BACKGROUNDTransplanting a vascularized autologous submandibular gland (SMG) is considered an effective method to treat severe keratoconjunctivitis sicca. But the operation may fail due to the anatomic variances in the blood vessels of SMG. The present study aimed to investigate the submandibular glands at the microanatomy level.

METHODSThe microanatomy of blood vessels including arteries and veins of submandibular gland was investigated using 30 adult corpses and 60 submandibular glands were anatomized under a surgical microscope. The lengths and diameters of the arterial and venous glandular branches were measured using sliding caliper.

RESULTSThe submandibular gland was mainly supplied by the facial artery and submental artery, partly by the lingual artery and external jugular artery. The venous drainage of the submandibualr gland occurred through the anterior facial vein, the venae comitantes of facial artery, the vein close to the Whaston's duct (the hilum vein), and seldom drained to external jugular vein and other veins.

CONCLUSIONSThe anatomy of SMG is a complicated structure. Determining the main blood vessels of the submandibular gland is very important to achieve a successful vascularized autologous SMG transplant.

Adult ; Arteries ; anatomy & histology ; Female ; Humans ; Male ; Submandibular Gland ; anatomy & histology ; blood supply ; Veins ; anatomy & histology

OBJECTIVETo study the numbers and locations of spermatic veins, testicular arteries, and lymphatic vessels in the spermatic cord of the varicocele patient under the laparoscope.

METHODSFifty-seven varicocele patients received laparoscopic ligation of spermatic veins, during which we recorded the numbers and observed the locations of spermatic veins, testicular arteries, and spermatic lymphatic vessels.

RESULTSDuring the surgery, we identified 3.3 ± 1.2 spermatic veins, 1.4 ± 0.9 testicular arteries, and 4.3 ± 1.1 spermatic lymphatic vessels. No statistically significant differences were observed between the two side in the numbers of the spermatic veins, testicular arteries and spermatic lymphatic vessels (P > 0.05). The testicular arteries were seen on the exterior of the spermatic veins and winding around them, while the spermatic lymphatic vessels mostly between the veins.

CONCLUSIONThe spermatic veins, testicular arteries, and lymphatic vessels in the spermatic cord of the varicocele patient have their specific anatomic characteristics. Laparoscopic identification of these vessels may contribute to the surgical treatment of varicocele.

Arteries ; anatomy & histology ; Humans ; Laparoscopy ; Ligation ; Male ; Spermatic Cord ; anatomy & histology ; Testis ; Varicocele ; pathology ; Veins ; anatomy & histology

OBJECTIVETo study the anatomy of internal mammary artery perforator (IMAP) flap.

METHODSFive fresh cadavers were used, the morphology and blood supply of IMAP flap were examined by the method of microsurgical anatomy. During dissections, following parameters were recorded: number, type and diameter of perforators vessels, course (infra fascia and supra fascia) and location of perforators vessels.

RESULTSAll 1st-4th IMAPs were found in 10 specimen. Average diameter of 1st-4th IMAP artery/vein was as follows (x +/- s): (1.29 +/- 0.28) mm, (1.46 +/- 0.22) mm; (1.1 +/- 0.27) mm, (1.41 +/- 0.39) mm; (0.87 +/- 0.23) mm, (1.17 +/- 0.15) mm; (0.92 +/- 0.22) mm, (1.12 +/- 0.14) mm. The largest perforator was mostly first or second IMAP. The angiosomal territory of IMAPs extended from the clavicle superiorly to the xiphisternum inferiorly, from the midline medially to anterior axillary fold laterally.

CONCLUSIONIMAP flap offers an option in reconstruction of head neck defects and should be considered as an alternative to the deltopectoral flap and pectoralis major flap in some patients.

Adult ; Anatomy, Regional ; Female ; Humans ; Male ; Mammary Arteries ; anatomy & histology ; Surgical Flaps ; blood supply ; Thorax ; anatomy & histology ; blood supply

The detailed knowledge of the microvascular anatomy and the recognition of the anatomical variations of the middle cerebral artery (MCA) are very important for neurosurgeons to construct a better and safer microdissection plan and to prevent postoperative neurological deficits. This paper mainly reviewed segments, perforators, cortical arteries, branching patterns, anomalies, and regional anatomy relating various neurovascular surgery such as vascular anastomosis and the management of aneurysms and arteriovenous malformations of the MCA.
Anatomy, Regional ; Aneurysm ; Arteries ; Arteriovenous Malformations ; Microdissection ; Middle Cerebral Artery*

The detailed knowledge of the microvascular anatomy and the recognition of the anatomical variations of the middle cerebral artery (MCA) are very important for neurosurgeons to construct a better and safer microdissection plan and to prevent postoperative neurological deficits. This paper mainly reviewed segments, perforators, cortical arteries, branching patterns, anomalies, and regional anatomy relating various neurovascular surgery such as vascular anastomosis and the management of aneurysms and arteriovenous malformations of the MCA.
Anatomy, Regional ; Aneurysm ; Arteries ; Arteriovenous Malformations ; Microdissection ; Middle Cerebral Artery*

OBJECTIVETo probe into the reflection of "artery" phenomenon in human channels.

METHODSFind out the discussion about "artery" from ancient medical books and compare with Chinese ancient philosophy thoughts.

RESULTSIn TCM, "artery" has been used as reference in differentiating channels. The circulation system of channels is possibly established on the expectation of "to and fro circulation" in the Chinese philosophy, and the power of channels originates from the qi stored between the kidney, and the pricking blood therapy was used for treatment of many kinds of diseases in ancient times.

CONCLUSIONStudy on channels should pay attention to this link of "artery".

Arteries ; anatomy & histology ; physiology ; Humans ; Medicine, Chinese Traditional ; Meridians

OBJECTIVETo investigate the applied anatomy of the blood supply of the cervicoacromial crossing flap and its feasibility in clinical application.

