Hwang Se Hwan, Joo Young Hoon, Seo Jae Hyun, Kang Jun Myung
Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Clin Anat. 2014 Jul;27(5):691-7. doi: 10.1002/ca.22329. Epub 2013 Dec 5.
The maxillary artery (MA) is the main source of brisk bleeding during maxillectomy and procedures in the subcondylar portion of the mandible. The purpose of the study was to investigate the relationship between the MA and the mandible in the infratemporal fossa. The CT scans of 100 patients were retrospectively evaluated. The distances from the MA to bony landmarks were assessed in a three-dimensional model of the CT scan. In the cases where the MA was lateral to the LP [164 of 200 MAs (82%)], the mean shortest distances from the MA to the apex of the coronoid and condyle and the deepest portion of the mandibular notch were 13.6 ± 1.6 mm, 21.3 ± 2.0 mm, and 3.6 ± 1.0 mm, respectively. The contact point between the MA and medial surface of the mandible was measured and found to be 3.6 ± 2.2 mm posterior and 1.7 ± 1.4 mm inferior relative to the deepest portion of the mandibular notch. In the cases where the MA was medial to the LP [36 of 200 MAs (18%)], the mean shortest distances from the MA to the apex of the coronoid and condyle and the deepest portion of the mandibular notch were 19.5 ± 2.5 mm, 20.7 ± 2.4 mm, and 16.3 ± 3.7 mm, respectively. The studied measurements will help guide surgeons to determine the anatomy of the operative field in relation to the MA and minimize risks of injuring the vessel.
上颌动脉（MA）是上颌骨切除术及下颌骨髁突下部分手术中活跃出血的主要来源。本研究的目的是调查颞下窝内MA与下颌骨之间的关系。对100例患者的CT扫描进行回顾性评估。在CT扫描的三维模型中评估MA到骨性标志的距离。在MA位于翼突外侧板外侧的病例中[200条MA中的164条（82%）]，MA到冠突尖、髁突以及下颌切迹最深部的平均最短距离分别为13.6±1.6mm、21.3±2.0mm和3.6±1.0mm。测量了MA与下颌骨内侧面的接触点，发现该接触点相对于下颌切迹最深部在后方3.6±2.2mm、下方1.7±1.4mm处。在MA位于翼突外侧板内侧的病例中[200条MA中的36条（18%）]，MA到冠突尖、髁突以及下颌切迹最深部的平均最短距离分别为19.5±2.5mm、20.7±2.4mm和16.3±3.7mm。所研究的测量结果将有助于指导外科医生确定手术区域相对于MA的解剖结构，并将损伤血管的风险降至最低。
