1
|
Siwetz M, Widni-Pajank H, Hammer N, Bruneder S, Wree A, Antipova V. Course and Relation of the Facial Vessels-An Anatomical Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:805. [PMID: 38792988 PMCID: PMC11123074 DOI: 10.3390/medicina60050805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/09/2024] [Accepted: 05/11/2024] [Indexed: 05/26/2024]
Abstract
Background and Objectives: Facial vascular anatomy plays a pivotal role in both physiological context and in surgical intervention. While data exist on the individual course of the facial artery and vein, to date, the spatial relationship of the vasculature has been ill studied. The aim of this study was to assess the course of facial arteries, veins and branches one relative to another. Materials and Methods: In a total of 90 halved viscerocrania, the facial vessels were injected with colored latex. Dissection was carried out, the relation of the facial vessels was studied, and the distance at the lower margin of the mandible was measured. Furthermore, branches including the labial and angular vessels were assessed. Results: At the base of the mandible, the facial artery was located anterior to the facial vein in all cases at a mean distance of 6.2 mm (range 0-15 mm), with three cases of both vessels adjacent. An angular vein was present in all cases, while an angular artery was only present in 34.4% of cases. Conclusions: The main trunk of the facial artery and vein yields a rather independent course, with the facial artery always located anterior to the vein, while their branches, especially the labial vessels, demonstrate a closer relationship.
Collapse
Affiliation(s)
- Martin Siwetz
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Auenbruggerplatz 25, A-8036 Graz, Austria; (M.S.); (H.W.-P.)
| | - Hannes Widni-Pajank
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Auenbruggerplatz 25, A-8036 Graz, Austria; (M.S.); (H.W.-P.)
- Department of Oral and Maxillofacial Surgery, Klagenfurt Am Wörthersee Clinic, Feschnigstraße 11, A-9020 Klagenfurt am Wörthersee, Austria
| | - Niels Hammer
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Auenbruggerplatz 25, A-8036 Graz, Austria; (M.S.); (H.W.-P.)
- Department of Orthopedic and Trauma Surgery, University of Leipzig, D-04103 Leipzig, Germany
- Division of Biomechatronics, Fraunhofer Institute for Machine Tools and Forming Technology Dresden, D-09126 Dresden, Germany
| | - Simon Bruneder
- Department of Oral and Maxillofacial Surgery, Medical University of Graz, Auenbruggerplatz 5, A-8036 Graz, Austria;
| | - Andreas Wree
- Institute of Anatomy, Rostock University Medical Center, Gertrudenstr. 9, D-18057 Rostock, Germany;
| | - Veronica Antipova
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Auenbruggerplatz 25, A-8036 Graz, Austria; (M.S.); (H.W.-P.)
| |
Collapse
|
2
|
Shen WW, Jiao CB, Ma JX, Xia YC, Cui LG. Evaluation of facial artery course variations, diameters, and depth by Doppler ultrasonography. J Plast Reconstr Aesthet Surg 2023; 84:79-86. [PMID: 37327736 DOI: 10.1016/j.bjps.2023.05.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 05/07/2023] [Accepted: 05/15/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The facial artery (FA) is the main blood vessel supplying blood to the face. It is essential to understand the anatomy of FA around the nasolabial fold (NLF). This study aimed to provide the detailed anatomy and relative positioning of FA to help avoid unexpected complications in plastic surgery. METHODS FA was observed from the inferior border of the mandible to the end of its terminal branch in 66 hemifaces of 33 patients with Doppler ultrasonography. The evaluation parameters were: (1) location, (2) diameter, (3) FA-skin depth, (4) relationship between the NLF and FA, (5) distance between the FA and significant surgical landmarks, and (6) the running layer. The FA course is classified based on the terminal branch. RESULTS The most common FA course was Type 1, which had an angular branch as the final branch (59.1%). The most common FA-NLF relationship was that the FA was situated inferior to the NLF (50.0%). The mean FA diameter was 1.56 ± 0.36 mm at the mandibular origin, 1.40 ± 0.37 mm at the cheilion, and 1.32 ± 0.34 mm at the nasal ala. The FA diameter on the right hemiface was thicker than that on the left hemiface (p < 0.05). CONCLUSION The FA mainly terminates in the angular branch, running in the medial NLF and in dermis and subcutaneous tissue, with a blood supply advantage in the right hemisphere. We suppose that a deep injection into periosteum around the NLF may be safer than an injection into the superficial musculoaponeurotic system (SMAS) layer.
