下颌角周围相关动脉走行的CTA定位研究

目的:应用CTA影像测量下颌角周围动脉与下颌角手术的解剖关系,为避免手术中损伤下颌角周围动脉提供指导。方法:选择30名正常成人下颌角及周围血管CTA扫描图像,应用ADW4.2图像处理软件测量面动脉距下颌角点;颈外动脉距下颌角点、颈外动脉距下颌骨升支后缘各点的三维解剖位置。结果:面动脉距下颌角点的距离为(28.26±8.34)mm;颈外动脉据下颌角点的距离为(18.66±6.34)mm;颈外动脉在下颌角点上10mm处距下颌骨升支后缘的距离为(12.28±5.12)mm;在下颌角点上20mm处距下颌骨升支后缘的距离为(9.58±5.42)mm;在下颌角点上30mm处距下颌骨升支后缘的距离为(6.38±4.12)mm,在下颌角点上40mm处距下颌骨升支后缘的距离为(3.46±2.56)mm,左右侧无显著差异。结论:在下颌角截骨或磨削手术时应注意面动脉和颈外动脉的损伤,位置越高颈外动脉距下颌升支边缘越近。手术安全范围应控制在距下颌角点上30mm以内的位置。

The measurement position study of external carotid artery and facial artery with CTA in the mandibular angle plasty

Objective The aim of this study was to investigate the position and course of external carotid artery and facial artery with CTA in the mandibular angle plasty,and the relationship with mandiable angle of these two vascular using computed tomographic angiography(CTA)imaging,to provide guidance in the mandibular angle plasty,and avoid a series complications caused by bleeding because damaging these vascular.Methods Multi-detector row helical CTA measurement was performed on thirty adult.With ADW4.2 software,the distances from the facial artery to mandibular angle,from the external carotid artery to mandibular angle and mandible border were analyzed.Results The distance from the external carotid artery to the gonion is(18.66±6.34)mm,and to above 10 mm from the point of gonion in the edge of mandibular border is(12.28±5.12)mm,and to above 20 mm from the point of gonion in the edge of mandibular border is(9.58±5.42mm),and to above 30 mm from the point of gonion in the edge of mandibular border is(6.38±4.12)mm,and to above 40 mm from the point of gonion in the edge of mandibular border is(3.46±2.56)mm.the distance from the facial artery to the gonion is(28.26±8.34)mm.Conclusion The study is to provide further understanding of the external carotid artery and facial artery in relation to the design of the mandibuler angle plasty,the higher of the operating position,the closer of the distance from external carotid artery to mandible,and the more likely damage the artery,In according to the data obtained,we can control the clinical safety guidelines in 30mm above the gonion.