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Elvan Ö, Uzmansel D. Mapping the localization of the facial artery and vein at the inferior border of the mandible for clinical applications. Anat Sci Int 2024:10.1007/s12565-024-00806-1. [PMID: 39466568 DOI: 10.1007/s12565-024-00806-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Accepted: 10/11/2024] [Indexed: 10/30/2024]
Abstract
AIM To spatially map the position of the facial artery and vein along the inferior border of the mandible based on specific facial reference points. METHODS This cross-sectional study included 40 sides of 21 formalin-fixed cadaver heads (11 female, 10 male) with a mean age of 72.92 ± 11.72 years. Superficial dissection was performed to visualize the facial artery and vein at the inferior border of the mandible (FA and FV). Measurements were taken from the FA and FV to various facial landmarks using a digital caliper and medical protractor. Statistical analysis was conducted using Shapiro-Wilk, independent sample t-tests, and paired sample t-tests. RESULTS The mean distance between FA and FV was 6.20 ± 2.97 mm. Distances from FA and FV to gnathion, oral commissure, nasal wing, lateral canthus, angle of mandible, intertragic notch, and Manson's point were determined, with no significant differences found between sides and genders (p > 0.05). The closest distances from FA and FV to the line between the intertragic notch and oral commissure were 38.63 ± 4.86 mm and 37.78 ± 5.28 mm, respectively. The angular measurements of FA and FV with inferior border of mandible were 61.45 ± 13.71 and 76.56 ± 10.17 degrees, respectively. The angle between intertragic notch, FA and oral commisure was 102.40 ± 11.12 degrees. CONCLUSION The detailed measurements and analysis provided in this study aim to enhance the precision of surgical interventions involving the facial artery and vein. The practical localization methods proposed can assist in minimizing the risk of vascular injuries, improving outcomes in reconstructive and aesthetic procedures.
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Affiliation(s)
- Özlem Elvan
- Faculty of Health Sciences, Mersin University, Çiftlikköy Campus, Yenişehir, 33343, Mersin, Turkey.
| | - Deniz Uzmansel
- Anatomy Department, Faculty of Medicine, Mersin University, Mersin, Turkey
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2
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Ranade AV, Rai R, Rai AR, Joy T, Janardhanan JP, Dass PM. Drainage Pattern of Craniofacial Veins With Emphasis on its Influence on Facial Reconstruction Procedures. J Craniofac Surg 2024; 35:243-246. [PMID: 37646347 DOI: 10.1097/scs.0000000000009720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/09/2023] [Indexed: 09/01/2023] Open
Abstract
As the facial transplantation procedures are becoming more popular and frequent in recent years, for repairing facial trauma, variations in the veins of head and neck needs to be reported time and again. This study was undertaken to examine the course and drainage pattern of the facial vein and external jugular vein on this context and emphasize its surgical implications. The authors studied the head and neck region of 50 embalmed cadavers of both sexes to document normal and variant anatomy of facial, retromandibular, and external jugular veins. In 30% of the head and neck regions, different draining pattern of the above-mentioned veins were observed. One of the rare variation discovered was the splitting of the retromandibular vein to embrace the external carotid artery within the parotid gland. The data about variations in the termination of facial vein, retromandibular vein, and external jugular vein, as observed in the present study might be useful in avoiding accidental injury to these vessels during any surgical intervention in the face as well as neck. Level of Evidence: IV.
