解剖学报 ›› 2020, Vol. 51 ›› Issue (5): 659-663.doi: 10.16098/j.issn.0529-1356.2020.05.004

• 解剖学与耳鼻喉科学 • 上一篇    下一篇

颞肌瓣鼻颅底区转位的解剖

刘全 孙希才 王欢 张焕康 余洪猛* 王德辉*   

  1. 复旦大学附属眼耳鼻喉科医院耳鼻喉科,上海 200031
  • 收稿日期:2020-04-07 修回日期:2020-05-22 出版日期:2020-10-06 发布日期:2020-10-06
  • 通讯作者: 余洪猛;王德辉 E-mail:wangdehuient@sina.com
  • 基金资助:
    上海市卫生健康委员会面上项目;中国医学科学院内镜下鼻颅底肿瘤外科治疗技术创新单元;上海申康医院发展中心/新兴前沿技术联合攻关项目;上海市科学技术委员会科技创新行动计划临床医学项目

Anatomy of transposition of the temporalis muscle flap for skull base reconstruction

LIU Quan SUN Xi-cai WANG Huan ZHANG Huan-kang YU Hong-meng* WANG De-hui*#br#   

  1. Department of Otolaryngology, Eye & ENT Hospital of Fudan University, Shanghai 200031, China
  • Received:2020-04-07 Revised:2020-05-22 Online:2020-10-06 Published:2020-10-06
  • Contact: YU Hong-meng;WANG De-hui E-mail:wangdehuient@sina.com

摘要:

目的 探讨颞肌瓣的显微和内镜解剖,为使用颞肌瓣(TMF)进行内镜下颅底重建提供解剖学资料。  方法 在6例共12侧新鲜灌注的头颅标本上进行颞肌瓣的解剖,测量颞肌瓣的长度和宽度,显露颞肌瓣的血供;将获取的颞肌瓣经颞下窝、上颌窦路径转位至鼻颅底区进行颅底重建,分析其所能覆盖的颅底区域。  结果 获取的颞肌瓣平均长度为(11.7±0.7)cm,宽度为(9.2±0.8)cm。颞肌瓣经颞下窝、上颌窦路径可有效地转位至鼻颅底区,覆盖前颅底、鞍区和斜坡区。 结论 将颞肌瓣经颞下窝、上颌窦径路转位至鼻颅底区进行有效的颅底重建,在内镜颅底手术后的颅底重建方面具有较好的应用前景。

关键词: 颞肌瓣, 颅底, 颞下窝, 内镜,

Abstract:

Objective To investigate surgical anatomy of transposition of the temporalis muscle flap(TMF) for skull base reconstruction.  
 Methods The dissection of the temporalis muscle flap was performed on six fresh cadaver heads (12 sides). The temporalis muscle was harvested through a traditional open approach. The length and width of the temporalis muscle flap were measured and the arterial supply of the temporalis muscle flap was also exposed. The temporalis muscle flap was transposed into the maxillary sinus and nasal cavity through the infratemporal fossa by an endoscopic transnasal transmaxillary approach. The simulate operation that the temporalis muscle flap was used to reconstruct the skull base defects was performed on six fresh cadaver heads.  Results The length of the temporalis muscle flap harvested from temporal line to the tip of the coronoid process of the mandible was (11.7±0.7)cm. Maximum width of the flap was (9.2±0.8)cm. The temporalis muscle flap could reconstruct the defects of cranial skull base, sellar and clivus.   Conclusion Transposition of the temporalis muscle flap via the infratemporal fossa is an alternative and effective method  for reconstruct the skull base after the endoscopic surgery.

Key words:  Temporalis muscle flap, Skull base, Infratemporal fossa, Endoscopy, Human

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