Archives of Craniofacial Surgery (대한두개안면성형외과학회지)

Korean Cleft Palate-Craniofacial Association (대한두개안면성형외과학회)
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The branching patterns and termination points of the facial artery: a cadaveric anatomical study

  • Vu Hoang Nguyen (Department of Anatomy, University of Medicine and Pharmacy, Ho Chi Minh City) ;
  • Lin Cheng-Kuan (Department of Environmental Health, Harvard T.H. Chan School of Public Health) ;
  • Tuan Anh Nguyen (Department of Plastic and Cosmetic Surgery, University of Medicine and Pharmacy, Ho Chi Minh City) ;
  • Trang Huu Ngoc Thao Cai (Department of Plastic and Cosmetic Surgery, University of Medicine and Pharmacy, Ho Chi Minh City)
  • Received : 2024.01.22
  • Accepted : 2024.04.19
  • Published : 2024.04.20
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Abstract

Background: The facial artery is an important blood vessel responsible for supplying the anterior face. Understanding the branching patterns of the facial artery plays a crucial role in various medical specialties such as plastic surgery, dermatology, and oncology. This knowledge contributes to improving the success rate of facial reconstruction and aesthetic procedures. However, debate continues regarding the classification of facial artery branching patterns in the existing literature. Methods: We conducted a comprehensive anatomical study, in which we dissected 102 facial arteries from 52 embalmed and formaldehyde-fixed Vietnamese cadavers at the Anatomy Department, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam. Results: Our investigation revealed eight distinct termination points and identified 35 combinations of branching patterns, including seven arterial branching patterns. These termination points included the inferior labial artery, superior labial artery, inferior alar artery, lateral nasal artery, angular artery typical, angular artery running along the lower border of the orbicularis oculi muscle, forehead branch, duplex, and short course (hypoplastic). Notably, the branching patterns of the facial artery displayed marked asymmetry between the left and right sides within the same cadaver. Conclusion: The considerable variation observed in the branching pattern and termination points of the facial artery makes it challenging to establish a definitive classification system for this vessel. Therefore, it is imperative to develop an anatomical map summarizing the major measurements and geometric features of the facial artery. Surgeons and medical professionals involved in facial surgery and procedures must consider the detailed anatomy and relative positioning of the facial artery to minimize the risk of unexpected complications.

Keywords

Acknowledgement

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

References

  1. Al-Hoqail RA, Abdel Meguid EM. An anatomical and analytical study of the modiolus: enlightening its relevance to plastic surgery. Aesthetic Plast Surg 2009;33:147-52. https://doi.org/10.1007/s00266-008-9187-x
  2. Dickson G, Clark SK, George D, Mackenzie F, Mann NA, Wright K, et al. The variability of the facial artery in its branching pattern and termination point and its relevance in craniofacial surgery. Eur J Plast Surg 2014;37:1-8. https://doi.org/10.1007/s00238-013-0891-7
  3. Dupoirieux L, Plane L, Gard C, Penneau M. Anatomical basis and results of the facial artery musculomucosal flap for oral reconstruction. Br J Oral Maxillofac Surg 1999;37:25-8. https://doi.org/10.1054/bjom.1998.0301
  4. 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
  5. Gardetto A, Dabernig J, Rainer C, Piegger J, Piza-Katzer H, Fritsch H. Does a superficial musculoaponeurotic system exist in the face and neck? An anatomical study by the tissue plastination technique. Plast Reconstr Surg 2003;111:664-75. https://doi.org/10.1097/01.PRS.0000041538.49139.11
  6. Koziej M, Bonczar M, Ostrowski P, Piatek-Koziej K, Bonczar T, Pasternak A, et al. Termination points of the facial artery: a meta-analysis. Clin Anat 2022;35:469-76. https://doi.org/10.1002/ca.23817
  7. Koziej M, Trybus M, Holda M, Polak J, Wnuk J, Brzegowy P, et al. Anatomical map of the facial artery for facial reconstruction and aesthetic procedures. Aesthet Surg J 2019;39:1151-62. https://doi.org/10.1093/asj/sjz028
  8. 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
  9. Lohn JW, Penn JW, Norton J, Butler PE. The course and variation of the facial artery and vein: implications for facial transplantation and facial surgery. Ann Plast Surg 2011;67:184-8. https://doi.org/10.1097/SAP.0b013e31822484ae
  10. Loukas M, Hullett J, Louis RG Jr, 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
  11. Mitz V, Ricbourg B, Lassau JP. Facial branches of the facial artery in adults: typology, variations and respective cutaneous areas. Ann Chir Plast 1973;18:339-50.
  12. Niemann K, Lazarus L, Rennie C. An anatomical study of the facial artery. Int J Morphol 2019;37:1310-5. https://doi.org/10.4067/S0717-95022019000401310
  13. Niranjan NS. An anatomical study of the facial artery. Ann Plast Surg 1988;21:14-22.
  14. Pilsl U, Anderhuber F, Neugebauer S. The facial artery: the main blood vessel for the anterior face? Dermatol Surg 2016;42:203-8. https://doi.org/10.1097/DSS.0000000000000599
  15. 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
  16. Yang HM, Lee JG, Hu KS, Gil YC, Choi YJ, Lee HK, et al. New anatomical insights on the course and branching patterns of the facial artery: clinical implications of injectable treatments to the nasolabial fold and nasojugal groove. Plast Reconstr Surg 2014;133:1077-82. https://doi.org/10.1097/PRS.0000000000000099
  17. 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
  18. Koshi R. Cunningham's manual of practical anatomy. Vol 3: head and neck. Oxford University Press; 2018.
  19. Kulkarni AS, Geetha KN. Variations in branching pattern of facial artery: an anatomical study in 50 Indian adult cadavers. J Anat 2013;113:130-4.
  20. Wang D, Xiong S, Zeng N, Wu Y. Facial arterial variations in asians: a study on computed tomographic angiography. Aesthet Surg J 2022;42:527-34. https://doi.org/10.1093/asj/sjab380
  21. Tansatit T, Jitaree B, Uruwan S, Rungsawang C. Anatomical study of the dorsal nasal artery to prevent visual complications during dorsal nasal augmentation. Plast Reconstr Surg Glob Open 2021;9:e3924.
  22. Hong SJ, Park SE, Jo JW, Jeong DS, Choi DS, Won JH, et al. Variant facial artery anatomy revisited: conventional angiography performed in 284 cases. Medicine (Baltimore) 2020;99:e21048.
  23. Vasudha TK, Divya Shanthi D, Sadashivana G. A study on course and variations of facial artery on the face. Int J Anat Res 2018;6:4928-32. https://doi.org/10.16965/ijar.2017.510
  24. Koh KS, Kim HJ, Oh CS, Chung IH. Branching patterns and symmetry of the course of the facial artery in Koreans. Int J Oral Maxillofac Surg 2003;32:414-8. https://doi.org/10.1054/ijom.2002.0372