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Affiliation(s)
- Anu V Ranade
- Department of Basic Sciences, College of Medicine, University of Sharjah, Sharjah, UAE
| | - Rajalakshmi Rai
- Department of Anatomy, Center for Basic Sciences, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ashwin R Rai
- Department of Anatomy, Center for Basic Sciences, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Teresa Joy
- Department of Anatomy, College of Medicine, American University of Antigua, Coolidge, Antigua
| | - Jiji P Janardhanan
- Department of Anatomy, Center for Basic Sciences, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Prameela M Dass
- Department of Anatomy, Center for Basic Sciences, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Khorasanizadeh F, Delazar S, Gheidari O, Daneshpazhooh M, Balighi K, Ehsani AH, Emadi SN, Sadeghinia A, Mahmoudi H. Anatomic evaluation of the normal variants of the arteries of face using color Doppler ultrasonography: Implications for facial aesthetic procedures. J Cosmet Dermatol 2023; 22:1844-1851. [PMID: 36718833 DOI: 10.1111/jocd.15646] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 11/09/2022] [Accepted: 01/11/2023] [Indexed: 02/01/2023]
Abstract
BACKGROUND Knowledge of normal facial vascular variations could prevent catastrophic complications of cosmetic procedures as well as providing a guide for surgical planning. Color Doppler ultrasound is a safe and noninvasive method for real time vascular evaluation. OBJECTIVE The aim of this study was to evaluate the normal variations of the facial, angular, transverse facial, supratrochlear and supraorbital arteries in a sample of normal individuals. METHODS Normal individuals referred for dermal filler injection to the tertiary dermatologic center, were selected. Patients who were smoker or had a history of facial filler injection, facial surgery, or trauma were excluded from the study. Facial artery at three levels as well as angular, supratrochlear, supraorbital, and transverse facial arteries were evaluated by an 18 MHz ultrasound linear probe regarding their distance from facial reference lines and landmarks, and also their depths in various regions of face. RESULTS A total number of 43 individuals were evaluated in this study. Thirty-one (72.1%) were women. The number of absent facial artery was zero in level one, three (3.48%) in level two, and nine (10.46%) in level three. The angular artery was absent in 10 (11.62%) participants. The transverse facial artery was absent in 27 (31.39%) assessed individuals. Distance from reference lines at level 2 and 3 of facial artery and its depth at level 2 were significantly different between left and right side (p-values: <0.001, 0.01, and 0.03, respectively). No significant difference was seen between depth and distance of two sides for angular and transverse facial arteries. The comparison of the depths and distances from the reference lines of the assessed arteries between two sexes revealed only a significantly greater value of facial artery distance in level 1 in males (p-value: 0.001). BMI was also significantly correlated with the depth of facial artery in level 2 (Pearson correlation coefficient = 0.471, p-value = 0.002) and level 3 (Pearson correlation coefficient = 0.357, p-value = 0.03) and the distance of the facial artery in level 1 (Pearson correlation coefficient = 0.333, p-value = 0.029). CONCLUSIONS Color Doppler ultrasound could be used to map the arteries of face to prevent vascular complications and safely guide cosmetic procedures.
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Affiliation(s)
- Faezeh Khorasanizadeh
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sina Delazar
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
| | - Omid Gheidari
- Autoimmune Bullous Diseases Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Daneshpazhooh
- Autoimmune Bullous Diseases Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kamran Balighi
- Autoimmune Bullous Diseases Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Houshang Ehsani
- Autoimmune Bullous Diseases Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Nasser Emadi
- Autoimmune Bullous Diseases Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sadeghinia
- Autoimmune Bullous Diseases Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Mahmoudi
