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舌孔及其管道的临床解剖学与手术意义

Clinical anatomy and surgical significance of the lingual foramina and their canals.

作者信息

He Puhan, Truong Mindy K, Adeeb Nimer, Tubbs R Shane, Iwanaga Joe

机构信息

Harvard School of Dental Medicine, Boston, Massachusetts.

Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.

出版信息

Clin Anat. 2017 Mar;30(2):194-204. doi: 10.1002/ca.22824. Epub 2017 Feb 9.

Abstract

The lingual foramina and canals can be categorized as median or lateral based on their relation to the midline of the mandible. Investigation of the mandibular lingual region is often done with gross anatomical dissections of cadavers, 2D panoramic radiographic imaging, CT, and cone beam CT (CBCT). While gross studies are the most reliable at qualifying canal contents and course, CBCT proved to be superior to other radiographic techniques for visualizing lingual foramina and canals. The submental and sublingual arteries, and their branches are found in the lingual vascular canals. There is tremendous variation between individuals in terms of the course of the lingual canals and their anastomosis with other vascular canals. Performing the dental implantation procedures in the anterior and posterior regions of the mandible can result in perforation of the lingual cortex, which could injure the arteries that lie within the lingual canal. If hemorrhage occurs, it could lead to life-threatening upper airway obstruction. Pre-surgical investigation to identify the diameter of the lingual foramina and canal as well as their distance from the alveolar process might be necessary to prevent hemorrhage for all patients. Clin. Anat. 30:194-204, 2017. © 2017 Wiley Periodicals, Inc.

摘要

根据舌侧孔和管道与下颌骨中线的关系,可将其分为正中或外侧。对下颌舌侧区域的研究通常通过尸体大体解剖、二维全景放射成像、CT和锥形束CT(CBCT)进行。虽然大体研究在确定管道内容物和走行方面最为可靠,但CBCT在显示舌侧孔和管道方面被证明优于其他放射技术。颏下动脉和舌下动脉及其分支存在于舌侧血管管道中。舌侧管道的走行及其与其他血管管道的吻合情况在个体之间存在巨大差异。在下颌骨前后区域进行牙种植手术可能会导致舌侧皮质穿孔,从而损伤位于舌侧管道内的动脉。如果发生出血,可能会导致危及生命的上呼吸道阻塞。对于所有患者,术前进行检查以确定舌侧孔和管道的直径及其与牙槽突的距离,可能有必要预防出血。《临床解剖学》30:194 - 204,2017年。© 2017威利期刊公司。

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