Vascular Anastomosis And Clinical Study Of Superficial Temporal Artery-Ophthalmic Artery

Objective:Through the anatomical study of 12 cases of cadaver head specimens,observation anatomical characteristics of ophthalmic artery and its branches,and understand the the relationship with the peripheral nerve,muscle,measurement of vascular caliber size in detail respectively.Discusses using superfacial temporal artery-ophthalmic artery and its branches to the feasibility of vascular anastomosis,and studied by different ways of operation and orbital extraocular muscle clearance for vascular anastomosis and inferiority,as superficial temporoparietal-ophthalmic artery vascular anastomosis provide certain anatomical basis for surgical selection.Methods:1.Select 12 cases(24 sides)of the intact body head of formalin,and all specimens have been perfusion with colored silica gel.Anatomy of the orbital contents including 10 cases of samples,observe the ophthalmic artery and its main branches contorts,adjacent to the structure,measuring the diameter of the blood vessels to choose a branch of vascular anastomosis potential blood vessels,and to understand the common type of mutation.2.Observe through different extraocular muscle and nerve gap can expose of ophthalmic artery and its branches,to utilize the normal anatomy of the clearance and not cause nerve damage,record its way by the anatomical level.3.Determine the anatomical markers of the anastomotic vessels and provide references for the positioning of vessels in the operation.4.Compared the advantages and disadvantages of different surgical methods in the simulation surgery,it provides some anatomical basis for the selection of surgical options in clinic.Results:Ophthalmic artery trunk in orbital is divided into three segments,the first paragraph(1.81 + 0.42)mm diam.,the second paragraph(1.50 + 0.38)mm diam.,in this study have 19 cases with optic nerve from inside extroversion crossed above the optic nerve,is located in the optic nerve below the 1 case.The third section diameter is about(1.26 + 0.22)mm.The ophthalmic artery and main branches of the inner orbital segment were ideal for the position and diameter of the eyes: the lacrimal artery(1.01±0.16)mm,the first to the third segment of the ophthalmic artery.The outer orbital branches mainly include the superior orbital artery,the upper block of the artery and the dorsal artery.Among them,the distance between the superficial temporal artery branch and the supraorbital incision and the cutting distance of the block were respectively(7.39 ± 1.34)mm and(8.62 ± 0.41)mm,and the distance between the turning point of the forehead and the cut of the block was(4.28 ± 0.54)mm and(5.43 ± 1.32)mm.2.Exposure can be seen through the lateral clearance: the first segment of the ophthalmic artery,the ophthalmic artery Angle,and the second segment of the ophthalmic artery above the optic nerve,the lacrimal artery and the lateral ciliary artery.The medial interstitial space can be exposed to the ophthalmic artery Angle and Angle,the second and third segment of the ophthalmic artery,the medial nasal ciliary artery,the screen,and the posterior screen artery.The central clearance can expose the second segment of the ophthalmic artery,the ciliary artery,and the lower lateral clearance can be observed to the central retinal artery.3.The supraorbital incisure within the supraorbital rim of 1/3,distance to the center of the forehead line distance(22.27 ± 4.25)mm,block incisura on supraorbital hole inside near the nose,from the forehead midline distance(12.38 ± 3.52)mm,it can locate the preliminary temporal superficial artery and orbital ophthalmic artery branch points.Open orbital surgery alone can open the lateral wall of the orbit and expose the lateral clearance between the lacrimal glands of the lacrimal artery through the external rectus and above(0.72 ± 0.03).The artery can be followed to the ophthalmic artery by the lacrimal artery.The length of the lacrimal artery(2.03 ± 0.38)mm,the anastomotic depth was(1.89 + 0.32)mm.Transcranial orbital pattern can be used to select the medial and medial space,and can also be used to remove partial sphenoid ridge and sphenoid limb,and increase the appearance of lateral clearance.Conclusion:1.The arterial trunk and branches of the ophthalmic artery are complicated,but the vessels with the true potential of anastomosis have the first and third segment of the ophthalmic artery in the orbit,the lacrimal artery.The outer orbit is mainly the superior orbital artery and the upper block artery.2.Use normal extraocular muscle clearance can achieve the purpose of exposed vascular anastomosis,including the lateral clearance is the most broad,to pull the smallest ways,can be used as the preferred,by contrast,the inside of the gap is exposed by the central clearance space is larger,but in practice should be combined with cerebral angiogram understanding of ophthalmic artery variations,so as to choose the best path.3.The orbital artery is surrounded by periorbital fat,and the easiest way to find the ophthalmic artery can be through the lacrimal artery,which is the larger branch of the ophthalmic artery,and can directly anastomose the main artery of the lacrimal gland.4.In the choice of surgical method,the anastomosis of the ophthalmic artery is the simplest and the lowest risk;The anastomosis of the orbit can provide blood to the proximal end of the ophthalmic artery,and only open the periorbital bone,which is not involved in the skull,and can expose the lateral clearance well,which has certain application value.Craniotomy is a major injury,but the scope of surgical field and exposure is both incomparable and the last option for other surgical approaches.