- Autoimmune Bullous Diseases Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Zheng C, Fu Q, Zhou GW, Lai LY, Zhang LX, Zhang DQ, Chen GJ, Liang LM, Chen ML. Efficacy of Percutaneous Intraarterial Facial/Supratrochlear Arterial Hyaluronidase Injection for Treatment of Vascular Embolism Resulting From Hyaluronic Acid Filler Cosmetic Injection. Aesthet Surg J 2022; 42:649-655. [PMID: 34958671 DOI: 10.1093/asj/sjab425] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Vascular embolism is a serious complication of hyaluronic acid (HA) filler cosmetic injection, and hyaluronidase injection has been proposed as the treatment. Until now, there has been a lack of adequate clinical evidence regarding the benefits of treatment for HA filler-induced vascular embolism by percutaneous facial or supratrochlear arterial hyaluronidase injection. OBJECTIVES The authors sough to evaluate the efficacy of percutaneous facial or supratrochlear arterial hyaluronidase injection as a rescue treatment for HA filler-induced vascular embolism. METHODS We included 17 patients with vascular embolism after facial HA filler injection. Intraarterial injection of 1500 units hyaluronidase was performed via facial artery for 13 cases with skin necrosis and via supratrochlear arterial for 4 cases with severe ptosis and skin necrosis but no visual impairment. Simultaneously, general symptomatic treatment and nutritional therapy were performed. RESULTS After hyaluronidase injection, facial skin necrosis in all cases was restored and ptosis in the 4 cases was also significantly relieved. Patients were subsequently followed-up for 1 month to 1 year. The skin necrosis in 16 patients completely healed, and only 1 patient had small superficial scars. CONCLUSIONS It is effective to alleviate skin necrosis and ptosis resulting from HA filler embolism via percutaneous facial or supratrochlear arterial hyaluronidase injection. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Can Zheng
- Senior Department of Burns and Plastic Surgery, the Fourth Medical Center of PLA (People’s Liberation Army) General Hospital, Beijing, China
| | - Qiang Fu
- Senior Department of Burns and Plastic Surgery, the Fourth Medical Center of PLA (People’s Liberation Army) General Hospital, Beijing, China
| | - Gui-wen Zhou
- Senior Department of Burns and Plastic Surgery, the Fourth Medical Center of PLA (People’s Liberation Army) General Hospital, Beijing, China
| | - Lin-ying Lai
- Senior Department of Burns and Plastic Surgery, the Fourth Medical Center of PLA (People’s Liberation Army) General Hospital, Beijing, China
| | - Li-xia Zhang
- Senior Department of Burns and Plastic Surgery, the Fourth Medical Center of PLA (People’s Liberation Army) General Hospital, Beijing, China
| | - De-quan Zhang
- Senior Department of Burns and Plastic Surgery, the Fourth Medical Center of PLA (People’s Liberation Army) General Hospital, Beijing, China
| | - Guo-jie Chen
- Senior Department of Burns and Plastic Surgery, the Fourth Medical Center of PLA (People’s Liberation Army) General Hospital, Beijing, China
| | - Li-ming Liang
- Senior Department of Burns and Plastic Surgery, the Fourth Medical Center of PLA (People’s Liberation Army) General Hospital, Beijing, China
| | - Min-liang Chen
- Senior Department of Burns and Plastic Surgery, the Fourth Medical Center of PLA (People’s Liberation Army) General Hospital, Beijing, China
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5
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Wang D, Xiong S, Zeng N, Wu Y. The Facial Vein on Computed Tomographic Angiography: Implications for Plastic Surgery and Filler Injection. Aesthet Surg J 2022; 42:NP319-NP326. [PMID: 36413200 DOI: 10.1093/asj/sjab391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Knowledge of the anatomy of the facial vein is essential for plastic surgery and filler injection. OBJECTIVES The authors sought to investigate the variation and 3-dimensional (3D) course of the facial vein utilizing computed tomographic angiography. METHODS The computed tomographic angiography images of 300 facial veins from 150 Asian patients were included in this study. The distance between each anatomical landmark and the facial vein was measured to position the course. The depth of the facial vein beneath the skin and the height of the facial vein above the periosteum were measured at 5 anatomical planes. RESULTS The facial vein showed a relatively constant course with a frequency of 7.0% variation. The vertical distance between the medial canthus, midpoint of inferior orbital rim, or external canthus and the facial vein was 10.28 ± 2.17 mm, 6.86 ± 2.02 mm, or 48.82 ± 7.26 mm, respectively. The horizontal distance between medial canthus, nasal alar, or oral commissure and the facial vein was 6.04 ± 1.44 mm, 22.34 ± 3.79 mm, or 32.21 ± 4.84 mm, respectively. The distance between the mandibular angle or oral commissure and the facial vein at the inferior of mandible was 24.99 ± 6.23 mm or 53.04 ± 6.56 mm. The depth of the facial vein beneath the skin and the height of the facial vein above the periosteum varied from the plane of the medial canthus to the plane of the mandible. CONCLUSIONS This study revealed the 3D course of the facial vein with reference to anatomical landmarks. Detailed findings of the facial vein will provide a valuable reference for plastic surgery and filler injection.
