Summary
Differences in the description of the blood supply of the lower trapezius m. and the fact that all former findings are based on very few cases caused us to reinvestigate the arterial supply of the lower trapezius m. Based on the anatomic investigation of 70 human cadavers, the trapezial branch of the dorsal scapular a. was found to be the constant vessel to the lower trapezius m. The origin of the dorsal scapular a., however, was found to be very variable. In 45% it was a direct branch of either the subclavian a. or the costocervical trunk. In the remaining 55% the dorsal scapular a. formed different trunks with the superficial cervical a. and/or supras-capular a. branching off either the subclavian a., the thyrocervical trunk, or the internal thoracic a. Additional segmental musculocutaneous perforators also supply the lower part of the trapezius m. and the overlying skin. Consequently, the lower or ascending part of the trapezius m. has a vascular pattern type V. Thus, the lower trapezius musculocutaneous flap merits consideration in head and neck reconstruction.
Résumé
Des différences significatives existent dans la description de la vascularisation de la partie inférieure du m. trapèze (“trapèze inférieur“), notamment du fait que ces descriptions ont été basées sur un très petit nombre de cas. Notre travail est basé sur l'étude de 70 sujets. Un rameau trapézien naissant de l'a. scapulaire dorsale a été retrouvé de façon constante. L'origine de l'a. scapulaire dorsale est toutefois variable : dans 45 % des cas, il s'agit d'une branche directe provenant soit de l'a. subclavière, soit du tronc costo-cervical. Dans les 55 % des cas restants, l'a. scapulaire dorsale constitue différents troncs avec l'a. cervicale superficielle et/ou l'a. suprascapulaire, l'a. subclavière, le tronc thyro-cervical, ou de l'a. thoracique interne. Des aa. perforantes musculo-cutanées participent également à la vascularisation du “trapèze inférieur” et de la peau sus-jacente. En conséquence, la partie inférieure du m. trapèze a une vascularisation de type V de Mathes et Nahai. Ainsi, le lambeau musculo-cutané du trapèze inférieur mérite une place de choix dans les reconstructions cervico-céphaliques.
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Weiglein, A., Haas, F. & Pierer, G. Anatomic basis of the lower trapezius musculocutaneous flap. Surg Radiol Anat 18, 257–261 (1996). https://doi.org/10.1007/BF01627601
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DOI: https://doi.org/10.1007/BF01627601