多血管神经蒂腹内斜肌瓣修复面瘫的应用解剖

目的：为了探索晚期面瘫动力性修复中多神经支配的供区，提供多血管神经蒂腹内斜肌瓣的应用解剖学基础。方法：在２２侧红色乳胶灌注的成人尸体上，测量观察了腹内斜肌的神经支配及血供情况。结果：腹内斜肌主要接受第１１肋间神经和肋下神经支配的占９０．９％，接受第１０、１１肋间神经和肋下神经支配的占９．１％。第１１肋间神经入肌处至腋后线的平均长度为１２．７ｃｍ，肋下神经入肌处至腋后线的平均长度为１２．９ｃｍ，血供主要来源于第１１肋间动脉、肋下动脉和旋髂深动脉的腹壁肌支，在腹内斜肌和腹横肌筋膜之间有丰富的血管吻合。结论：可利用腹内斜肌多血管神经支配的特点，设计超长吻合多血管神经蒂的腹内斜肌瓣跨面移植治疗晚期面瘫的新术式。

Applied anatomy of free flap transfer of internal oblique muscle of abdominis in facial palsy

Objective:To explore the donor tissue in dynamic repair of advanced facial palsy. Methods:Eleven adult cadavers were measured and observed for the innervation and blood supply of oblique abdominis muscle ,which were supplied by the eleventh intercostal and the subcostal nerves and arteries,or by the tenth and the eleventh intercostal and the subcostal nerves and arteries.The average lengthes from the eleventh intercostal and the subcostal nerves and arteries,and the average lengthes from the points where the nerves enter the muscle to the postaxillaryline of the eleventh intercostal and the subcostal nerves were 12.7 cm and 12.9 cm respectively.Blood supply was mainly from the eleventh intercostal artery,the subcostal artery and the muscular branches of deep iliac circumflex artery.Conclusions:A multi neurovascular internal oblique abdominis muscle flap was designed in the treatment of advanced facial palsy.