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Affiliation(s)
- Dawei Wang
- Department of Plastic Surgery, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Shixuan Xiong
- Department of Plastic Surgery, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Ning Zeng
- Department of Plastic Surgery, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Yiping Wu
- Department of Plastic Surgery, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
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Rysz M, Nowakowski F, Mazurek M. Facial vessels course in the cheek in open mouth position for intraoral microvascular anastomoses purposes. J Plast Reconstr Aesthet Surg 2021; 75:439-488. [PMID: 34838497 DOI: 10.1016/j.bjps.2021.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 05/04/2021] [Accepted: 11/06/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Maciej Rysz
- Reconstructive Team, The Maria Skłodowska Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland.
| | - Filip Nowakowski
- Reconstructive Team, The Maria Skłodowska Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland
| | - Maciej Mazurek
- Reconstructive Team, The Maria Skłodowska Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; West Pomeranian Center for Severe Burns and Plastic Surgery, Gryfice, Poland
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7
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Patel C, Abdel-Rahman A, Gahir D. Potential of the common facial vein as a recipient vein in free flap reconstruction. Clin Anat 2021; 34:1208-1214. [PMID: 34448241 DOI: 10.1002/ca.23778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 08/12/2021] [Accepted: 08/17/2021] [Indexed: 11/05/2022]
Abstract
Recipient vessel selection for free flap reconstruction depends on numerous factors and may be limited due to previous treatment. Currently, little evidence is available regarding the anatomy and reconstructive potential of the common facial vein (CFV), a tributary of the internal jugular vein (IJV). The aim of this project was to determine the diameter of the CFV at various points along its course and identify suitable landmarks to locate the CFV, to consider the vessel as a potential recipient vein in free flap reconstruction. A cadaveric study was conducted by dissecting 17 embalmed neck hemi-sections in the Keele University Medical School Anatomy Suite. Our intent was to describe the gross anatomy of the CFV in terms of diameter and relation to surrounding structures. We found the mean diameter of the CFV to be 5.9 (± 1.8) mm at its termination into the IJV. We also found the mean distance of the CFV termination into the IJV from the level of the hyoid bone was 8.0 (± 4.0) mm. The diameter of the CFV could accommodate for end-to-end anastomoses to be formed with the IJV system. The diameter also suggests the vein to be appropriate for microvascular anastomosis with commonly used free flaps. The results propose that the CFV can be found within 12 mm of the level of the hyoid bone, knowledge of which could reduce operative time and site morbidity. These findings support the CFV as a potential recipient vein in free flap reconstruction of the head and neck.
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Affiliation(s)
- Chantal Patel
- Keele Medical School Anatomy Department, Keele University, Keele, Staffordshire, UK
| | - Ahmed Abdel-Rahman
- Department of Oral and Maxillo-Facial Surgery, Royal Stoke Hospital, University Hospitals of North Midlands, Stoke-on-Trent, UK
| | - Daya Gahir
- Keele Medical School Anatomy Department, Keele University, Keele, Staffordshire, UK.,Department of Oral and Maxillo-Facial Surgery, Royal Stoke Hospital, University Hospitals of North Midlands, Stoke-on-Trent, UK
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8
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Localization and Topography of the Arteries on the Middle Forehead Region for Eluding Complications Following Forehead Augmentation: Conventional Cadaveric Dissection and Ultrasonography Investigation. J Craniofac Surg 2020; 31:2029-2035. [PMID: 32604295 DOI: 10.1097/scs.0000000000006644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Forehead augmentation with filler injection is one of the most dangerous procedures associated with iatrogenic intravascular injection resulting in the severe complications. Nonetheless, few studies have determined the explicit arterial localization and topography related to the facial soft tissues and landmarks. Therefore, this study aimed to determine an arterial distribution and topography on the middle forehead region correlated with facial landmarks to grant an appropriate guideline for enhancing the safety of injection. Nineteen Thai embalmed cadavers were discovered with conventional dissection and 14 Thai healthy volunteers were investigated with ultrasonographic examination on the middle forehead. This study found that at the level of mid-frontal depression point, the transverse distance from the medial canthal vertical line to the superficial and deep branches of supraorbital artery were 9.1 mm and 15.1 mm, respectively. Whereas the depths from the skin of these arteries were 4.1 mm and 4.3 mm, respectively. Furthermore, the frontal branch of superficial temporal artery was detectable in 42.1% as an artery entering the forehead area. At the level of lateral canthal vertical line, the vertical distance of frontal branch was 31.6 mm, and the depth from skin of the artery was 2.7 mm. In conclusion, a proper injection technique could be performed based on an intensive arterial distribution and topography, and ultrasonographic examination before the injection is also suggested in order to restrict the opportunity of severe complications.
