鼻部Pitanguy韧带的解剖学研究  

Clinical anatomic study of Pitanguy ligament of the nose

作　　者：田举[1] 黎志明[2] 罗志军[1] 王和庚[1] 

机构地区：[1]广东省中山市人民医院烧伤科,528403 [2]广州中山大学附属第一医院整形修复外科,528403

出　　处：《中华整形外科杂志》2014年第2期126-129,共4页Chinese Journal of Plastic Surgery

摘　　要：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具标本行太体解剖，于鼻背正中线切I：1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。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.

关 键 词：Pitanguy韧带 鼻 解剖学 局部 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]