Facial Artery Research Articles

Cross Sectional Study on Thyroid Arteries with Clinical Correlations

Introduction- Thyroid gland is a highly vascular endocrine gland. The aim of our study is to explore thyroid arteries to escape eventual iatrogenic complications.
 Materials and Methods- Both sides of neck of total 60 adult embalmed cadavers were dissected in West Bengal (2020-2021).
 Results- We found Superior Thyroid Arteries in 100% cases originating from External Carotid Artery in 77.5% cases, Carotid Bifurcation in 11.67% cases, Common Carotid Artery in 7.5% cases, as well as a common trunk with Lingual artery in 1.67% cases, Lingual and Facial arteries in 1.67% cases. Source of origin of Superior Thyroid Artery when compared with level of origin and between male and female cadavers, the result was found statistically significant (p< 0.05). Inferior Thyroid Artery was present in 90% cases and absent in 10% cases. Inferior Thyroid Artery originated from Thyrocervical Trunk in 92.5% cases, Common Carotid Artery in 1.67% cases, Subclavian Artery in 0.83% cases. Thyroidea Ima Artery was found in 3.33% cases arising from Arch of Aorta and Brachiocephalic Trunk.
 Conclusion- Knowledge of thyroid arterial variations will help to prevent loss of patient life due to hemorrhage during surgery.

The Anatomy of the Stomatognathic System in Different Skull Types in Dogs.

The anatomy of the stomatognathic system is important for both clinical evaluations and surgical approaches in all animal species. The aim of this study was to describe the innervation and vascularization of the stomatognathic system of the dog. Twelve dogs without a history of disease or cranial malformation were used: 4 brachycephalic, 4 mesocephalic, and 4 dolichocephalic. The dogs were dissected, and arteries, veins, and nerves related to the masticatory and swallowing components were identified. The distribution pattern of these structures in the 3 different skull types were observed. The entire blood supply of the stomatognathic system is derived from the external carotid artery, which originates from the common carotid artery, and terminates as it branches into the superficial temporal and maxillary arteries. The other main branches of the common carotid artery are the occipital, cranial laryngeal, ascending pharyngeal, lingual, facial, caudal auricular, and parotid arteries. Blood drainage was achieved via the external jugular vein, which originates from the union of the linguofacial and maxillary veins. Brachycephalic dogs had blood vessels with greater sinuosity (more deviations) when compared to dolichocephalic and mesocephalic dogs. The stomatognathic system innervation of brachycephalic skull dogs showed differences in the distribution of the facial nerve in the labial commissure and maxillary and mandibular regions. The cranial conformation of dogs demonstrated anatomical variations of the vascular and neural structures of the stomatognathic system. This data may be useful to improve clinical practice, surgical planning, and interpretation of clinical dysfunctions.

Biochemical and morphological indicators of blood of cows with subclinical form of mastitis

This study aims to study the biochemical and morphological parameters of the blood of cows with subclinical mastitis. Experimental studies were conducted at Selyana LLC (Kuzbassky village, Kemerovo district, Kemerovo region) in 2021–2022. For this experiment, 12 cows were selected. Animals were divided into experimental (sick) and control (healthy) - 6 goals in each group. Animals were chosen according to the pair-analogues method, considering their live weight, breed, age at calving, milk yield, fat milk content, and physiological state. Body temperature was measured with a mercury thermometer with a scale graduated in Celsius from 34 to 42 ºС. The measurements were carried out for 5 min. The pulse rate was determined on the external maxillary artery for a minute. The number of exhalations calculated the frequency of respiratory movements. The same feeding and maintenance were organised for two groups of animals, i.e., they were in their usual conditions. In animals, after diagnostic tests for mastitis, blood was taken to study biochemical and morphological parameters. In sick animals, hyperproteinemia (87.43±0.82 g/l), low calcium content (87.43±0.82 g/l), and an increase in the level of phosphatase (156.15±0.50 U/l) were noted. In cows with mastitis, the number of leukocytes increased to 14.06 ± 2.29 × 1012/l. The average haemoglobin concentration in the erythrocyte was 27.77±0.43 in the control group and 27.87±0.21 g/dl in the experimental group. When studying the leukogram, the number of monocytes in the control group was 2.23±1.51, and in the group of animals with mastitis - 3.47±1.71%.