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Alian SM, Esmail HA, Gabr MM, Elewa EA. Predictors of subclinical cardiovascular affection in Egyptian patients with juvenile idiopathic arthritis subtypes. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2020. [DOI: 10.1186/s43166-020-00002-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
To assess the subclinical cardiovascular affection in juvenile idiopathic arthritis (JIA) Egyptian patient subtypes using Doppler ultrasonography (US) for carotid and femoral arteries and detecting their predictors
Results
Forty percent of the patients were polyarticular type, while 40% were systemic onset and 20% were oligoarticular. There was a statistically significant difference between JIA and controls in all parameters of subclinical atherosclerosis by ultrasonography except right external carotid velocity and (right and left) femoral velocity. There was also a highly significant increase in intima-media thickness (IMT) in systemic onset type of JIA. There was a statistically positive correlation between increased internal carotid velocity (right and left) and high erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (hs-CRP), lipid profile, and disease activity. High disease activity and lipid profile were valid predictors of subclinical atherosclerotic cardiovascular affection in JIA.
Conclusion
Increased cardiovascular risks and subclinical atherosclerosis in patients with JIA especially systemic onset type may be due to higher prevalence of multiple risk factors in these patients. Doppler ultrasonography is a simple, non-invasive technique which can be used to detect subclinical atherosclerosis in JIA. Control of disease activity by treat to target strategy and proper diet control should be applied for every patient with JIA especially those with systemic onset type for future prevention of cardiovascular disease.
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Phumyoo T, Jiirasutat N, Jitaree B, Rungsawang C, Uruwan S, Tansatit T. Anatomical and Ultrasonography‐Based Investigation to Localize the Arteries on the Central Forehead Region During the Glabellar Augmentation Procedure. Clin Anat 2019; 33:370-382. [DOI: 10.1002/ca.23516] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 10/13/2019] [Accepted: 10/26/2019] [Indexed: 11/10/2022]
Affiliation(s)
- Thirawass Phumyoo
- Department of Anatomy, Faculty of Medicine, and The Chula Soft Cadaver Surgical Training CenterChulalongkorn University and King Chulalongkorn Memorial Hospital Bangkok Thailand
- Department of Basic Medical ScienceFaculty of Medicine Vajira Hospital, Navamindradhiraj University Bangkok Thailand
| | | | - Benrita Jitaree
- Department of Anatomy, Faculty of Medicine, and The Chula Soft Cadaver Surgical Training CenterChulalongkorn University and King Chulalongkorn Memorial Hospital Bangkok Thailand
| | - Chalermquan Rungsawang
- Department of Anatomy, Faculty of Medicine, and The Chula Soft Cadaver Surgical Training CenterChulalongkorn University and King Chulalongkorn Memorial Hospital Bangkok Thailand
| | - Sukanya Uruwan
- Department of Anatomy, Faculty of Medicine, and The Chula Soft Cadaver Surgical Training CenterChulalongkorn University and King Chulalongkorn Memorial Hospital Bangkok Thailand
| | - Tanvaa Tansatit
- Department of Anatomy, Faculty of Medicine, and The Chula Soft Cadaver Surgical Training CenterChulalongkorn University and King Chulalongkorn Memorial Hospital Bangkok Thailand
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The transverse facial artery anatomy: Implications for plastic surgery procedures. PLoS One 2019; 14:e0211974. [PMID: 30730953 PMCID: PMC6366864 DOI: 10.1371/journal.pone.0211974] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 01/23/2019] [Indexed: 11/30/2022] Open
Abstract
Background The transverse facial artery (TFA) perfuses the lateral face. Knowledge of topographical anatomy of the lateral face is crucial for safe procedural performance in aesthetic and plastic surgery, especially the face lift flap and face transplant. The aim of the present study was to assess detailed TFA morphometrical features. Patients and methods One-hundred computed tomography head angiographies were analyzed. TFA numbers and origins were recorded bilaterally (200 cases). TFA diameters and lengths in addition to their positions in relation to neighboring vessels and the zygomatic arches were measured. Results TFA was present in 96% of cases (192/200, left = 97, right = 95). A single TFA was present in 95.3% and double TFAs were present in 4.7% of cases. In 91.7%, the TFA originated from the superficial temporal artery, and in 3.1%, it originated from the external carotid artery. One left TFA originated from the maxillary artery. The TFA was significantly longer on the right than on the left side (56.6±26.0 versus 47.3±22.2 mm; p = 0.03). The TFA mean diameter was 1.0±0.4 mm (range: 0.4–2.2 mm) with no difference between face sides. TFA length correlated with its diameter (r = 0.46, p <0.05). The TFA always originated below the zygomatic arch, and it should be found in the 8.8 mm wide area beginning 17.0mm below the lower border of the zygomatic arch. Conclusions The TFA has a significant role in lateral face vascularization, and absence of this vessel is very uncommon.
