Bavitz J B, Harn S D, Homze E J
University of Nebraska, College of Dentistry.
Oral Surg Oral Med Oral Pathol. 1994 Mar;77(3):232-5. doi: 10.1016/0030-4220(94)90290-9.
According to many anatomy textbooks, the blood supply to the mandibular lingual gingiva and the floor of the mouth is derived from the sublingual branch of the lingual artery. Sometimes a variation exists in which the submental branch of the facial artery pierces the mylohyoid muscle to supply this region in addition to or in lieu of the sublingual artery. The purpose of this study was to detail the vascular supply to this region and to delineate the relative contribution and importance of the sublingual versus the submental artery in humans. A large branch of the submental artery that perforates through the mylohyoid muscle was found in 60% of the cases. The sublingual artery was found to be small, missing, or insignificant in 53% of cases. In these 53% of cases, a large perforating branch from the submental artery was present. Consequently, the submental artery can be considered the main arterial blood supply to the floor of the mouth and mandibular lingual gingiva. This study demonstrates the need to change the procedure of extraoral ligation for control of hemorrhage in the floor of the mouth. On the basis of the results of this study, the submental artery or its parent facial artery should first be ligated. Then, if bleeding is not controlled, the lingual artery should be ligated to insure satisfactory hemostasis in this region.
根据许多解剖学教科书，下颌舌侧牙龈和口腔底部的血液供应源自舌动脉的舌下分支。有时存在变异情况，即面动脉的颏下分支会穿透下颌舌骨肌，以补充或替代舌下动脉来供应该区域。本研究的目的是详细阐述该区域的血管供应情况，并描述舌下动脉与颏下动脉在人体中的相对贡献及重要性。在60%的病例中发现了一条穿过下颌舌骨肌的颏下动脉大分支。在53%的病例中，舌下动脉细小、缺失或不显著。在这53%的病例中，存在一条来自颏下动脉的大穿支。因此，颏下动脉可被视为口腔底部和下颌舌侧牙龈的主要动脉血液供应。本研究表明有必要改变口外结扎以控制口腔底部出血的操作方法。基于本研究结果，应首先结扎颏下动脉或其所属的面动脉。然后，如果出血未得到控制，应结扎舌动脉以确保该区域实现满意的止血效果。
