下颌矢状劈开截骨术相关颌内动脉的CTA研究

目的:通过CTA影像测量颌内动脉及其分支下牙槽动脉的位置,避免在双侧下颌骨矢状劈开截骨术(bilateral sagittal split ramus osteotomy,BSSRO)时损伤颌内动脉及下牙槽动脉。方法:随机选择60例(男38例,女22例)正常成年人(平均年龄31岁)的颌面部CTA扫描图像,应用ADW4.2图像处理软件测量颌内动脉、下牙槽动脉及下颌小舌的三维位置关系。结果:通过测量显示下牙槽动脉起始处距下颌小舌的距离为颌内动脉距下颌小舌的最近距离,该空间距离的平均值为14.83mm。颌内动脉在正中矢状面的投影离下颌平面的最小距离为11.91mm,下颌小舌在正中矢状面的投影离下颌平面的平均距离为2.62mm。结论:①在距下颌小舌12～14mm内剥离下颌骨内侧面软组织,可以降低损伤颌内动脉的可能;②行水平骨劈开时,器械距颌平面的高度至少控制在11mm内,避免直接损伤颌内动脉。

Study on internal maxillary artery with CTA in the bilateral sagittal split osteotomy

Objective The aim of the study was to using computed tomographic angiography imaging investigate the position of internal maxillary artery and inferior alveolar artery,avoiding damnify these blood vessels in BSSRO.Methods The multi-detector row helical CTA of 60 adults was elected and using ADW4.2 software to measure 3D positional relationship of the internal maxillary artery,inferior alveolar artery and mandibular lingual.Results The distance from the starting point of inferior alveolar artery to mandibular lingual is the shortest length which the length from internal maxillary artery to mandibular lingual,and the length is 14.83mm.The distance from the projection of the maxillary artery in the median sagittal plane to mandibular plane is 11.91mm,and the distance from the projection of the mandibular lingual in the median sagittal plane to mandibular plane is 2.62mm.Conclusion ①In order to reduce the possibility of the maxillary artery injury,we can dissect the soft tissue which in the medial of mandible within the scope of 12～14mm away from the mandibular lingual;②The altitude from the tools to mandibular plane was controlled within 11mm,avoiding direct damage of internal maxillary artery.