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Tucunduva MJ, Tucunduva-Neto R, Saieg M, Costa AL, de Freitas C. Vascular mapping of the face: B-mode and doppler ultrasonography study. Med Oral Patol Oral Cir Bucal 2016; 21:e135-41. [PMID: 26827055 PMCID: PMC4788790 DOI: 10.4317/medoral.20754] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 10/02/2015] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND To analyze the face vascularization pattern using B-mode and Doppler ultrasonography, and also propose an arterial vessel mapping. MATERIAL AND METHODS The investigation was performed on 20 ultrasonography exams of facial vessels through linear and endocavitary transducers. We analyzed and determined the average values for diameters, peak systolic velocity and resistive index of the following arteries: external carotid, lingual, deep lingual, sublingual, facial, submental, inferior labial, superior labial, angular, maxillary inferior alveolar, mental, buccal, greater palatine, infraorbital, superficial temporal, transverse facial and frontal. RESULTS Data was obtained allowing the analysis of the tissue hemodynamics. We were able to map the vascularization of the face and it was possible to access three arteries of small diameter (0,60mm angular artery; 0,55mm greater palatine artery; 0,45mm infraorbital artery). CONCLUSIONS The results presented in this article are valid tool supporting the non-invasive mapping of facial vascularization.
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Affiliation(s)
- M-J Tucunduva
- Rua Conselheiro Torres Homem 45, Jd Paulista - São Paulo, 01432-010, SP - Brazil,
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Butler DP, Henry FP, Leckenby JI, Grobbelaar AO. The Incidence of Facial Vessel Agenesis in Patients with Syndromic Congenital Facial Palsy. Plast Reconstr Surg 2014; 134:955e-958e. [DOI: 10.1097/prs.0000000000000731] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14
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An algorithm to guide recipient vessel selection in cases of free functional muscle transfer for facial reanimation. Arch Plast Surg 2014; 41:716-21. [PMID: 25396185 PMCID: PMC4228215 DOI: 10.5999/aps.2014.41.6.716] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 10/09/2014] [Accepted: 10/13/2014] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The aim of this study was to review the recipient vessels used in our cases of facial reanimation with free functional muscle transfer and to identify patient variables that may predict when the facial vessels are absent. From this we present a protocol for vessel selection in cases when the facial artery and/or vein are absent. METHODS Patients were identified from November 2006 to October 2013. Data was collected on patient demographics, facial palsy aetiology, history of previous facial surgery/trauma and flap/recipient vessels used. A standard operative approach was adopted and performed by a single surgeon. RESULTS Eighty-seven eligible patients were identified for inclusion amongst which 98 hemifaces were operated upon. The facial artery and vein were the most commonly used recipient vessels (90% and 83% of patients, respectively). Commonly used alternative vessels were the transverse facial vein and superficial temporal artery. Those with congenital facial palsy were significantly more likely to lack a suitable facial vein (P=0.03) and those with a history of previous facial surgery or trauma were significantly more likely to have an absent facial artery and vein (P<0.05). CONCLUSIONS Our algorithm can help to guide vessel selection cases of facial reanimation with free functional muscle transfer. Amongst patients with congenital facial palsy or in those with a previous history of facial surgery or trauma, the facial vessels are more likely to be absent and so the surgeon should then look towards the transverse facial vein and superficial temporal artery as alternative recipient structures.
