【摘要】 目的通过对中国汉族成人尸体会厌滋养血管的显微解剖观察,为喉移植、修复、重建以及会厌相关疾病的研究提供相关的数据和形态学资料。方法采用10%甲醛常规防腐固定的头颈部正常、身体无明显畸形和外伤的成年尸体30具(男27具,女3具),常规颈部解剖下从舌骨至气管2~4环取下喉。在体式解剖显微镜下进行显微解剖,观察喉上动脉及其分支的分布、走行及形态,并将喉上动脉在甲状软骨上缘附近分出的一支分布、走行于会厌的动脉命名为“会厌动脉”。结果30具(60侧)尸体中会厌动脉均起源于喉上动脉。喉上动脉分支处外径平均(x-±s,以下同)为(1·06±0·16)mm,会厌动脉起始处外径平均为(0·79±0·13)mm。男性喉上动脉分支处外径平均为(1·09±0·12)mm,男性会厌动脉起始处外径平均为(0·81±0·11)mm。会厌动脉起始处到甲状软骨上角的垂直距离(27·16±3·85)mm。会厌动脉向上行于会厌前间隙的黏膜下疏松结缔组织和脂肪组织内,于会厌谷或杓会厌皱襞附近形成会厌动脉袢,再发出2~5个分支。动脉袢位于甲状舌骨膜处或会厌谷黏膜下疏松结缔组织和脂肪组织中,呈“M”、“N”、“Ω”“U”等形状。60侧中仅1侧在甲状舌骨膜外侧发出会厌动脉袢。结论会厌动脉袢是手术中会厌动脉最容易损伤的部位,在使用会厌瓣作为喉功能重建时应注意避免损伤。更多还原

【Abstract】 Objective To study the microsurgical anatomy of human epiglottic blood vessel to provide exact and reliable data and morphological properties for further studies of laryngeal transplantation, reconstruction and other epiglottis-related diseases. Methods Thirty Chinese adult cadavers (27 males and 3 females) were examined for the present study. The cadavers were dissected under magnification along the anatomic planes from skin down to vertebral column. The anterior neck was exposed by a midline incision and extended laterally along the angle of mandible superiorly, and on clavicle inferiorly. After the visualization of laryngeal prominence of thyroid cartilage, strap muscles were resected and superior laryngeal artery and epiglottic blood vessel were exposed under an operating microscope (original magnification 7~30). The epiglottic artery was named for the first time. Results The diameter of superior laryngeal artery was (1.06±0.16)mm(male: 1.09 mm±0.12 mm). The diameter of origin epiglottic artery was (0.79±0.13)mm (male: 0.81 mm±0.11 mm). The vertical distance between origin epiglottic artery and superior horn of thyroid cartilage was (27.16±3.85)mm. Epiglottic artery loop was observed in all the cadavers, which could be M-, N-, Ω-, or U-shaped and mixed under the thyrohyoid membrane or in the epiglottic vallecula. Conclusions These findings could improve the application of epiglottis in laryngeal functional reconstruction after partial laryngectomy, as well as in the prevention of epiglottic artery loop injuries during the operation.更多还原