Characteristics and management of vascular compromise after an organ transplantation surgery of the head and neck region: Analysis of 220 submandibular glands with autologous transplantation

BackgroundMicrovascular submandibular gland transplantation (SMGT) for severe dry eye disease (DED) has rarely been reported in the literature. The aim of this study was to report a case series of SMGT with the special focus on monitoring and management of postoperative vascular compromise. MethodsUsing a retrospective single-cohort study design, the investigators enrolled a sample of DED patients undergoing SMGT in a Chinese university hospital during 1999 and 2021. The main outcomes were baseline and surgical data, post-operative manifestations, and surgical results. Descriptive, uni- and bivariate statistics were computed with the significant P < 0.05. ResultsDuring the study period, 220 DED patients (55.9% female) with a mean age of 32.66±14.47 years underwent SMGT. Vascular compromises occurred in 27 grafted glands (12.3%; 22 venous compromises and 5 arterial compromises) at a median of 27 h(range, 3.3 to 288 h) after surgery. Harden texture and swelling of the covering skin flap of the donor indicated venous compromises, while some specific sign was absent for arterial compromise. The accompanying vein of the facial artery (FAV) as a donor's vein was associated with less vascular compromise compared to the anterior facial vein (AFV). Timely reexploration was performed in 25 glands (92.6%), with a salvaged rate of 48%, and more venous compromises were salvaged compared to artery compromises (54.6% vs. 0%, P = 0.047). Temporary hypersecretion on postoperative 2–5 days was noticed in the grafted glands with no or salvaged vascular compromise (Schirmer's test, 35 mm/5 min and 37 mm/5 min, respectively, P = 0.749), while they were absent for the 15 surgically failed grands (Schirmer's test 0 mm/5 min, P<0.001). ConclusionsVascular compromise appears to be a common complication of SMGT. Postoperative hypersecretion of the grafted glands may indicate good circulation, and the use of FAV as the donor's vein could help to decrease the risk of vascular compromise.

Topographic anatomy of the submental artery and its clinical implications for reconstructive surgery.

Knowledge about the anatomy of the submental artery (SA) is of immense importance when performing plastic and reconstructive procedures. A retrospective study was performed to analyze the topographic anatomy of the SA. The measurements were performed on 80 consecutive patients who underwent head and neck computed tomography angiography (CTA). The SA was present in 131 out of 137 hemifaces (95.6%). The vessel originated from the facial artery in all cases (100.0%). Moreover, the SA was found to have 0-4 branches. However, most commonly, the said artery had no branches of considerable size (51.1%). Due to the high variability of the course of the said artery, the authors of the present study created a novel classification system presenting the most prevalent courses of the SA in the submental region. The current study utilized 131 hemifaces of 80 (CTA) to create a heat map of the SA, illustrating its precise origin and course in the submental region. The findings of this study could assist surgeons in developing a mental map of the arterial anatomy of the submental region, potentially improving the efficiency of localizing the SA and reducing the risk of complications during plastic and reconstructive procedures.

Diameters of lingual, facial, and maxillary arteries measured according to an objective protocol on 3D computed tomography angiography images.

Retrograde superselective intra-arterial chemoradiotherapy is a radical treatment for advanced oral cancer. The catheter tip is placed into tumor-feeding arteries-the lingual, facial, or maxillary arteries. The diameter of the tumor-feeding arteries newly bifurcated from the external carotid artery is crucial for determining the requirement of a catheter navigation system. This study aimed to measure the diameter and distribution of the tumor-feeding artery according to an objective protocol using 3D computed tomography angiography images reproducibly. Angiographic data of 20 noncatheterized carotid arteriesof 10 randomly selected patients were analyzed. We followed the external carotid artery to the entrance of each feeding artery to determine the center point where the artery diameter was measured. The diameter of the optimum circle measured at the adopted center point was taken as the diameter of each tumor-feeding artery. The diameters (mean ± standard deviation) were 3.5 ± 0.45, 2.9 ± 0.56, and 3.5 ± 0.56mm for the maxillary, lingual, and facial arteries, respectively. The diameters of the maxillary and facial arteries were similar (p = 0.877), whereas the diameter of the lingual artery was smaller than that of the maxillary and facial arteries (p < 0.001). The findings of this study will be beneficial in determining the need of a new catheter navigation system and diameter of catheters to be used in the clinical practice. From the viewpoint of measurement automation and reproducibility, 3DCTA vessel measurement taken according to the proposed protocol was considered to be effective.

Facial Reconstruction Using Facial Artery Myomucosal Flap: A Comprehensive Review.

The facial artery myomucosal (FAMM) flap is a type of facial flap that is constructed with the buccal mucosa and submucosa along with a portion of the buccinator muscle, which is connected to nearby blood vessels to maintain its blood supply. It is a versatile and reliable option for head and neck reconstruction, particularly in oral cavity defects. This flap is employed in the reconstruction of the floor of the mouth, alveolar cleft surgery, and tongue defect repair. Previous studies have discussed the use of FAMM flaps for facial reconstructions. However, there are no current and updated comprehensivereviews discussing the use of FAMM flaps in facial reconstruction. In light of this, this study aimed to review all relevant studies that discuss the use of FAMM flaps in facial reconstruction.

