基于鼻内带蒂组织瓣蝶腭动脉的解剖研究
Anatomy of the sphenopalatine artery on the vascularized pedicled endonasal flap
目的 研究蝶腭动脉及其分支的解剖特征，为临床获取鼻内黏膜瓣提供解剖学依据。 方法 用10具（20侧）成人尸颅标本在在手术显微镜下对蝶腭动脉及其分支鼻后中隔动脉和鼻后外侧动脉进行观测。 结果 蝶腭动脉是鼻腔的主要供血动脉，在出蝶腭孔前或后分为鼻后中隔动脉和鼻后外侧动脉，鼻后中隔动脉在蝶窦前壁分成两支，主干或上支到蝶窦开口的距离为（3.95±0.74）mm，主干或下支距离后鼻孔的最短距离为（8.96±1.69）mm。鼻后外侧动脉在中鼻甲后端前下约10 mm处分为中鼻甲动脉和下鼻甲动脉。 结论 熟悉掌握蝶腭动脉及其分支的解剖特征对获取鼻内组织瓣有重要意义。鼻中隔粘膜瓣切取时应紧贴蝶窦开口上缘及后鼻孔边缘。在获取下鼻甲、中鼻甲黏膜瓣时，应特别注意靠近下鼻甲的下鼻甲后端10 mm及中鼻甲后端前下约10 mm区域。
Objective To study the anatomical characteristics of sphenopalatine artery and its branches in order to offer anatomical evidence for harvest of endonasal flap. Methods Twenty sides of 10 adult cadaver heads were used. The sphenopalatine arteries and their branches were observed using microscope. Results The sphenopalatine artery is the main blood supply of the lateral nasal wall. It divides into two major branches (the posterior lateral nasal artery and the septal artery) before or after traveling through the sphenopalatine foramen. The posterior septal artery divided into 2 branches in the anterior wall of the sphenoid sinus. The distance between the main stem or the superior branch of the posterior septal artery to sphenoid ostium was (3.95±0.74) mm, and the main stem or the inferior branch of the posterior septal artery to arch of choana was (8.96±1.69) mm, approximately 10 mm anteroinferior to the posterior end of the middle turbinate. Conclusion Familiarity with the anatomic features of sphenopalatine artery and its branches to obtain endonasal flap has important significance. When harvesting the nasoseptal flap, the posterior superior incision should not venture lower than the level of the inferior aspect of the sphenoid ostium and the inferior incision should be near the arch of the choanae. When harvesting the inferior turbinate flap and the middle turbinate flap, We should pay more attention to the area which is 10 mm anterior to the posterior attachment of inferior turbinate on the lateral nasal wall close to the inferior turbinate and 10 mm anteroinferior to the posterior end of the middle turbinate.
Endonasal flap / Microsurgical anatomy / Sphenopalatine artery
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