Microsurgical Anatomy And Clinic Application Of The Superficial Temporal Artery

Objective:1. To study the anatomy of superficial temporal artery, therefore provide anatomical bases for relevant operations for related vascular diseases;2. To study the features and variations Of the superficial temporal artery angiography and after the encephalo-duro-arterial synangiosias (EDAS) in the patients with Moyamoya disease.,therefore provide reference for clinical treatment of ischemic moyamoya disease.3. To study the superficial temporal artery pathology results, so as to discuss the impact of hypertension, diabetes and hyperlipidemia on the superficial temporal artery.Methods:1.15formalin-fixed adult cadavers (30sides) with colorful silica gel injected in blood vessels will be dissected under microscopy.The diameter, courser, main branches, variation, edge of blood supply, and the relationship with adjacent structures will be studied under microscopy;2. Mimicking fascia simulated surgical approach on the specimens so as to learn this approach protection for the temporal branch of the facial nerve3. EDAS was performed with Moyamoya disease, who received TCD examination before and after the EDAS in order to assess the hemodynamic change in STA. The hemodynamic parameters of STA before and after the surgery were statistically analyzed.4. To study the superficial temporal artery pathology results in35cases,they are all diabetes, hypertension and hyperlipidemia in patients.Results:1. Superficial temporal artery in front of the tragus diameter1.82～3.70mm, an average of2.73±0.5lmm; frontal branch diameter of2.14～2.66mm, an average of2.14±0.54mm; top branch diameter of1.1～2.75mm, with an average of1.81±0.45mm; temporal artery bifurcation points above the zygomatic arch in21cases,5cases hunched located zygomatic,4cases located in the following of the zygomatic arch.2. Mimicking fascia simulated surgical approach on the specimens, revealing the relationship between the superficial temporal artery branch and temporal branch of the facial nerve, temporal branch of the facial nerve branches from the outermost superficial temporal artery on the amount of support distances up to (26.45±7.22mm) recently distance (17.99±6.07mm);3. The spectrums of STA were the typical spectrums of the excranial arteries, The spectrums of STA TCD were similar to the intracranial arteries spectrums, STA TCD after the surgery were significantly different from those before the surgery. The outcomes of the vascular reconstruction shown by TCD were consistent with ones shown by DSA in11patients (73.33%) after EDAS;4.30cases of clinical pathology analysis of the superficial temporal artery: branch of the superficial temporal artery intima showed focal thickening with fibroblast proliferation layered elastic membrane, and partially elastic plate fracture; medial smooth muscle cell degeneration, the local film thinning and some accompanied by calcium depositionConclusion1. In this study, the superficial temporal artery and its surrounding facial nerve with the observations of people line between fascia surgical approach has positive significance.2. Superficial temporal artery to walk the line, diameter, main branch, variation, blood vessel anastomosis with neighboring range can bypass the treatment of ischemic cerebrovascular disease as intracranial low flow provides better anatomical reference; through the superficial temporal data analysis shows artery diameter, frontotemporal branch diameter, top diameter and zygomatic arch support bifurcation point and the basic research done by different authors agree; most of the bifurcation point is located above the zygomatic arch, frontotemporal branch over the parietal-occipital branch diameter thick, may be preferred frontotemporal branch of surgery-related bridge and the blood supply to the brain have to consider factors such as whether the clinical presence of frontotemporal branch back.3. The hemodynamic changes in STA before and after EDAS can be noninvasively detected easily by TCD, which can provide objective basis for the assessment of the curative effect of the EDAS on the patents with Moyamoya disease.4. Superficial temporal artery pathology results suggest that high blood pressure, diabetes, and hyperlipidemia on the superficial temporal artery intima, internal elastic membrane, the membrane and the smooth muscle layer are affected unevenly intimal thickening, hyperplasia of the internal elastic membrane long-term efficacy of a solid middle cerebral artery vascular vascular anastomosis and indirect fusion surgery-layer phenomenon, medial smooth muscle cell degeneration, part of the smooth muscle layer thinning and calcium deposition, this pathological changes may affect the superficial temporal artery to the superficial temporal artery...