口腔医学研究 ›› 2018, Vol. 34 ›› Issue (1): 60-64.DOI: 10.13701/j.cnki.kqyxyj.2018.01.015

• 口腔颌面外科学研究 • 上一篇    下一篇

以颞中静脉为解剖平面行冠状切口颞区翻瓣

宋勇*, 王俊林, 刘彦杰, 陈裕聪, 何浒杰, 王博灏   

  1. 柳州市人民医院口腔科 广西 柳州 545000
  • 收稿日期:2017-08-31 出版日期:2018-01-28 发布日期:2018-01-26
  • 通讯作者: 宋勇,E-mail:songyong@whu.edu.cn
  • 作者简介:宋勇(1982~ ),男,四川人,副主任医师,博士,主要从事颌面外科临床工作。

Middle Temporal Vein Guided Flapping in Coronal Incision: a Clinical Study

SONG Yong*, WANG Jun-lin, LIU Yan-jie, CHEN Yu-cong, HE Hu-jie, WANG Bo-hao   

  1. Department of Stomatology, Liuzhou General Hospital. Liuzhou 545006, China
  • Received:2017-08-31 Online:2018-01-28 Published:2018-01-26

摘要: 目的:探讨颞中静脉在冠状切口中的应用价值。方法:收集36例颧骨复合体或颧骨颧弓骨折,行冠状切口的病例,分别在颞中静脉平面及颞深筋膜上翻瓣,观察手术及术后并发症等情况。结果:颞中静脉位于颞深筋膜浅深两层之间的颞浅脂肪垫内,位于其浅层,走行位置相对恒定;18例患者颞中静脉无缺失,均翻瓣顺利,颞浅脂肪垫保存完整,骨折显露充分,复位效果良好,术后暂时性面瘫发生率较筋膜上翻瓣组明显降低,永久性面瘫、颞窝凹陷与筋膜上翻瓣组无统计学差异。结论:以颞中静脉为解剖平面行冠状切口颞区翻瓣,定位标志明确,层次清晰,方法简便易行,可降低面神经损伤、颞窝凹陷发生率,在临床上有一定的推广价值。

关键词: 冠状切口, 颞中静脉, 解剖平面, 面神经损伤, 颞窝凹陷

Abstract: Objective: To investigate the role of middle temporal vein in coronal incision. Methods: Thirty-six patients with zygomatic fractures in our hospital were included. All fracture segments were exposed by coronal incision along the plane of middle temporal vein or deep temporal fascia. Factors taken into the study included flapping time, bleeding volume, variation of middle temporal vein, and clinical outcomes. Results: The middle temporal vein ran constantly through superficial part of temporal fat pad between the two layers of deep temporal fascia. All 18 middle temporal vein cases were recorded without middle temporal vein missing, with successful flapping, intact temporal fat pad, good exposure, and satisfactory reduction of fractures. Transient facial paralysis was reduced significantly in the middle temporal vein group, while permanent facial nerve injury and temporal hollowing showed no significant difference. Conclusion: Temporal flapping guided by middle temporal vein is a simple and clear way that can reduce facial nerve injury and temporal hollowing in coronal incision.

Key words: Coronal incision, Middle temporal vein, Anatomical plane, Facial nerve injury, Temporal hollowing

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