Meguid E A, Agawany A E
Anatomy Department, Faculty of Medicine, Alexandria University, Egypt.
Folia Morphol (Warsz). 2009 Nov;68(4):233-43.
A precise knowledge of the sources of the arterial and neural supply of the sternohyoid (SH), sternothyroid (STM), and superior belly of omohyoid (OM) is of value to surgeons using the infrahyoid muscles in reconstruction procedures of the head and neck. This study was designed to define the anatomical bases of the variable sources of the arterial and neural supply of these muscles. Fourteen cadavers were unilaterally dissected in the neck region, and the arterial pedicles of these muscles were followed and accurate measurements were taken. For the SH, two arterial pedicles (superior and inferior) originated from the superior thyroid artery ST and supplied the muscle in 57.1% of cases. The inferior pedicle was absent in 42.9% of cases. As regards the STM, one arterial pedicle from the ST supplied its upper end by multiple branches in 57.1% of cases. In 14.3% of cases, branches from the inferior thyroid artery (IT) supplied the STM in addition to its supply from the ST. As regards the OM, two arterial pedicles originated from the ST and supplied its upper and lower ends in 57.1% of cases. The main artery from the ST to the superior belly of OM entered at its superior portion. The ansa cervicalis (AC) innervated the infrahyoid muscles. SH usually had a double nerve supply. In 57.1% of cases, its superior part was innervated by the nerve to the superior belly of OM. Its inferior part received branches from the AC. In 35.7% of cases, its superior part received direct branches from the AC. As regards the STM, in (71.4%) of cases, a common trunk arose from the loop and supplied the inferior part of both the SH and STM. The nerve supply to the superior belly of OM originated from the AC below the loop in 64.3% of cases. These data will be useful for preserving the neuro-vascular supply of the infrahyoid muscles during flap preparation.
精确了解胸骨舌骨肌(SH)、胸骨甲状肌(STM)和肩胛舌骨肌上腹(OM)的动脉和神经供应来源,对于在头颈部重建手术中使用舌骨下肌群的外科医生具有重要价值。本研究旨在明确这些肌肉动脉和神经供应来源多变的解剖学基础。对14具尸体的颈部区域进行单侧解剖,追踪这些肌肉的动脉蒂并进行精确测量。对于胸骨舌骨肌,两条动脉蒂(上方和下方)起源于甲状腺上动脉(ST),在57.1%的病例中供应该肌肉。42.9%的病例中不存在下方动脉蒂。对于胸骨甲状肌,来自甲状腺上动脉的一条动脉蒂在57.1%的病例中通过多个分支供应其上端。在14.3%的病例中,除了来自甲状腺上动脉的供应外,甲状腺下动脉(IT)的分支也供应胸骨甲状肌。对于肩胛舌骨肌,两条动脉蒂起源于甲状腺上动脉,在57.1%的病例中供应其上端和下端。从甲状腺上动脉至肩胛舌骨肌上腹的主要动脉在其上部进入。颈袢(AC)支配舌骨下肌群。胸骨舌骨肌通常有双重神经供应。在57.1%的病例中,其上部由支配肩胛舌骨肌上腹的神经支配。其下部接受来自颈袢的分支。在35.7%的病例中,其上部接受来自颈袢的直接分支。对于胸骨甲状肌,在71.4%的病例中,一个共同的干从袢发出,供应胸骨舌骨肌和胸骨甲状肌的下部。在64.3%的病例中,支配肩胛舌骨肌上腹的神经起源于袢下方的颈袢。这些数据将有助于在皮瓣制备过程中保留舌骨下肌群的神经血管供应。