CAS
CSCD
北大核心
2000年第4期208-211,共4页
Chinese Journal of Plastic Surgery
关键词
软腭
局部解剖
动脉血供
腭裂
修复
Soft palate
\ Regional anatomy
\ Arterial supply
