| BackgroundMaxillofacial region is an important part of somaesthetics.Therefore,it is of high requirements during reconstruction of soft tissue defect in maxillofacial region.Superficial temporal artery-based retroauricular flaps are ideal option for reconstruction of facial tissue defect.However,the anatomy of these flaps has yet to be clarified.Three-dimensional(3D)reconstruction technology can be used to shape the 3D profiles of human bodies,and makes virtual reality in many operations.The precise and complicated part of human anatomy can be studied directly and accurately through 3D reconstructed retroauricular flap.It is of great importance to conduct virtual anatomic measurement of reconstructed flaps,which contributes a lot to the study of superficial temporal artery-based retroauricular flap that gross anatomy failed or insufficient.PurposeIn this study,we focus on the structures of superficial temporal artery-based retroauricular flap.Anastomose of vasculars in the flaps are critically observed and measured through autopsy.This will help to provide detailed and reliable anatomic parameters as well as theoretical basis for the better clinical application of flaps.We try to establish models of superficial temporal artery-based retroauricular flap based on the data set obtained by multislice CT angiography(CTA).Evaluate the reality and efficacy of reconstructed flaps through comparison of virtual anatomy and conventional gross anatomy,hoping to facilitate basic research,clinical application,surgery design,and anatomy teaching of flaps,and provide dynamic anatomic data.Methods1.Simulate the process of clinical design of flaps,and make gross anatomy of retroauricular region using hierarchical anatomical approach.Observe the origin,caliber,distribution and anastomose of blood vessels in the flaps.And classify the connection between superficial temporal artery and retroauricular artery.Measure the range of each anastomose,and analyze the accompanying vein related to specific artery.2.The 2D data set obtained by CTA are imported into image data center equipped with PHILIPS IntelliSpace Portal system to establish retroauricular flap model.Analyze the anatomic characteristics of the established models.After virtual anatomical measurement,comparison between the 3D model and gross anatomy are made to evaluate the reality of this flap model.Results1.We found that the blood supply of retroauricular mastoid area originated mainly from superficial temporal artery and retroauricular artery.The results of origin,caliber,and distribution we observed were in accordance with previously reported.Anastomose of blood vessels presented as stairs and mesh anastomosis.Few superficial temporal artery give out branches directing to retroauricular regions.Defect in retroauricular artery branches was also observed.There was no critical regulation between the vein and the accompanied artery in both superficial temporal and retroauricular regions.No regular anatomic relations were observed in the veins.2.We established 3D model of superficial temporal artery-based retroauricular flaps on the basis of data set obtained by living scanning of head position.The model showed the anatomic structure of flaps and its inner anastomose in in a well manner.Relevant virtual anatomic measurements were in accordance to gross anatomy.ConclusionsIn this study,we made precise anatomic measurement of superficial temporal artery-based retroauricular flaps through gross anatomy.We further classified anastomose in the superficial temporal and retroauricular regions.These results were of great significance for clinical therapy and anatomic studies.In addition,we established the model of superficial temporal artery-based retroauricular flaps by combining CTA with 3D reconstruction technology.We showed anastomose of inner blood vessels in the flap models for the first time.And we found that these virtual anatomic results were consistent with conventional gross anatomy,which indicated that the flap models we established were reliable. |
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