【摘要】 目的　进一步探讨以颈横血管为蒂的上斜方肌肌皮瓣及肩胛冈骨肌皮瓣的应用解剖学基础 ,及其在口腔颌面缺损修复中的应用。方法　解剖观测 32侧上斜方肌、肩胛冈的形态和血供 ,并应用 5例该组织瓣修复口腔颌面部缺损。结果　①上斜方肌近似于梯形 ,平均高度上、下、内、外四缘分别为 174 6 3、15 7 18、86 98和 80 95mm ,面积 12 6 78cm2 ;肩胛冈全长 131 2 1mm。②颈横动脉干、颈浅动脉干及其升支、肩胛冈支长度分别为 42 5 0、2 7 80、43 12和 2 8 75mm。升支发出 0 5mm以上肌皮穿支 3～ 6支 ;回流静脉与相应动脉伴行。③临床应用 5例 ,均获成功。结论　以颈横血管为蒂的上斜方肌肌皮瓣及肩胛冈骨肌皮瓣血管蒂长、手术易操作 ,且可带肩胛冈修复 ,适合于修复口腔颌面部缺损更多还原

【Abstract】 Objective To explore the anatomic basis of the superior trapezius myocutaneous and osteomyocutaneous flap pedicled with the transverse cervical vessel, and provide a new operation for oral and maxillofacial reconstruction. Methods\ The blood vessels, the spina scapula and the superior trapezius muscle were dissected and examined in 32 cases. The flaps pedicled with the transverse cervical vessel have been applied to 5 cases of oral and maxillofacial defects. Results\ ①The shape of the superior trapezius muscle looks like a trapezium. The upper, lower, inner and outer borders of the muscle are 174 63mm, 157 18mm, 86 98mm, and 80.95 mm in average respectively. The area of the muscle is 126 78cm 2. The spina scapula is 131 21mm in length. ② The transverse cervical artery trunk, the superficial cervical artery trunk and its ascending artery, the spina scapulae branch artery are 42 50mm, 27 80mm, 43 12mm, 28 75mm in average respectively. The ascending artery gave 3～6 branches of over 0 5mm in diameter. The venous blood is mainly drained by the concomitant vein. ③All 5 flaps survived in oral and maxillofacial reconstruction. Conclusion\ The myocutaneous and osteomyocutaneous flap has long vascular pedicle, is easy for operation, and may also be transferred with the spina scapulae. The flap is an effective method in oral and maxillofacial reconstruction.更多还原