Collapse
Affiliation(s)
- Wei-Wei Shen
- Department of Ultrasound, Peking University Third Hospital, Beijing 100191, China
| | - Chen-Bo Jiao
- Department of Plastic Surgery, Peking University Third Hospital, Beijing 100191, China
| | - Jian-Xun Ma
- Department of Plastic Surgery, Peking University Third Hospital, Beijing 100191, China.
| | - You-Chen Xia
- Department of Plastic Surgery, Peking University Third Hospital, Beijing 100191, China
| | - Li-Gang Cui
- Department of Ultrasound, Peking University Third Hospital, Beijing 100191, China
| |
Collapse
|
3
|
Decellularized vascularized bone grafts as therapeutic solution for bone reconstruction: A mechanical evaluation. PLoS One 2023; 18:e0280193. [PMID: 36638107 PMCID: PMC9838862 DOI: 10.1371/journal.pone.0280193] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 12/22/2022] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Large bone defects are challenging for surgeons. Available reimplanted bone substitutes can't properly restore optimal function along and long term osteointegration of the bone graft. Bone substitute based on the perfusion-decellularization technique seem to be interesting in order to overcome these limitations. We present here an evaluation of the biomechanics of the bones thus obtained. MATERIAL AND METHODS Two decellularization protocols were chosen for this study. One using Sodium Dodecyl Sulfate (SDS) (D1) and one using NaOH and H2O2 (D2). The decellularization was performed on porcine forearms. We then carried out compression, three-point bending, indentation and screw pull-out tests on each sample. Once these tests were completed, we compared the results obtained between the different decellularization protocols and with samples left native. RESULTS The difference in the means was similar between the tests performed on bones decellularized with the SDS protocol and native bones for pull-out test: +1.4% (CI95% [-10.5%- 12.4%]) of mean differences when comparing Native vs D1, compression -14.9% (CI95% [-42.7%- 12.5%]), 3-point bending -5.7% (CI95% [-22.5%- 11.1%]) and indentation -10.8% (CI95% [-19.5%- 4.6%]). Bones decellularized with the NaOH protocol showed different results from those obtained with the SDS protocol or native bones during the pull-out screw +40.7% (CI95% [24.3%- 57%]) for Native vs D2 protocol and 3-point bending tests +39.2% (CI95% [13.7%- 64.6%]) for Native vs D2 protocol. The other tests, compression and indentation, gave similar results for all our samples. CONCLUSION Vascularized decellularized grafts seem to be an interesting means for bone reconstruction. Our study shows that the decellularization method affects the mechanical results of our specimens. Some methods seem to limit these alterations and could be used in the future for bone decellularization.
Collapse
|
4
|
Nicholls DL, Rostami S, Karoubi G, Haykal S. Perfusion decellularization for vascularized composite allotransplantation. SAGE Open Med 2022; 10:20503121221123893. [PMID: 36120388 PMCID: PMC9478687 DOI: 10.1177/20503121221123893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 08/12/2022] [Indexed: 11/01/2022] Open
Abstract
Vascularized composite allotransplantation is becoming the emerging standard for reconstructive surgery treatment for patients with limb trauma and facial injuries involving soft tissue loss. Due to the complex immunogenicity of composite grafts, patients who undergo vascularized composite allotransplantation are reliant on lifelong immunosuppressive therapy. Decellularization of donor grafts to create an extracellular matrix bio-scaffold provides an immunomodulatory graft that preserves the structural and bioactive function of the extracellular matrix. Retention of extracellular matrix proteins, growth factors, and signaling cascades allow for cell adhesion, migration, proliferation, and tissue regeneration. Perfusion decellularization of detergents through the graft vasculature allows for increased regent access to all tissue layers, and removal of cellular debris through the venous system. Grafts can subsequently be repopulated with appropriate cells through the vasculature to facilitate tissue regeneration. The present work reviews methods of decellularization, process parameters, evaluation of adequate cellular and nuclear removal, successful applications of perfusion decellularization for use in vascularized composite allotransplantation, and current limitations.
