PDF(Pubmed)
Abstract：
OBJECTIVE: To evaluate the influence of collateral vascularization on surgical cleft palate closure and deformities.
METHODS: Corrosion casting was performed using red-colored acrylic resin in twelve fresh adult cadavers with a normal hard palate. Additionally, white-colored barium sulfate was injected into a fetus with a unilateral complete cleft palate, and layer-by-layer tissue dissection was performed. Both substances were injected into the external carotid arteries. Corrosion casting involved dissolving the soft and hard tissues of the orofacial area utilizing an enzymatic solution.
RESULTS: In normal palates, bilateral intraosseous infraorbital arteries formed a network in the premaxilla with the intraosseous nasopalatine- and greater palatine arteries (GPAs). The perforating GPAs anastomosed with the sphenopalatine artery sub-branches. Bilateral extraosseous GPA anastomoses penetrated the median palatine suture. Complex vascularization in the retrotuberal area was detected. In the cleft zone, anastomoses were omitted, whereas in the non-cleft zone, enlarged GPAs were distributed along the cleft edges and followed the anatomical course anteriorly to initiate the network with facial artery sub-branches.
CONCLUSIONS: The anatomical subunits of the palate exhibited distinct anastomosis patterns. Despite omitted anastomoses with collateral circulation in the cleft zone, arteries maintained their anatomical pattern as seen in the normal specimen in the non-cleft zone.
CONCLUSIONS: Based on the findings in normal- and cleft palates, surgeons may expect developed anastomosis patterns in the non-cleft zone. Due to the lack of microcirculation in the cleft zone, the existent anastomoses should be maintained as much as possible by the surgical technique. This applies anteriorly in the incisive canal territory, alveolar ridges, and posteriorly in the retrotuberal area.
METHODS: Corrosion casting was performed using red-colored acrylic resin in twelve fresh adult cadavers with a normal hard palate. Additionally, white-colored barium sulfate was injected into a fetus with a unilateral complete cleft palate, and layer-by-layer tissue dissection was performed. Both substances were injected into the external carotid arteries. Corrosion casting involved dissolving the soft and hard tissues of the orofacial area utilizing an enzymatic solution.
RESULTS: In normal palates, bilateral intraosseous infraorbital arteries formed a network in the premaxilla with the intraosseous nasopalatine- and greater palatine arteries (GPAs). The perforating GPAs anastomosed with the sphenopalatine artery sub-branches. Bilateral extraosseous GPA anastomoses penetrated the median palatine suture. Complex vascularization in the retrotuberal area was detected. In the cleft zone, anastomoses were omitted, whereas in the non-cleft zone, enlarged GPAs were distributed along the cleft edges and followed the anatomical course anteriorly to initiate the network with facial artery sub-branches.
CONCLUSIONS: The anatomical subunits of the palate exhibited distinct anastomosis patterns. Despite omitted anastomoses with collateral circulation in the cleft zone, arteries maintained their anatomical pattern as seen in the normal specimen in the non-cleft zone.
CONCLUSIONS: Based on the findings in normal- and cleft palates, surgeons may expect developed anastomosis patterns in the non-cleft zone. Due to the lack of microcirculation in the cleft zone, the existent anastomoses should be maintained as much as possible by the surgical technique. This applies anteriorly in the incisive canal territory, alveolar ridges, and posteriorly in the retrotuberal area.
摘要：
目的：评价侧支血管形成对外科腭裂闭合及畸形的影响。
方法：使用红色丙烯酸树脂在12具正常硬腭的新鲜成年尸体中进行腐蚀铸造。此外,将白色硫酸钡注射到单侧完全性腭裂的胎儿中，并进行逐层组织解剖。两种物质都被注射到颈外动脉中。腐蚀铸造涉及利用酶溶液溶解口面区域的软组织和硬组织。
结果：在正常腭中，双侧骨内眶下动脉在前颌骨中形成了一个网络，与骨内鼻腭和大动脉（GPA）形成了网络。穿孔的GPA与蝶腭动脉分支吻合。双侧骨外GPA吻合穿透正中腭缝。检测到结节后区域的复杂血管形成。在裂隙区,吻合被省略，而在非裂隙区，扩大的GPA沿裂隙边缘分布，并沿解剖路线向前延伸，以启动具有面部动脉分支的网络。
结论：腭的解剖亚单位表现出明显的吻合模式。尽管在裂隙区省略了侧支循环的吻合，动脉保持了其解剖模式，如在非裂隙区的正常标本中所见。
结论：根据正常腭裂和腭裂的发现，外科医生可能会期望在非裂隙区形成吻合模式。由于裂隙区缺乏微循环,应通过手术技术尽可能维持现有的吻合口。这适用于尖锐的运河区域，牙槽脊,在后面的结节后区域。
方法：使用红色丙烯酸树脂在12具正常硬腭的新鲜成年尸体中进行腐蚀铸造。此外,将白色硫酸钡注射到单侧完全性腭裂的胎儿中，并进行逐层组织解剖。两种物质都被注射到颈外动脉中。腐蚀铸造涉及利用酶溶液溶解口面区域的软组织和硬组织。
结果：在正常腭中，双侧骨内眶下动脉在前颌骨中形成了一个网络，与骨内鼻腭和大动脉（GPA）形成了网络。穿孔的GPA与蝶腭动脉分支吻合。双侧骨外GPA吻合穿透正中腭缝。检测到结节后区域的复杂血管形成。在裂隙区,吻合被省略，而在非裂隙区，扩大的GPA沿裂隙边缘分布，并沿解剖路线向前延伸，以启动具有面部动脉分支的网络。
结论：腭的解剖亚单位表现出明显的吻合模式。尽管在裂隙区省略了侧支循环的吻合，动脉保持了其解剖模式，如在非裂隙区的正常标本中所见。
结论：根据正常腭裂和腭裂的发现，外科医生可能会期望在非裂隙区形成吻合模式。由于裂隙区缺乏微循环,应通过手术技术尽可能维持现有的吻合口。这适用于尖锐的运河区域，牙槽脊,在后面的结节后区域。
