Division of Oral and Maxillofacial Surgery, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Division of Anatomy and Cell Biology of the Hard Tissue, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Clin Anat. 2021 Oct;34(7):1087-1094. doi: 10.1002/ca.23738. Epub 2021 May 5.
There is little anatomical evidence about the venous plexus in the floor of the oral cavity, although venous injury can elicit late postoperative bleeding after oral surgery and it is difficult to identify the exact location of such an injury. The aim of this study was to assess the relative risk for venous injury during surgery. We investigated the course patterns of the venous plexus in the floor of the oral cavity and analyzed their relationships to those of the arteries using 23 human cadavers (41 halves) in the anatomy course at Niigata University during 2016-2018. The venous plexus in the floor of the oral cavity comprised the perforating submental vein, the vena comitans of the hypoglossal nerve, the vena comitans of the submandibular duct, the vena comitans of the lingual nerve, the sublingual vein, and the deep lingual vein. Individual variations of this plexus include duplications or absences of some veins. There is a high incidence of a submental branch running above the mylohyoid or perforating submental artery in the sublingual fossa among individuals with the perforating submental vein piercing the mylohyoid muscle, whereas the sublingual artery has a high incidence there when there is no perforating submental vein. The course patterns of arteries in the floor of the oral cavity can be predicted by estimating the course patterns of the submental veins. The course patterns of the submental veins or veins associated with the nerves and submandibular duct need to be carefully considered during surgery.
口腔底部静脉丛的解剖学证据很少，尽管静脉损伤可导致口腔手术后迟发性出血，且难以确定此类损伤的确切位置。本研究旨在评估手术中静脉损伤的相对风险。我们在 2016 年至 2018 年期间，在新潟大学解剖学课程中使用 23 具人体尸体（41 个半），调查了口腔底部静脉丛的循行模式，并分析了它们与动脉的关系。口腔底部静脉丛包括颏下静脉穿支、舌下神经伴行静脉、下颌下腺导管伴行静脉、舌神经伴行静脉、舌下静脉和舌深静脉。该静脉丛的个体变异包括一些静脉的重复或缺失。在有颏下静脉穿支穿过颏舌肌的个体中，舌骨下肌或颏下动脉穿支上方有较高的颏下支发生率，而当没有颏下静脉穿支时，舌骨下动脉的发生率较高。口腔底部动脉的循行模式可以通过估计颏下静脉的循行模式来预测。手术时需要仔细考虑颏下静脉或与神经和下颌下腺导管相关的静脉的循行模式。