Collapse
Affiliation(s)
| | - Sara Rostami
- Latner Thoracic Surgery Laboratories, Toronto General Hospital Research Institute, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Golnaz Karoubi
- Latner Thoracic Surgery Laboratories, Toronto General Hospital Research Institute, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.,Departments of Mechanical and Industrial Engineering and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Siba Haykal
- Latner Thoracic Surgery Laboratories, Toronto General Hospital Research Institute, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.,Division of Plastic & Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
5
|
He A, Yu J, Liu N, Ye X. Reconstruction of Distal Nasal Defects With a Large Postauricular Skin-Fat-Fascia Composite Graft. Ann Plast Surg 2022; 88:49-53. [PMID: 34670965 DOI: 10.1097/sap.0000000000002947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Composite grafts have previously been reported to achieve a good outcome for nasal defect repair, but composite grafts have greater metabolic needs than simple skin. Therefore, the traditionally recommended size of a composite graft for nasal reconstruction is less than 1.5 cm in diameter. However, the distal nose is generally well supplied with blood vessels, which might support the use of larger composite grafts in such a highly vascularized recipient site. The aim of the article is to investigate whether a large skin-fat-fascia composite graft (larger than 2.0 cm) is viable for the repair of partial-thickness nasal defects. METHODS From October 2017 to December 2019, 13 patients with partial-thickness nasal defects underwent nasal reconstruction using a large postauricular skin-fat-fascia composite graft. Cases were followed up for 3 to 14 months postoperatively. The aesthetic outcome was evaluated in comparison with preoperative digital images. RESULTS Skin-fat-fascia composite grafts survived without graft necrosis, dermal fibrosis, or skin contraction in all cases. Favorable aesthetic outcomes were obtained in all patients, and no further revision surgery was need. CONCLUSIONS A postauricular composite graft larger than 2.0 cm is a safe and effective reconstruction approach for partial-thickness nasal defects. This technique offers significant advantages in terms of no additional facial scar, no visible asymmetry on the face, no additional surgery for revision, and with mild scar in the donor site of the postauricular region.
Collapse
Affiliation(s)
- Aijuan He
- From the Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China
| | | | | | | |
Collapse
|
6
|
Hu X, Xing Y, Mu C, Liu Y, Hua H. Association between cheilitis granulomatosa and odontogenic infections: A case-control study. J Dermatol 2021; 48:1731-1738. [PMID: 34405432 DOI: 10.1111/1346-8138.16108] [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: 04/02/2021] [Revised: 07/19/2021] [Accepted: 07/25/2021] [Indexed: 11/28/2022]
Abstract
The association between cheilitis granulomatosa and dental infections (dental caries and apical periodontitis) is still not well understood. Herein, we aimed to investigate the association in large hospital cases with cohort controls. Cheilitis granulomatosa cases (n = 181) were retrieved from Peking University Hospital of Stomatology and age- and sex-matched to controls (n = 181). The χ2 -test, Student's t-test, and Mann-Whitney U-test were used to compare the differences between groups. The χ2 -test and odds ratio were used to verify if there was an association and risk relationship. The results showed that both dental caries and apical periodontitis were associated with cheilitis granulomatosa (p < 0.001). Individuals with cheilitis granulomatosa had approximately a twofold increased frequency of dental caries than those without cheilitis granulomatosa (104/181, 57.5% vs. 53/181, 29.3%) (p < 0.001). The odds ratio of dental caries occurring in the case group compared to the control group was 3.211. The frequency of apical periodontitis in patients with cheilitis granulomatosa was significantly greater than in those without cheilitis granulomatosa (109/181, 60.2% vs. 28/181, 15.5%) (p < 0.001). The odds ratio was 8.272. Moreover, apical periodontitis was also locationally related to cheilitis granulomatosa (p < 0.001). Collectively, our study showed that the foci of dental infections are associated with cheilitis granulomatosa, suggesting that proper treatment of focal teeth may be important in the management of cheilitis granulomatosa.
Collapse
Affiliation(s)
- Xiaosheng Hu
- Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yixiao Xing
- Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing, China
| | - Changqing Mu
- Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing, China.,Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yang Liu
- Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing, China
| | - Hong Hua
- Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing, China
| |
Collapse
|
7
|
Duisit J, Maistriaux L, Bertheuil N, Lellouch AG. Engineering Vascularized Composite Tissues by Perfusion Decellularization/Recellularization: Review. CURRENT TRANSPLANTATION REPORTS 2021. [DOI: 10.1007/s40472-021-00317-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
8
|
Koziej M, Trybus M, Hołda M, Polak J, Wnuk J, Brzegowy P, Popiela T, Walocha J, Chrapusta A. Anatomical Map of the Facial Artery for Facial Reconstruction and Aesthetic Procedures. Aesthet Surg J 2019; 39:1151-1162. [PMID: 30721996 DOI: 10.1093/asj/sjz028] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The facial artery (FA) is the main blood vessel supplying the anterior face and an understanding of its anatomy is crucial in facial reconstruction and aesthetic procedures. OBJECTIVES The aim of this study was to assess the many anatomical features of the FA utilizing a multidimensional approach. METHODS Head and neck computed tomographic angiographies of 131 patients (255 FAs) with good image quality were evaluated. The FA was classified according to its termination pattern, course, and location with reference to soft tissue/bone surrounding structures. RESULTS In total, each branch was present as follows: the submental artery (44.8%), the inferior labial artery (60%), the superior labial artery (82.2%), the lateral nasal artery (25.1%), and the angular artery (42.5%). The most common FA course was the classic course, situated medially to the nasolabial fold (27.1%). In total 65.5% of the arteries were located medially to the nasolabial fold, and only 12.3% of them were totally situated lateral to the nasolabial fold. The median distance (with quartiles) from the inferior orbital rim reached the FA after the superior labial artery branched off in 50.2% of cases and was 36.6 mm (33.4; 43.3). The angle between the FA and the inferior border of the mandible was 49.8o (31.9; 72.4). The horizontal distances between the oral commissure and naris to the FA were 8.5 ± 4.0 mm and 12.1 ± 6.7 mm, respectively. CONCLUSIONS An anatomical map summarizing the major measurements and geometry of the FA was generated. The detailed anatomy and relative positioning of the FA should be considered to avoid any unexpected complications in plastic surgery.
