O'Neill Jennifer, Shaw-Dunn John, Robertson Stuart, Rea Paul
Graduate Teaching Assistant, Laboratory of Human Anatomy, School of Life Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
Honorary Research Fellow, Laboratory of Human Anatomy, School of Life Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
J Oral Maxillofac Surg. 2016 May;74(5):1084-90. doi: 10.1016/j.joms.2015.12.011. Epub 2016 Jan 7.
Radical surgery for neoplasms of the tongue can endanger at least 1 lingual artery, threatening the survival of the remaining tissue and the recovery of speech and swallowing. Although there is little anastomosis in the substance of the tongue, this study investigated whether arterial anastomoses outside the tongue could provide collateral circulation to protect the surviving tissue.
Parts of 9 embalmed cadaver heads were examined. In 2 specimens, the arteries had been previously injected with latex and India ink. In the remaining, a mixture of latex and India ink was injected into the lingual artery at its origin on 1 side. Five injections were successful.
There was considerable variation in the course and distribution of the lingual arteries. Arteries did not cross the midline of the tongue, but actual or potential anastomoses could be seen round the base of the tongue, in the floor of the mouth, and with facial artery branches. After the experimental injections, the mass filled the lingual artery and its branches on the injected side, but also reached the trunk and main branches of the opposite side.
A mass injected into the lingual artery of 1 side can reach the trunk and territory of the lingual artery of the opposite side. In life, it is likely that a similar collateral circulation would exist. Some clinical literature supports this conclusion, but preoperative arteriography might be a reasonable precaution.
舌部肿瘤根治性手术至少会危及1条舌动脉，从而威胁剩余组织的存活以及言语和吞咽功能的恢复。尽管舌实质内几乎没有吻合支，但本研究调查了舌外动脉吻合支是否能提供侧支循环以保护存活组织。
对9个防腐处理的尸头部分进行检查。2个标本的动脉事先已注入乳胶和印度墨水。其余标本中，将乳胶和印度墨水的混合物注入一侧舌动脉的起始处。5次注射成功。
舌动脉的走行和分布存在很大差异。动脉不越过舌中线，但在舌根周围、口底以及与面动脉分支处可见实际或潜在的吻合支。实验性注射后，注入物充满注射侧的舌动脉及其分支，但也到达了对侧的主干和主要分支。
注入一侧舌动脉的物质可到达对侧舌动脉的主干和供血区域。在活体中，可能也存在类似的侧支循环。一些临床文献支持这一结论，但术前动脉造影可能是一种合理的预防措施。
