From the Bona Microtia and Aesthetic Ear Surgery Clinic, Seoul, Korea.
Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea.
Ann Plast Surg. 2022 Apr 1;88(4):446-450. doi: 10.1097/SAP.0000000000002936.
Since arterial supply of the anterior ear was described in 1992 by Park et al, various anatomical studies and surgical techniques have been published in the literatures. Although anatomic studies about the vascular pattern of the ear have been previously reported, most were incomplete to understand the vascular anatomy of the ear and its surgical outcomes. In this report, the authors defined further detailed vascular pattern of the arterial networks and of the main perforators of the anterior ear.
The authors dissected in a total of 11 auricles that had been fixed in 10% formalin solution. Prior to dissection, a red latex solution was injected into the common carotid artery. The anteroauricular and postauricular skin was dissected to expose the arterial network under ×10 microscope magnification.
There are 2 arterial networks in the anteroauricular surface of the ear: triangular-scapha fossa and concha network. In this study, triangular-scapha fossa network has 2 vascular patterns by a dominant arterial supply: the superficial temporal artery (STA) type (6/11, 54.5%) and the posterior auricular artery (PAA) type (5/11, 45.4%). The STA type is distributed by a subbranch of the ascending helical artery of the STA, whereas the dominant arterial supply of the PAA type is a perforator of the triangular fossa from the PAA. We describe an important inflow to the triangular-scapha fossa network as blood supply from the middle division of the PAA, which directly emerges from the posterior to the anterior surface over the cartilage border at midhelix.
The detailed vascular anatomy of this report allows surgeons to perform surgical procedures safely and to develop various flaps in the field of the ear reconstruction.
自 1992 年 Park 等人描述了耳前动脉的供应以来,各种解剖学研究和手术技术已在文献中发表。尽管以前有关于耳部血管模式的解剖研究,但大多数都不完整,无法了解耳部的血管解剖结构及其手术结果。在本报告中,作者进一步详细定义了动脉网络和耳前主要穿支的血管模式。
作者共解剖了 11 个固定在 10%甲醛溶液中的耳廓。在解剖之前,将红色乳胶溶液注入颈总动脉。在前耳和后耳皮肤下解剖以在×10 显微镜放大倍数下暴露动脉网络。
耳前表面有 2 个动脉网络:三角窝-舟状窝网络和耳廓网络。在这项研究中,三角窝-舟状窝网络有 2 种主要动脉供应的血管模式:颞浅动脉(STA)型(6/11,54.5%)和耳后动脉(PAA)型(5/11,45.4%)。STA 型由 STA 的升支螺旋动脉的分支分布,而 PAA 型的主要动脉供应是来自 PAA 的三角窝穿支。我们描述了一个重要的血流进入三角窝-舟状窝网络,即来自 PAA 的中部分支的血流供应,该分支直接从前向后穿过中螺旋软骨边界。
本报告详细的血管解剖结构使外科医生能够安全地进行手术,并在耳部重建领域开发各种皮瓣。