Collapse
Affiliation(s)
- Mateusz Koziej
- Department of Anatomy, Jagiellonian University Medical College, The Ludwik Rydygier Hospital, Krakow, Poland
- The Malopolska Center for Burns and Plastic Surgery, The Ludwik Rydygier Hospital, Krakow, Poland
| | - Marek Trybus
- Second Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland
| | - Mateusz Hołda
- Department of Anatomy, Jagiellonian University Medical College
| | - Jakub Polak
- Head of the Department of Radiology, Department of Rescue Medicine and Multiorgan Trauma, University Hospital, Krakow, Poland
| | - Jakub Wnuk
- Head of the Department of Radiology, Department of Rescue Medicine and Multiorgan Trauma, University Hospital, Krakow, Poland
| | - Paweł Brzegowy
- Head of the Department of Radiology, Department of Rescue Medicine and Multiorgan Trauma, University Hospital, Krakow, Poland
| | - Tadeusz Popiela
- Head of the Department of Radiology, Department of Rescue Medicine and Multiorgan Trauma, University Hospital, Krakow, Poland
| | - Jerzy Walocha
- Department of Anatomy, Jagiellonian University Medical College
| | - Anna Chrapusta
- Head of The Malopolska Center for Burns and Plastic Surgery, The Ludwik Rydygier Hospital, Krakow, Poland
| |
Collapse
|
9
|
Touzet-Roumazeille S, Nicol P, Fontaine C, Vacher C. Anatomic study of the arterial territories of the face depending on the external carotid artery branches. Morphologie 2019; 104:38-43. [PMID: 31494018 DOI: 10.1016/j.morpho.2019.08.002] [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: 03/30/2019] [Revised: 08/10/2019] [Accepted: 08/14/2019] [Indexed: 10/26/2022]
Abstract
AIM OF THE STUDY Blood supply of the skin of the face is mainly provided by 3 branches of the external carotid artery: facial artery (FA), superficial temporal artery (STA) and transverse facial artery (TFA) which is a branch of the STA. The aim of the study was to describe the arterial territories of the skin of the face depending on the external carotid branches. MATERIAL AND METHODS After dissection of the first two centimeters of these arteries on one side, we performed an injection of India ink of different colors in the arteries in order to describe the arterial territories (angiosomes) of the face on 24 embalmed cadavers. RESULTS The lips and the tip of the nose were vascularized in most cases by the FA. The STA vascularizes the temporal and frontal areas and a part of the auricle. The buccal area blood supply is coming from the FA with a participation of the TFA which is variable (10/24 cases), and the zygomatic area blood supply is coming from the STA with a participation of the TFA (9/24 cases). CONCLUSIONS Variations in the angiosomes of the face have to be considered in reconstructive surgery, and in face transplantation.
Collapse
Affiliation(s)
- S Touzet-Roumazeille
- Oral and Maxillofacial Department, Universitary Hospital of Lille, University of medicine of Lille, Place de Verdun, 59045 Lille cedex, France
| | - P Nicol
- Department of oral and maxillofacial surgery, Beaujon Hospital, AP-HP, 92110 Clichy, Paris, France; Department of Anatomy, University of medicine Paris Diderot, Beaujon Hospital, AP-HP, 100, boulevard Général Leclerc, 92110 Paris, France
| | - C Fontaine
- Department of anatomy, Faculty of Medecine Henri Warembourg, University of medicine of Lille, Place de Verdun, 59045 Lille cedex, France
| | - C Vacher
- Department of oral and maxillofacial surgery, Beaujon Hospital, AP-HP, 92110 Clichy, Paris, France; Department of Anatomy, University of medicine Paris Diderot, Beaujon Hospital, AP-HP, 100, boulevard Général Leclerc, 92110 Paris, France; EUniversité de Paris, EA2496, 92120 Montrouge, France.
| |
Collapse
|