CAJ | 학술논문

目的为临床应用锁骨上动脉岛状瓣提供解剖学依据,评价其修复舌部缺损的可靠性.方法用成人尸体10例(20侧)经锁骨下动脉灌注氧化铅-明胶溶液的标本,观测颈横动脉和锁骨上动脉的分支、起始位置、行程、长度和管径,观察其静脉回流情况.用锁骨上动脉岛状瓣修复4例舌癌切除术后缺损,通过观察舌部形态和功能恢复及供区并发症等,评价修复效果.结果颈横动脉由甲状颈干或锁骨下动脉分支而来,在锁骨中1/3上方分为深支和浅支.锁骨上动脉由颈横动脉浅支发出.颈横动脉起点至锁骨上动脉起点距离约4.3 cm,锁骨上动脉起点至其分支穿深筋膜点的距离约3.6 cm.颈横动脉起点处血管外径约2.7 mm,锁骨上动脉起点处血管外径约1.1 mm.两条锁骨上动脉伴行静脉分别回流入颈横静脉和颈外静脉.4例用于修复舌部缺损的皮瓣中,3例全部成活,1例小部分皮岛坏死,肩功能运动不受影响.结论以锁骨上动脉为营养血管的锁骨上动脉岛状瓣带蒂转移适于修复口腔颌面颈部组织缺损,也可以颈横动脉为吻合血管制作游离皮瓣.
목적 위림상응용쇄골상동맥도상판제공해부학의거,평개기수복설부결손적가고성.방법 용성인시체10례(20측)경쇄골하동맥관주양화연-명효용액적표본,관측경횡동맥화쇄골상동맥적분지、기시위치、행정、장도화관경,관찰기정맥회류정황.용쇄골상동맥도상판수복4례설암절제술후결손,통과관찰설부형태화공능회복급공구병발증등,평개수복효과.결과 경횡동맥유갑상경간혹쇄골하동맥분지이래,재쇄골중1/3상방분위심지화천지.쇄골상동맥유경횡동맥천지발출.경횡동맥기점지쇄골상동맥기점거리약4.3 cm,쇄골상동맥기점지기분지천심근막점적거리약3.6 cm.경횡동맥기점처혈관외경약2.7 mm,쇄골상동맥기점처혈관외경약1.1 mm.량조쇄골상동맥반행정맥분별회류입경횡정맥화경외정맥.4례용우수복설부결손적피판중,3례전부성활,1례소부분피도배사,견공능운동불수영향.결론 이쇄골상동맥위영양혈관적쇄골상동맥도상판대체전이괄우수복구강합면경부조직결손,야가이경횡동맥위문합혈관제작유리피판.
Objective To study the anatomy of supraclavicular artery island flap and report the clinical.application of the island flap for the reconstruction of tongue defects. Methods The branch,origination,course,length and diameter of transverse cervical artery and supraclavicular artery were observed on 20 flaps of 10 adult cadavers perfused with lead oxide-gel,and the draining veins were also observed.The supraclavicular artery island flaps were used to reconstruct the defects following tongue cancer ablation in 4 patients,and the data concerning functional impairment,aesthetic outcome and donor site morbidity were analyzed.Results The transverse cervical artery were originated from the thyrocervical trunk or subclavical artery,and separated into deep branch and superficial branch above the middle third of the clavicle.The supraclavicular artery were originated from superficial branch of the transverse cervical artery and extended to backward and outward,and run over surface of trapezius,acromial end of clavicle and deltoid fascia,and then penetrated the deep fascia and go into skin and subcutaneous tissue of supraclavicular and shoulder regions.The distance between the origins of the supraclavicular and transverse cervical arteries was on average 4.3 cm,and the distance between the origin of supraclavicular artery and the point where it penetrated the deep fascia was on average 3.6 cm.The external diameter of the transverse cervical artery was on average 2.7 mm,and the external diameter of supraclavicular artery was on average 1.1mm.Two supraclavicular comitant veins ran adjacent to the supraclavicular artery and drained into the transverse cervical vein and external jugular vein respectively. In the clinical study,3 flaps survived completely and part of the skin paddle of the flap in one case exhibited necrosis.The contour and function of tongues were restored well and there was no limitation of shoulder motion in all 4 cases.Conclusions The supraclavicular artery island flap with supraclavicular artery as nutrient vessel is reliable for reconstruction of oral,maxillofacial and neck defects,and it can be used as a free flap equipped with the transverse cervical