METHODS5 fresh adult and 10 forman fixed adult cadaver specimens were used. The arteries, veins, cutaneous arteries, subdermal vascular network, and vascular network of the superficial layer of deep fascia in the cervico-acromial area were observed and studied under the microscope. The frontier border of the cervico-acromial area is clavicle, the posterior border is the spine of scapula, the outer border is acromion and the inner border is cervical base.

RESULTS(1) The perforator branches concentrate at the front edge of trapezius muscle; (2) The vessel network around the front edge of trapezius muscle is abundant. Among the anastomosis, two or three anastomosis which across the area from the base of the neck to acromion can be observed in the axial of every cervico-acromial area. Abundant vessel network can be observed in the superficial layer of deep fascia.

CONCLUSIONSThe blood supply of the cervico-acromial flap is abundant, which constains constant perforator point. The cervico-acromial crossing skin flap can be applied with the rich blood supply and abundant vessel network in the superficial layer of deep fascia.

Adult ; Arteries ; anatomy & histology ; Cadaver ; Clavicle ; Humans ; Scapula ; Surgical Flaps ; blood supply ; Veins ; anatomy & histology

OBJECTIVETo study the course of branches of the superficial temporal artery (BSTA) and the accompanying pattern of their veins in order to provide anatomic basis for flap design.

METHODSHead and facial part of ten adult corpses (19 sides) were dissected and photographed. The coordinate system was set up with external auditory foramen as the point of origin, aided by the graph analysis software Digimizer. The course of the frontal branch and parietal branch of the superficial temporal artery (STA), and the accompanying pattern between the BSTA and the veins were measured and analyzed. The STA and its branches were located by Ultrasonic Doppler, and the corresponding branches of the superficial temporal vein (BSTV) were disclosed by bowing patient's head with breath holding or cerclaging the basement of the patient's skull. And then 10 sides of transposition (fascia) flaps with axis at the angular bisector between BSTA and BSTV were devised to repair wounds of 9 patients that hospitalized from February 2008 to December 2009. Data were processed with test of variance homogeneity.

RESULTSFrontal BSTV absence was found in 6 head sides, and the maximum distance between artery and vein was (2.1 ± 1.2) cm. Parietal BSTV absence was found in 3 head sides, and the maximum distance was (1.4 ± 0.7) cm. The distance between frontal BSTA and BSTV was larger than that between parietal BSTA and BSTV, and the dispersion degree of the former was higher than that of the latter (F = 0.0404, P = 0.0475). All the (fascia) flaps survived without congestion or necrosis.

CONCLUSIONSWhen branch of the superficial temporal vessel was selected as the axial vessel of flap, the flap design shall depend on the accompanying pattern of BSTV to avoid the flap necrosis due to poor venous return after surgery. The superficial temporal vein and its branches can be well disclosed by bowing head or cerclaging skull. The approach is simple, useful, safe, and reliable.

Adult ; Humans ; Male ; Surgical Flaps ; blood supply ; Temporal Arteries ; anatomy & histology ; surgery ; Veins ; anatomy & histology ; surgery

OBJECTIVETo study the microsurgical anatomy of the posterior inferior cerebellar artery (PICA) for neurosurgery.

METHODSTwenty Chinese adult brain samples (40 sides) were measured with microscope for the diameters, lengths, origins, courses, and the branches of the PICA. The relationship between the PICA and cranial nerves was also checked.

RESULTSThere were 35 PICAs in 20 brain samples. The mean diameter of the PICAs was (1.6 +/- 0.6) mm, the mean length from PICAs' origin of vertebral artery to the vertebrobasilar junction was (16 +/- 5) mm. In 35 PICAs, 28 PICAs go through the rootlets of XII cranial nerves, 7 PICAs go through inferior XII cranial nerves, and 32 PICAs go through the rootlets of XI cranial nerves.

CONCLUSIONSPICA is an important branch artery with more variation and complex relationship to the cranial nerves trend in the vertebral artery system. It is necessary to master the microsurgical anatomy of PICA and to be careful protection during the neurosurgical operations.

Adult ; Carotid Artery, Common ; anatomy & histology ; Cerebellum ; blood supply ; Cerebral Arteries ; anatomy & histology ; Cranial Nerves ; anatomy & histology ; Humans ; Vertebral Artery ; anatomy & histology

OBJECTIVE: To provide the clinical anatomic data of the lingual artery with 3D CT reconstruction. METHOD: Ten healthy subjects were recruited. Spiral CT scan ranged from the sternoclavicular joint to the lower edge of the orbit and the data was subjected to three-dimensional reconstruction. The distance from the origin of the lingual artery to the bifurcation of the common carotid artery and tip of the greater horn of hyoid bone were measured respectively and the distance between the midline of the lingual artery and the midline of tongue were also measured. RESULT: The horizontal distance between starting level of lingual artery to the level of the hyoid horn tip was (1.51 +/- 0.35) cm. The horizontal distance between the level of the lingual artery to the carotid bifurcation was (0.95 +/- 0.31) cm. The comparison of the distance from lingual artery 1 cm anterior or posterior to foramen cecum to midline of tongue showed (t = 45.27, P < 0.01) a statistically significant difference. CONCLUSION The lingual artery could be demonstrated clearly in 3D reconstruction. To ensure the operative safety, the depth of radiofrequency for OSAHS at the tongue base should be limited within 2 centimeters.
Adult ; Aged ; Arteries ; anatomy & histology ; Carotid Artery, Common ; anatomy & histology ; Carotid Artery, External ; anatomy & histology ; Female ; Humans ; Male ; Middle Aged ; Tongue ; anatomy & histology ; blood supply ; Young Adult