Anatomy of arteries and veins of submandibular glands / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Transplanting 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.</p><p><b>METHODS</b>The 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.</p><p><b>RESULTS</b>The 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.</p><p><b>CONCLUSIONS</b>The 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.</p>

Eye socket reconstruction with free flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To discuss the effect of eye reconstruction with free flap.</p><p><b>METHODS</b>Free flap was used in 21 patients of contracted eye socket and anophthalmos. The forearm free flap was utilized in 19 patients,the scapular flap in 2. Free flap with microvascular anastomoses was transferred into contracted eye socket. And hydroxyapatite implant was selectively inserted for intraorbital implantation according to the extent of contracted eye socket postoperation. Eye socket was reconstructed in one stage operation.</p><p><b>RESULTS</b>The flaps were transferred successfully in all patients. All patients were followed up between 4 to 42 months, better cosmetic results were achieved and well-fitted eye prosthesis was weaned.</p><p><b>CONCLUSION</b>Free flap is a useful alternative in treatment of severe contracted eye socket.</p>

Management of blood vessels in the vascularized autogenous submandibular gland transfer for severe keratoconjunctivitis sicca / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To summarize the management of blood vessels in the transfer of vascularized autogenous submandibular gland.</p><p><b>METHODS</b>Sixty-eight cases of vascularized transfer of autogenous submandibular gland for severe keratoconjunctivitis sicca performed from August 1999 to April 2004 were reviewed. Data collected for each patient included general items, donor and recipient vessels, vessel crisis, salvage of the vessel thrombosis, and survival of transferred glands.</p><p><b>RESULTS</b>Among the 68 cases, all the donor and recipient arteries were facial artery and superficial temporal artery respectively. For donor veins, 55 were facial veins, 1 was vein near the duct, and 12 were venae comitantes of facial artery. For recipient veins, 62 were superficial temporary veins and five were veins in the upper neck, one was deep temporary vein. Vessel thromboses occurred in 10 cases, 9 were venous and 1 were arterial. The salvage rate was 10.0%, with the overall survival rate of 86.8% of transferred gland.</p><p><b>CONCLUSIONS</b>Variation in venous outflow is common in microvascular transfer of submandibular gland, and anastomosis between venae comitante of facial artery and superficial temporal vein is most dependable. Vessel anastomosis under microscope may reduce the vessel thrombosis rate after operation.</p>