CAJ | 학술논문

目的观察Pitanguy韧带的起止走行,为临床治疗鼻尖下垂、鼻小柱过短、牙龈外露等鼻唇部畸形提供解剖学依据.方法 10％甲醛固定头颅标本15具,其中12具标本行大体解剖,于鼻背正中线切口逐层解剖,显示Pitanguy韧带起止及其与周围组织的相互关系,取Pitanguy韧带,石蜡包埋,HE染色,沿韧带纵向切片;3具标本自骨膜层剥除整个外鼻,石蜡包埋,HE染色,水平面切片,显微镜下观察韧带的组织学成分,并拍照.结果 Pitanguy韧带位于鼻中线,起自鼻背下1/3的鼻背筋膜,沿鼻背正中线向下行至鼻尖转折向后,走行于两侧鼻翼软骨内侧脚之间,止于鼻小柱基底部,与口轮匝肌、降鼻中隔肌等肌纤维相互交织.HE染色提示韧带包括纤维结缔组织、肌肉组织等成分,未见软骨成分.结论 Pitanguy韧带这一解剖结构的确存在,其组织学成分复杂,导致其命名尚有争论;因其与口轮匝肌、降鼻中隔肌等肌纤维之间相互交织,切断或缩短Pitanguy韧带可以改变鼻唇角、鼻长度等,治疗鼻唇部畸形.
목적 관찰Pitanguy인대적기지주행,위림상치료비첨하수、비소주과단、아간외로등비진부기형제공해부학의거.방법 10％갑철고정두로표본15구,기중12구표본행대체해부,우비배정중선절구축층해부,현시Pitanguy인대기지급기여주위조직적상호관계,취Pitanguy인대,석사포매,HE염색,연인대종향절편;3구표본자골막층박제정개외비,석사포매,HE염색,수평면절편,현미경하관찰인대적조직학성분,병박조.결과 Pitanguy인대위우비중선,기자비배하1/3적비배근막,연비배정중선향하행지비첨전절향후,주행우량측비익연골내측각지간,지우비소주기저부,여구륜잡기、강비중격기등기섬유상호교직.HE염색제시인대포괄섬유결체조직、기육조직등성분,미견연골성분.결론 Pitanguy인대저일해부결구적학존재,기조직학성분복잡,도치기명명상유쟁론;인기여구륜잡기、강비중격기등기섬유지간상호교직,절단혹축단Pitanguy인대가이개변비진각、비장도등,치료비진부기형.
Objective To observe the origins and insertions of Pitanguy ligament,in order to find the anatomically theoretical basis for the treatment of nasal deformity such as drooping nose,short columella,gingival show.Methods 15 cadaveric heads fixed by 10％ formalin were used.12 specimens underwent nasal anatomic study.The skin was incised,along the nasal midline to expose the Pitanguy ligament.The origin of Pitanguy ligament and its relationship with surrounding tissue were studied.Then the Pitanguy ligament was taken out for HE staining.Longitudinal section along the ligament was observed.3 specimens underwent harvesting of full-thickness nasal tissue from skin to periosteal membrane.Then the samples were used for HE staining to show histologic study of ligament at horizontal section.Results Pitanguy ligament originates in the midline of lower third of the nasal superficial musculoaponeurotic system,extends down to the tip along the midline of the nasal dorsum and then turns backwards at the nasal tip,and runs between the medial crura of the lower lateral cartilages,inserts into the base of columella.Its muscle is connected with the orbicularis oris muscle and the depressor septi nasi muscle.HE staining showed the ligament consists of fibrous connective tissue,muscle tissue and other ingredients,but without cartilage.Conclusions Pitanguy ligament exists with complex histological composition,so its name is still controversial.Because it has multiple connection with the orbicularis oris muscle and the depressor septi nasi muscle,so cutting or shortened the Pitanguy ligament can treat deformity of nose and lip by adjustment of nasolabial angles and the nasal length.