表浅肌肉腱膜系统岛状瓣一期全耳廓再造的应用解剖  

Applied anatomy of insular superficial musculoaponeurotic system flaps for one-stage total auricular reconstruction

作　　者：匡建国[1] 楚建军[2] 唐胜建[1] 

机构地区：[1]潍坊医学院整形外科研究所,潍坊261042 [2]复旦大学附属眼耳鼻喉科医院

出　　处：《解剖学杂志》2005年第6期692-695,共4页Chinese Journal of Anatomy

摘　　要：目的:深入探讨头部表浅肌肉腱膜系统(SMAS)的组织学结构和血管构筑特点,为全耳廓再造中SMAS岛状瓣的设计提供可靠的解剖学基础。方法:对新鲜和固定头部标本进行了显微外科解剖以及组织切片观察,并完成手术模拟。结果:头部 SMAS可划分为5个区域;各分区均由一组以上的轴型血管营养,每组轴型血管可跨越不同区域并相互吻合,维持各区间血供相互连续;颞区和额眶区SMAS最为菲薄均匀,血运丰富。依据各区SMAS轴型血管的走行特点,设计出三种不同的SMAS岛状瓣模拟一期全耳廓再造。结论:头部SMAS具有多个独立连续的血供系统,可设计多种SMAS岛状瓣;以颞浅血管顶支或额支为蒂的颞区SMAS岛状瓣是一期全耳廓再造的首选方案。Objective： To clarify the character of histological structure and angioarchitecture of cephalic superficial musculoaponeurotic system （SMAS）, so as to provide reliable anatomical basis for design of insular SMAS flaps for total auricular reconstruction. Methods. Five fresh and ten formalin fixed adult cadaver head specimens were dissected and observed under an operative microscope and full-thickness specimens were processed for histological study. The simulations of total auricular reconstruction on formalin fixed adult cadaver head specimens were accomplished. Results： The cephalic SMAS was compartmentalized into 5 areas. There were more than one group axial nutrient vessels in each area. In each group, axial vessel extended to adjoining areas and maintained the blood supply continuously through anastomosis. The SMAS in temporal region and frontal-orbital region were the thinnest and well-distributed, and bad plentiful blood supply. Three different insular SMAS flaps were designed for one-stage total auricular reconstruction based on distribution of axial vessels in each area. Conclusion： Multiple SMAS tissue flaps can be designed because the cephalic SMAS has several sole and continuous blood supply systems. Insular SMAS flaps in temporal region, which is supplied by the parietal or frontal branch of superficial temporal artery, is the preferred project in one-stage total auricular reconstruction.

关 键 词：表浅肌肉腱膜系统 显微外科解剖学 组织学 全耳廓再造 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]