Hyaluronic Acid Filler Injection Guided by Doppler Ultrasound.

Doppler ultrasound can be used to detect almost all arteries of the face before injecting the hyaluronic acid (HA) filler. The relatively more dangerous sites of filler injection are the glabellar wrinkle, forehead, temple, nose, and nasolabial fold area, and it is recommended to map the vasculature of these areas by Doppler ultrasound before performing filler injection. The Doppler ultrasound detection method is included as a video. Internal carotid arterial branches, the supratrochlear, supraorbital, and dorsal nasal arteries, and external carotid arterial branches, the superficial temporal and facial arteries, are very important arteries when injecting HA filler; thus, Doppler ultrasound detection is recommended.

Submandibular Gland Excision with Facial Artery Preservation: The Argument for Changing the Established Norms.

To evaluate the difference in average operating time and intraoperative blood loss in transcervical submandibular gland excision for isolated benign submandibular diseases, while preserving the facial artery and ligating the facial artery. A prospective study was conducted in our institute for a duration of 6months from January 2022 to June 2022. 30 patients undergoing excision of the submandibular gland as an isolated procedure were included. They were randomly divided into 2 groups of 15, Group "A" where the facial artery was preserved, and "B" where the artery was ligated. The operating time in minutes and intra operative blood loss was compared. The mean operating time was 48.26min in Group A, and 46.2min in Group B. The p value between the two groups was 0.189586, which was not significant. The mean blood loss in group A was 44.6ml, and 45.8ml in group B. The p value was not significant at 0.331254. Preserving the facial artery in benign tumours while excising the gland neither increases operating time nor intraoperative bleeding. This will not only retain the anatomy, but provide a second option for flap reconstruction in case needed later.

Versatality of facial artery musculomucosal flap in medium sized defects following ablation of oral cancers - A case series

Facial artery musculomucosal flaps (FAMM) are frequently utilised to restore medium-sized abnormalities after surgical removal of oral malignancies. This case series provides an overview of how patients are chosen for FAMM flap surgery, the operative anatomy, the surgical procedure, and the benefits of FAMM flap in reconstruction.

Outcomes in Fibula Free Flap Reconstruction for Treatment of Mandibular Osteonecrosis

Background: Osteoradionecrosis (ORN) of the mandible is an unfortunate possible sequela of radiotherapy for head and neck cancer. In advanced cases of ORN, mandibulectomy and free fibula flap reconstruction is required. We hypothesized that patients undergoing fibula free flap reconstruction of ORN mandibulectomy pose unique challenges and experience more complications than patients undergoing fibula free flaps after oncologic mandibulectomy. Methods: After IRB approval, we created a database of all free fibula flaps for mandible reconstruction from April 2005 through October 2019. Medical records were retrospectively reviewed for patient and surgical characteristics and post-operative outcomes. Results: 549 patients met inclusion criteria (173 ORN versus 376 non-ORN patients). Average age was 61.8±13.7 years. Mean follow-up was 35.0±29.5 months. ORN patients received more double-skin-island fibula flaps compared to non-OR patients (21.4% vs. 5.9%, p<0.001). Recipient artery other than the facial artery was utilized more commonly in ORN patients (41.0% vs. 19.1%, p <0.001). ORN patients had higher rates of delayed wound healing (27.2% vs. 17.3%, p=0.006) and surgical site infections (22.0% vs. 16.0%, p=0.058). Rates of flap loss, return to operating room, hematoma, operative time, and length of stay were similar between the groups. Conclusion: Mandibular reconstruction with fibula flaps for osteoradionecrosis is a more complicated procedure, often requiring two skin islands for both intraoral and extraoral resurfacing as well as utilization of unconventional recipient vessels due to previous history of neck dissection and radiotherapy. ORN patients also experience more complications such as delayed wound healing and infection compared to non-ORN patients.

The Facial Artery as a Branch of the External Carotid Artery in Thomas Turner's (1793-1873) Treatise on the Arterial System (1825) and a Comparison with Modern Anatomy.

The aim of the present paper is to contribute to the understanding of the history of the anatomical study of the facial artery. The facial artery plays a fundamental role in the study of the anatomy of the face, and in maxillofacial and vascular surgery. The debate on the understating of this vessel is essential in the educational process, with special focus on the historical development of topographical and descriptive ideas about it. The comparison between the study of facial artery in the work of Thomas Turner (1793-1873) and modern anatomical concepts serves as an excellent educational paradigm. The documentary research method was used this short historical survey. CONCLUSION: Thomas Turner laid the scientific foundation for the accurate anatomical study of the facial artery.

