DOI QR코드

DOI QR Code

Facial artery: anatomical variations in the perioral region in cadavers

  • Vu Hoang Nguyen (Department of Anatomy, University of Medicine and Pharmacy) ;
  • Lin Cheng-Kuan (Department of Environmental Health, Harvard Chan School of Public Health) ;
  • Tuan Anh Nguyen (Department of Plastic and Cosmetic Surgery, University of Medicine and Pharmacy) ;
  • Trang Huu Ngoc Thao Cai (Department of Plastic and Cosmetic Surgery, University of Medicine and Pharmacy)
  • Received : 2023.09.25
  • Accepted : 2023.12.07
  • Published : 2023.12.20

Abstract

Background: In recent years, there has been an increase in reports of perioral vascular complications resulting from filler injections, such as necrosis of the lip or alar rim, occlusion, and in severe cases, blindness. Conversely, the use of perioral arterial flaps is becoming more prevalent in the treatment of cleft lips, cancer, and trauma. A thorough understanding of perioral arteries is essential to minimize complications and maximize the success of these flaps. However, the course of the facial artery (FA) in the perioral region remains incompletely understood. The aim of this study was to describe the variations of the FA in the perioral region. Methods: We dissected 52 embalmed and formaldehyde-fixed Vietnamese cadavers. We then studied the size and distribution of perioral arteries in 102 specimens. Results: The superior labial artery (SLA) was the most common branch, occurring in 87.25% of cadavers, followed by the inferior labial artery (ILA) at 78.43%. The SLA primarily originated above the mouth corner (cheilion), accounting for 91.01% of cases, and predominantly exhibited a tortuous course within the submucosa (78.65%). The ILA's branching pattern varied, but it was primarily located below the cheilion (91.25%). The ILA also followed a twisted path, generally within the submucosa. The ILA exhibited two patterns: the typical pattern, distributed at the vermilion border of the lower lip (8.82%), and the horizontal labiomental artery pattern, which ran horizontally in the middle of the lower lip area (69.61%). At their origin, the SLA and ILA had average external diameters of 1.29 mm and 1.28 mm, respectively. Conclusion: Numerous anatomical variations in the FA in the perioral region were found. A detailed anatomic description, suggested landmarks, and angiography before the procedure will be useful to help doctors avoid complications.

Keywords

Acknowledgement

This study was supported by the University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.

References

  1. Samizadeh S, Pirayesh A, Bertossi D. Anatomical variations in the course of labial arteries: a literature review. Aesthet Surg J 2019;39:1225-35. https://doi.org/10.1093/asj/sjy235
  2. Hofer SO, Posch NA, Smit X. The facial artery perforator flap for reconstruction of perioral defects. Plast Reconstr Surg 2005; 115:996-1003. https://doi.org/10.1097/01.PRS.0000154208.67390.5C
  3. Federative International Programme on Anatomical Terminology (FIPAT). Terminologia Anatomica. 2nd ed. FIPAT; 2011.
  4. Lee HJ, Won SY, O J, Hu KS, Mun SY, Yang HM, et al. The facial artery: a comprehensive anatomical review. Clin Anat 2018;31: 99-108. https://doi.org/10.1002/ca.23007
  5. Pinar YA, Bilge O, Govsa F. Anatomic study of the blood supply of perioral region. Clin Anat 2005;18:330-9. https://doi.org/10.1002/ca.20108
  6. Loukas M, Hullett J, Louis RG, Kapos T, Knight J, Nagy R, et al. A detailed observation of variations of the facial artery, with emphasis on the superior labial artery. Surg Radiol Anat 2006; 28:316-24. https://doi.org/10.1007/s00276-006-0093-0
  7. Al-Hoqail RA, Meguid EM. Anatomic dissection of the arterial supply of the lips: an anatomical and analytical approach. J Craniofac Surg 2008;19:785-94. https://doi.org/10.1097/SCS.0b013e31816aaad4
  8. Tansatit T, Apinuntrum P, Phetudom T. A typical pattern of the labial arteries with implication for lip augmentation with injectable fillers. Aesthetic Plast Surg 2014;38:1083-9. https://doi.org/10.1007/s00266-014-0401-8
  9. Cotofana S, Pretterklieber B, Lucius R, Frank K, Haas M, Schenck TL, et al. Distribution pattern of the superior and inferior labial arteries: impact for safe upper and lower lip augmentation procedures. Plast Reconstr Surg 2017;139:1075-82. https://doi.org/10.1097/PRS.0000000000003244
  10. Kawai K, Imanishi N, Nakajima H, Aiso S, Kakibuchi M, Hosokawa K. Arterial anatomy of the lower lip. Scand J Plast Reconstr Surg Hand Surg 2004;38:135-9. https://doi.org/10.1080/02844310310019068
  11. Park C, Lineaweaver WC, Buncke HJ. New perioral arterial flaps: anatomic study and clinical application. Plast Reconstr Surg 1994;94:268-76. https://doi.org/10.1097/00006534-199408000-00008
  12. Magden O, Edizer M, Atabey A, Tayfur V, Ergur I. Cadaveric study of the arterial anatomy of the upper lip. Plast Reconstr Surg 2004;114:355-9. https://doi.org/10.1097/01.PRS.0000131876.45116.77
  13. Furukawa M, Mathes DW, Anzai Y. Evaluation of the facial artery on computed tomographic angiography using 64-slice multidetector computed tomography: implications for facial reconstruction in plastic surgery. Plast Reconstr Surg 2013;131:526-35. https://doi.org/10.1097/PRS.0b013e31827c6f18
  14. Lee SH, Gil YC, Choi YJ, Tansatit T, Kim HJ, Hu KS. Topographic anatomy of the superior labial artery for dermal filler injection. Plast Reconstr Surg 2015;135:445-50. https://doi.org/10.1097/PRS.0000000000000858
  15. Edizer M, Magden O, Tayfur V, Kiray A, Ergur I, Atabey A. Arterial anatomy of the lower lip: a cadaveric study. Plast Reconstr Surg 2003;111:2176-81. https://doi.org/10.1097/01.PRS.0000060110.18366.49
  16. Lee SH, Lee HJ, Kim YS, Kim HJ, Hu KS. What is the difference between the inferior labial artery and the horizontal labiomental artery? Surg Radiol Anat 2015;37:947-53. https://doi.org/10.1007/s00276-015-1447-2
  17. Tansatit T, Phumyoo T, MCCabe H, Jitaree B. Translucent and ultrasonographic studies of the inferior labial artery for improvement of filler injection techniques. Plast Reconstr Surg Glob Open 2019;7:e2399.
  18. Schulte DL, Sherris DA, Kasperbauer JL. The anatomical basis of the Abbe flap. Laryngoscope 2001;111:382-6. https://doi.org/10.1097/00005537-200103000-00004
  19. Ahmadi SK, Rahpeyma A, Rezvani HN. Vermilion lower lip cross flap: an anatomic study on 22 fresh cadavers. Ann Maxillofac Surg 2012;2:107-10. https://doi.org/10.4103/2231-0746.101327
  20. Lee KL, Lee HJ, Youn KH, Kim HJ. Positional relationship of superior and inferior labial artery by ultrasonography image analysis for safe lip augmentation procedures. Clin Anat 2020; 33:158-64. https://doi.org/10.1002/ca.23379
  21. Zwierz A, Masna K, Perczak M, Burduk P. Unique characteristics and applications of reverse superior labial artery island flaps: a case series. Medicina (Kaunas) 2022;58:1012.