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目的 探讨逆流颞顶筋膜瓣临床应用的可行性。方法 ①在 12侧成人头颅标本上 ,对颞顶筋膜的形态和血供进行巨微解剖观测。②在 4侧头颅标本颞顶区的不同位置采集软组织标本进行组织学观察。③分别以颞浅动脉的额支或顶支或额、顶支双蒂设计逆流颞顶筋膜瓣应用于临床修复头颅深度软组织缺损。结果 ①颞顶筋膜主要由颞浅动脉供血 ,额支与顶支是颞浅动脉的终末分支 ,颞浅动脉经额支、顶支与耳后动脉、枕动脉、眶上动脉、滑车上动脉及对侧颞浅动脉有丰富吻合。颞浅静脉由静脉额支和静脉顶支汇合而成 ,动、静脉额支及动、静脉顶支基本伴行。②以额支、顶支为蒂的逆流颞顶筋膜瓣可获得的面积分别为 ( 119 75± 2 1 19)cm× ( 59 70±10 16)cm、( 110 67± 2 1 61)cm× ( 58 64± 7 65)cm。③临床应用 4例逆流颞顶筋瓣均获成功。结论 逆流颞顶筋膜瓣供血可靠 ,具有采取方便、供区隐蔽等优点 ,适用于颅、顶、枕等处深度软组织缺损的修复。
Objective To investigate the feasibility of clinical application of the infratemporal temporal fascial flap. Methods ① In 12 adult skulls, the morphology and blood supply of the TMF were observed by micro-microanatomy. ② Soft tissue specimens were collected at different positions of temporoparietal area of 4 cranial specimens for histological observation. ③ The superficial temporal branches of the superficial temporal artery or the sum of frontal branch and pedicle double pedicle were respectively designed for the clinical repair of deep soft tissue defect of skull. Results ① The superior temporal fascia was mainly supplied by the superficial temporal artery. The frontal and branch branches were the terminal branches of the superficial temporal artery. The superficial temporal artery was transected at the frontal branch, the top branch and the posterior ear artery, the occipital artery, the supraorbital artery, the pulley Artery and contralateral superficial temporal artery has a rich anastomosis. Temporal superficial veins by the amount of the veins and the convergence of the venous apex, the amount of the artery and vein, and the basic dynamic and venous apex accompanied. (2) The area available for the supratentorial temporoparietal fascia pedicles supported by forearm branches is (119 75 ± 2 1 19) cm × (59 70 ± 10 16) cm, (110 67 ± 2 1 61) cm × (58 64 ± 7 65) cm. ③ Clinical application of 4 cases of reflux of the temporal lobe tendons were successful. Conclusions The supratemporal and temporal fascial flap provides reliable blood supply. It has the advantages of easy access and concealed area for the repair of deep soft tissue defects such as the skull, roof and occipital lobe.