| Mandibular defects can be reestablished mainly using microvascular bone-containing free flap, resulting from resections of tumors of the head and neck, osteomyelitis of the jaws and traumas in the maxillofacial region. Many investigations about the applied anatomies in bone donor area have been done. A variety of osseocutaneous free flaps have been described to reconstruct the mandible in clinic microsurgery since the last 3 decades. The common advantageous donor sites are the iliac crest, the fibula, the scapular bone and the costal bone, et al. In view of the anatomic particularity in the structures of the mandible and its circumference, a thorough knowledge of the mandibular reconstructive procedure and detailed anatomical information about the reconstructed site and cervical vessels are essential when free tissue transfer is planed and carried out. As with all reconstructive decision, factors such as the defect spot and size of mandible, the direction and caliber of recipient vessels in the neck must be considered in determining the best route of reconstruction. However, few meticulous applied anatomical reports about the recipient area in microvascular mandible reconstruction have been published in the literatures up to now. In this study, detailed anatomical information about the mandibular reconstructed site and cervical recipient vessels, including the blood supply of mandible, the blood supply of masseter and medial pterygoid muscle, the distribution patterns and diameters of cervical vessels, and the frequency and location of venous valves were obtained through structural and morphometric examination.Materials and Methods1. The mandibular transparent specimens used and studied were taken from 6 fresh adult cadavers (3 males and 3 females), which were fixed postmortem through the left femoral artery with 10% formalin and injected with preparedChinese ink through the common carotid arteries. The source, distribution and anastomosis of the blood supplies of mandible were exhaustively observed and noted.2. The study was conducted on 36 well-preserved adult cadavers with formalin. 26 male and 10 female, used for medical teaching of grade 2001, the First Military Medical University. Both sides (72 sides all together) of the head and neck region were meticulously dissected after instillation with color emulsion through the left femoral artery and vein. Another 3 vascular cast of head and neck (2 male, 1 female) were observed. (1) The blood supply cortex of lower jaw bone were studied; (2) The blood supplies of masseter andmedial pterygoid muscle, its origin, distribution, direction and anastomosis were noted; (3) Anatomic characteristics and variations were studied in 72 external carotid arteries and their branches, including superior thyroid artery, lingual artery and facial artery. The distances between the origin of each artery and the carotid bifurcation, the diameters and lengths of each arterial sections were measured. (4) The formation, course, tributaries, relations , termination and morphology of valves of external jugilar vein and common facial vein were observed. (5) All date was tested using SPSS 8.0 in statistical analysis.3. The clinical data of 58 cases of radionecrosis of the jaws between the years from 1997 to 2002 was analyzed. All of the data was offered by the 9th People Hospital affiliated Shanghai Second Medical University.Results1. The normal mandible receives its blood supply from two types of vessels. The major nutrient vessel is the inferior alveolar artery, a branch of maxillary artery, which sends out many branches to support the main body of lower jaw bone. The second major source of vessels is the periosteal vessel meshwork. A lot of small periosteal vessels arise from facial artery or lingual artery, or vessels that supply the muscles of mastication particularly in the ascending ramus and the angle.2.The masseter muscle includes two parts: the deep part and superficial part. The deep part receives its blood supplies fro...
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