Anatomical study of the maxillary artery at the pterygomaxillary fissure in a Thai population: its relationship to maxillary osteotomy.
Anatomical study of the maxillary artery at the pterygomaxillary fissure in a Thai population: its relationship to maxillary osteotomy.
复制标题
泰国人群翼上颌裂处上颌动脉的解剖学研究：其与上颌截骨术的关系。
DOI：
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发表时间：
2004
影响因子：
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通讯作者：
A. Lertsirithong
中科院分区：
文献类型：
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作者：
W. Apinhasmit;D. Methathrathip;Sirilak Ploytubtim;S. Chompoopong;T. Ariyawatkul;A. Lertsirithong
背景
上颌动脉（MA）及其终末支在上颌骨截骨术中，尤其是翼上颌联合分离术中常受到损伤。
目的
评价泰国人翼上颌裂（PMF）处的MA与PMJ之间的位置关系，测量MA进入翼腭窝（PPF）时的直径以及PMJ、上颌骨结节和后上颌骨的高度。
受试者和方法
对100具泰国成人尸体（50男50女）的两侧进行了检查，受试者的平均年龄为64.5 ± 12.8岁。采用外侧颞下入路，解剖了MA第三部分、PMJ和上颌骨后外侧的分支。测量包括：第一，PMJ最下点到MA进入PPF时最下位置的距离;第二，MA进入PPF时的外径;第三，PMJ、上颌骨结节和后上颌骨的垂直高度。确定平均值、标准差和范围，并计算p < 0时两侧和性别之间的统计学差异。05.
结果
MA在PMJ最下点上方23.5 +/- 2.5 mm的平均距离处进入PPF。MA进入PPF时的平均外径为2.8 +/- 0.6 mm。PMJ、上颌结节和上颌后部的平均高度分别为19.5 +/- 2.3 mm、6.1 +/- 2.7 mm和25.6 +/- 3.3 mm。除了PMJ最下方点到MA最下方位置的距离男性比女性长（p < 0.05）之外，在侧别和性别方面没有差异。
结论
MA的平均位置距离PMJ的最下点为23.5 mm，因此，使用15 mm切割刃的骨凿可以在不损伤MA的情况下进行PMJ的分离。当正确放置时，成人中从骨凿的上级切割边缘到MA的安全裕度约为8 mm。
BACKGROUND
The maxillary artery (MA) and its terminal branches are commonly damaged in the maxillary osteotomy, especially during separation of the pterygomaxillary junction (PMJ).
OBJECTIVE
To evaluate the positional relationship between the MA at the pterygomaxillary fissure (PMF) and the PMJ in Thais, as well as to measure the diameter of the MA as it enters the pterygopalatine fossa (PPF) and the heights of PMJ, maxillary tuberosity and posterior maxilla.
SUBJECTS AND METHOD
Both sides of 100 Thai adult cadavers (50 males and 50 females) were examined The mean age of the subjects was 64.5 +/- 12.8 years. With the lateral infratemporal approach, the branches from the third part of the MA, PMJ and posterolateral maxilla were dissected. Measurements taken included the following: First, the distance from the most inferior point of the PMJ to the most inferior position of the MA as it entered the PPF; second, the external diameter of the MA as it entered the PPF; third, vertical heights of the PMJ, maxillary tuberosity and posterior maxilla. Means, standard deviations and ranges were determined and statistical differences were calculated between sides and genders at p < 0. 05.
RESULTS
The MA entered the PPF at a mean distance of 23.5 +/- 2.5 mm above the most inferior point of the PMJ. The mean external diameter of the MA as it entered the PPF was 2.8 +/- 0.6 mm. The mean heights of the PMJ, maxillary tuberosity and posterior maxilla were 19.5 +/- 2.3 mm, 6.1 +/- 2.7 mm, and 25.6 +/- 3.3 mm, respectively. There were no differences with respect to side and gender, except that the distance from the most inferior point of the PMJ to the most inferior position of the MA as it entered the PPF was longer in males than in females (p < 0.05).
CONCLUSION
The mean location of the MA was 23.5 mm apart from the most inferior point of the PMJ, therefore, dysjunction of the PMJ using an osteotome with a 15-mm cutting edge may be conducted without damaging to the MA. When properly placed, the margin of safety from the superior cutting edge of the osteotome to the MA is approximately 8 mm in adults.