- 期刊
後上齒槽動脈之骨內吻合與上顎竇增高術之關係
Intraosseous Vascular Anastomosis of the Posterior Superior Alveolar Artery
摘要
上顎竇側壁內常有後上齒槽動脈之骨內吻合存在，在施行側壁開窗上顎竇增高術時容易侵犯此血管，導致術中出血及術後血腫等併發症而影響手術進行及預後。本影像學研究旨在探討此血管吻合在上顎竇中的位置分布，直徑大小，進而計算符合側壁開窗上顎竇增高術之適應症息者中，可能侵犯此解剖構造並造成顯著出血之比例及風險。研究樣本為隨機選取共100位台北長庚紀念醫院牙科病息之椎狀束電腦斷層影像，並利用統計方法分析各測量值。本研究所選取的資料中可辨識的血管吻合影像為87.2%，血管吻合下緣至齒槽骨脊最外突點的平均距離為18.16 ± 5.71 mm，血管直徑大於等於2 mm者比例為 16.1%，手術中易侵犯直徑大於等於2 mm之血管並造成大量出血的高風險族群比例為2.4%。研究結果顯示，側壁開窗手術前可藉由適當的椎狀束電腦斷層影像調整術區大小，進而大大降低術中顯著出血的風險。
並列摘要
Intraosseous anastomosis of the posterior superior alveolar artery often presents at the lateral wall of maxillary sinus, should the artery be invaded during lateral wall sinus augmentation, complications such as brisk bleeding and post-operative hematoma would jeopardize healing and affect prognosis. The present radiographic study was designated to identify the location and diameter of the vascular anastomosis, and then calculate the risk of profound bleeding caused by severing the artery among indicated sites. The study sample consisted of 100 randomly selected maxillary full-arch cone-beam computed tomography (CBCT) scans obtained from the database of Taipei Chang-Gung Memorial Hospital Dental Department, Taipei, Taiwan. Results were analyzed by statistical methods. The artery anastomosis could be seen in 87.2%of selected images, the distance between the inferior border of the structure to the most lateral point of the alveolar ridge was 18.16±5.71 mm. The vascular diameter was 2 mm or above in 16.1% of all sites. The risk of excessive bleeding caused by invasion of the larger arteries during surgery was 2.4%. Results show that by using pre-operative CBCT studies to adjust the size of the lateral window will greatly reduce the risk of excessive bleeding during surgery.
延伸閱讀
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