Diversity of the free helical rim flap: A case series tailoring the microsurgical technique to esthetically optimize full-thickness nasal defect reconstructions

The free helical rim (FHR) flap offers like-with-like reconstruction for full-thickness nasal defects. A case series of nasal reconstruction using an FHR flap was presented, detailing surgical steps and refinements, as well as functional and esthetic outcomes. This is a retrospective cohort study of composite nasal defect reconstruction with FHR flap from August 2018 to March 2020. Descriptive data were analyzed by SPSS software. Six cases were recruited, four were unilateral alar defects, one was hemi-nose, and one was ala plus tip. The average size of the defect was 2.5×2.8cm2. Three FHR flaps were designed with retrograde pedicles and three with anterograde pedicles. The facial artery and veins were the recipient vessels in all cases. Vascular grafts were used in all six cases. Descending branch of the lateral circumflex femoral (DLCxF) artery and vein functioned as interposition vascular conduits in five cases. Superficial forearm vein grafts were used in one case. One patient needed flap re-exploration due to venous congestion. One patient had partial flap necrosis due to delayed infection, and one developed delayed wound dehiscence in the irradiated wound. The average follow-up was 18 months. The FHR flap has consistent vascular anatomy. It can be raised as an anterograde or retrograde flap for a contralateral or ipsilateral inset. FHR flap can be used in extensive composite nasal defects. This case series demonstrates that interposition vascular grafts are invariably needed and the possibility of using forearm vessels as grafts instead of DLCxF artery and vein.

Horse serum or equine platelet lysate increases total vascular endothelial growth factor A concentrations and correlates with vascular growth in an equine facial arterial ring assay.

To evaluate ex vivo angiogenesis of equine arterial rings in response to various growth media. Facial arteries were dissected from 11 horses post-euthanasia. Equine platelet lysate (ePL) was harvested from 6 horses. Arteries were exposed to endothelial growth media (EGM) + horse serum (HS) for first sprout (FS), vascular regression (VR), and (basement membrane matrix [Matrigel]) lysis (ML) evaluation. Additional rings supplemented with (1) EGM, (2) EGM + EDTA, (3) endothelial basal media (EBM), (4) EBM + HS, or (5) EBM + human VEGF were compared for vascular network area (VNA) and maximum network growth (MNG). Additional rings exposed to EGM + ePL at 10-(10xePL), 5-(5xePL), or 2-fold (2xePL) increases from baseline platelet concentration, EGM + HS, EGM + platelet-poor plasma (PPP), EBM + PPP and EBM were analyzed for branch number, density, VNA, and VEGF-A concentration from days 0-3. Arteries demonstrated sprouting in Matrigel supplemented with EBM alone. EGM + HS exposure resulted in no differences in FS (P = .3934), VR (P = .0607), or ML (P = .2364) between horses. VNA in EGM + HS was greater than EBM (P = .0015). MNG was greater in EGM + HS, EBM + HS, and EBM + hVEGF compared with EBM (P = .0001). ePL treatment did not have an overall significant angiogenic effect compared with supplementation with HS, PPP, or EBM alone; however, VEGF-A concentrations were higher for EGM + 10xePL, EGM + 5xePL, and EGM-HS compared with EBM and positively correlated with VNA (P = .0243). Equine arterial rings serve as an ex vivo model for angiogenesis but have a high degree of variability. HS, PPP, or ePL support vascular growth, and HS and ePL may stimulate the secretion and be sources of VEGF-A.

A unilateral sternopharyngeal branch of the sternocleidomastoid muscle in an aged Caucasian male: a unique cadaveric report.

The sternocleidomastoid muscle (SCM) consists of a sternal and a clavicular head which merge together and inserts distally posterolateral on the mastoid process and superior nuchal line, hence separating the anterior from the posterior triangle of the neck. Many types of structural variations in SCM have already been reported before. A unique variation of this muscle was discovered in an aged Caucasian male cadaver during an anatomical dissection at the Paracelsus Medical University in Nuremberg, Germany. This study reports a right unilateral accessory muscular branch at the sternal head of the SCM which formed a tendon on the level of omohyoid muscle before dividing into anterior and posterior fascicles. The posterior fascicle attached to the external carotid artery at the site where a common trunk for lingual and facial artery branched off, drawing external carotid artery inferiorly to build an inferior loop, whereas the anterior fascicle passed further superior and broadened to form a muscular belly. This superior muscular belly extended to the posterior and lateral side of the pharynx to ultimately merge into the superior constrictor pharyngeal muscle. Such anatomical variation has never been reported before. Therefore, we propose the nomenclature of this variational structure as a sternopharyngeal branch of the SCM. This report helps not only to inform the clinicians regarding the possible variation of this muscle during surgical procedures or radiological diagnostics but also encourage developmental researches in the future.