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Eid N, Ito Y, Otsuki Y. Anomalous branching pattern of external carotid artery: Clinical relevance to cervicofacial surgery. Clin Anat 2011; 24:953-5. [PMID: 22009500 DOI: 10.1002/ca.21126] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2010] [Revised: 11/29/2010] [Accepted: 12/02/2010] [Indexed: 11/07/2022]
Abstract
Anomalous branching pattern of the left external carotid artery (ECA) was detected in an old man. The ECA branched into high submental artery and large transverse facial artery ending as angular artery compensating for concurrent agenesis of ipsilateral facial artery. The lingual artery gave direct branch to the submandibular gland, whereas the superior thyroid artery arose directly from common carotid artery with high bifurcation level. This unreported branching pattern of the ECA may have important clinical relevance to cervicofacial surgery.
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Affiliation(s)
- N Eid
- Department of Anatomy and Cell Biology, Division of Life Sciences, Osaka Medical College, Takatsuki, Osaka, Japan
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Surgical planning for composite tissue allotransplantation of the face using 320-detector row computed tomography. J Comput Assist Tomogr 2010; 34:766-9. [PMID: 20861783 DOI: 10.1097/rct.0b013e3181e9c133] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We report initial surgical planning computed tomographic protocols for composite tissue allotransplantation of the face. This complex procedure replaces missing facial structures with anatomically identical tissues, restoring form and function. Achieved results are superior to those accomplished with conventional techniques. As a growing number of patients/recipients have undergone multiple reconstructions, vascular imaging plays an increasingly critical role in surgical planning and successful execution of the operation.
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18
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Yang H, Lee H. Response to letter: A New Perspective Regarding the Topographical Anatomy of the Transverse Facial Artery. Clin Anat 2010; 23:733. [DOI: 10.1002/ca.20999] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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19
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A new perspective regarding the topographical anatomy of the transverse facial artery. Clin Anat 2010; 23:460-1. [DOI: 10.1002/ca.20988] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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20
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Gravvanis A, Karakitsos D, Dimitriou V, Zogogiannis I, Katsikeris N, Karabinis A, Tsoutsos D. Portable duplex ultrasonography: A diagnostic and decision-making tool in reconstructive microsurgery. Microsurgery 2010; 30:348-53. [DOI: 10.1002/micr.20752] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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21
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Abstract
The transverse facial artery (TFA) is found in the lateral face and supplies the parotid gland and duct, facial nerve, facial muscles, and skin. To better understand the cutaneous vascularization of the lateral face and to better characterize the topography and other anatomical features of the TFA, microsurgical dissection was performed in 44 cadavers. The number of TFAs present ranged from one to three, and a single TFA was most common (70.5%). The TFA originated from the superficial temporal artery at or above the level of crossing by the temporofacial trunk of the facial nerve in the parotid gland (57.6%). The TFA divided into superior and inferior trunks in the gland, and continued as emerging branch. The superior emerging branch emerged from the gland superior to the parotid duct and divided into many branches. It supplied the malar area, crossed the parotid duct, terminated as perforator, vasa nervorum, or artery to the parotid duct or muscle. The inferior trunk in 72.5% continued as emerging branch instead of terminating in the gland. TFAs were classified into four types; the most common type was Type A in which the superior and inferior emerging branches and the duct-crossing branch were present. The mean number of perforators to the superficial cutaneous layer was 1.9. Most perforators extended from the superior emerging branches (77.9%). The most common perforating site was below the duct on the anterior third of the masseter muscle. In two cases, the TFA formed an anastomosis with the facial artery.
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Affiliation(s)
- Hee-Jun Yang
- National Biochip Research Center, Yonsei University College of Medicine, Seoul, Korea
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