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Retromandibular vein position and course patterns in relation to mandible: anatomical morphologies requiring particular vigilance during sagittal split ramus osteotomy

Anatomy & Cell Biology 2020년 53권 4호 p.444 ~ 450
Sugahara Keisuke, Matsunaga Satoru, Yamamoto Masahito, Noguchi Taku, Morita Sumiharu, Koyachi Masahide, Koyama Yu, Koyama Takumi, Kasahara Norio, Abe Shinichi, Katakura Akira,
소속 상세정보
 ( Sugahara Keisuke ) - Tokyo Dental College Department of Oral Pathobiological Science and Surgery
 ( Matsunaga Satoru ) - Tokyo Dental College Department of Anatomy
 ( Yamamoto Masahito ) - Tokyo Dental College Department of Anatomy
 ( Noguchi Taku ) - Tokyo Dental College Department of Anatomy
 ( Morita Sumiharu ) - Tokyo Dental College Department of Anatomy
 ( Koyachi Masahide ) - Tokyo Dental College Department of Oral Pathobiological Science and Surgery
 ( Koyama Yu ) - Tokyo Dental College Department of Oral Pathobiological Science and Surgery
 ( Koyama Takumi ) - Tokyo Dental College Department of Oral Pathobiological Science and Surgery
 ( Kasahara Norio ) - Tokyo Dental College Department of Forensic Odontology and Anthropology
 ( Abe Shinichi ) - Tokyo Dental College Department of Anatomy
 ( Katakura Akira ) - Tokyo Dental College Department of Oral Pathobiological Science and Surgery

Abstract


Major bleeding associated with sagittal split ramus osteotomy (SSRO) involves vessels such as the inferior alveolar, facial, and maxillary arteries and veins, and the retromandibular vein (RMV). The present study aimed to clarify and classify the three-dimensional variations in RMV position and course direction in relation to the mandible. Specimens comprised a total of 15 scientific cadavers, and the relationship between RMV and the mandible lateral and posterior views was observed. We identified 3 patterns on the lateral view, the mean distance between the RMV and the posterior border of the ramus was 3.9 mm at the height of the lingula. A total of five course patterns were identified on the posterior view. In no course pattern, the RMV inferior to the lingula was lateral to its position superior to the lingual. The present findings suggest that it may be possible to predict correlations with intraoperative bleeding risk. Further study is planned using contrast computed tomography in patients with jaw deformity for skeletal classification.

키워드

Retromandibular vein; Blood vessels; Neck dissection; Sagittal split ramus osteotomy; Hemorrhage

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