Evaluation of facial artery course variations, diameters, and depth by Doppler ultrasonography

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. 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. 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±0.36mm at the mandibular origin, 1.40±0.37mm at the cheilion, and 1.32±0.34mm at the nasal ala. The FA diameter on the right hemiface was thicker than that on the left hemiface (p<0.05). 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.

A Case of Giant Cell Arteritis that Presented with Buccal Skin Ulceration along the Facial Artery.

A 68-year-old man presented with right buccal ulceration along the facial artery, temporal pain, lagophthalmos, diplopia, and tongue deviation to the right. Contrast-enhanced computed tomography showed bilateral temporal artery and right maxillary artery wall thickening, and a diagnosis of giant cell arteritis (GCA) was made according to the American College of Rheumatology 1990 criteria. Treatment with corticosteroids ameliorated his symptoms. This is the first report of GCA with buccal skin ulceration along a facial artery. Because a delayed diagnosis can lead to irreversible damage, it is essential to notice rare symptoms, such as skin ulceration and multiple cranial neuropathy-like symptoms.

Facial, lingual, and infraorbital artery calcification: A rare incidental radiographic finding

Identifying calcification of arteries in the head and neck region may aid in the diagnosis of advanced systemic conditions. In contrast, failure to recognize them can result in incorrect diagnoses and ineffective treatments. Radiographic analyses can be used to detect such calcifications. This report focuses on calcifications discovered in the facial, lingual, and infraorbital arteries following a routine dental care panoramic radiograph. This report is particularly notable because it is the second in the literature to highlight the calcification of all three arteries.

Epithelialization of Free Flap Vascular Pedicles through the Nasal Cavity after Long-term Follow-up: A Case Report

Summary: A 59-year-old man with right maxillary cancer presented with a right buccal fistula and an ectropion of the lower eyelid after multidisciplinary treatment. With no suitable vessels in the right face or neck for anastomosis, we planned reconstruction with a free thinned deep inferior epigastric artery perforator flap using the contralateral left facial artery and vein as the recipient. To simulate the length of the vascular pedicle, we used our original software and determined to use the route passing through the nasal cavity. The vascular pedicle was passed through a tunnel from the medial wall of the right maxillary sinus, through the nasal septum and the medial-frontal wall of the left maxillary sinus, to the left facial artery and vein. The flap survived completely, and facial deformity was corrected. At 1 year postoperatively, there had been concerns about the fragility of the vascular pedicle in the nasal cavity and the possibility of easy bleeding. Endoscopic examination revealed that the vascular pedicle in the nasal cavity was covered by fibrous tissue and multirow lineage epithelium, and an excisional biopsy indicated a low possibility of hemorrhage. Cutting off the vascular pedicle to prevent bleeding may not be necessary because the vascular pedicle through the nasal cavity becomes fibrotic and epithelialized in the surrounding area in the long term.

Virtual Reality and Augmented Reality in Plastic and Craniomaxillofacial Surgery: A Scoping Review.

Virtual reality (VR) and augmented reality (AR) have evolved since their introduction to medicine in the 1990s. More powerful software, the miniaturization of hardware, and greater accessibility and affordability enabled novel applications of such virtual tools in surgical practice. This scoping review aims to conduct a comprehensive analysis of the literature by including all articles between 2018 and 2021 pertaining to VR and AR and their use by plastic and craniofacial surgeons in a clinician-as-user, patient-specific manner. From the initial 1637 articles, 10 were eligible for final review. These discussed a variety of clinical applications: perforator flaps reconstruction, mastectomy reconstruction, lymphovenous anastomosis, metopic craniosynostosis, dermal filler injection, auricular reconstruction, facial vascularized composite allotransplantation, and facial artery mapping. More than half (60%) involved VR/AR use intraoperatively with the remainder (40%) examining preoperative use. The hardware used predominantly comprised HoloLens (40%) and smartphones (40%). In total, 9/10 Studies utilized an AR platform. This review found consensus that VR/AR in plastic and craniomaxillofacial surgery has been used to enhance surgeons' knowledge of patient-specific anatomy and potentially facilitated decreased intraoperative time via preoperative planning. However, further outcome-focused research is required to better establish the usability of this technology in everyday practice.