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A true aneurysm is a dilation of the arterial wall that preserves vessel continuity, retains three layers (intima, media, and adventitia), and commonly occurs in the aorta, including the thoracic and abdominal aorta. In contrast, true aneurysms of the external carotid artery and its branches are rare. Among several therapeutic options for true aneurysms, catheter-based embolization is the traditional treatment method. However, parent artery occlusion may not always result in permanent exclusion of the aneurysm from the systemic circulation. Dilation of the vasa vasorum is one of the mechanisms of occlusion recanalization. Herein, we present a rare case of a true aneurysm of the facial artery aneurysm. The patient underwent coil embolization as the initial treatment. Subsequently, surgical resection was performed due to aneurysm regrowth caused by vasa vasorum dilation. Although embolization is a useful and safe treatment option for facial aneurysms, careful follow-up radiological examinations are required because of the possibility of regrowth. [ABSTRACT FROM AUTHOR]

During the dissection of the cervicofacial area in a donated male cadaver, an asymmetrical division of the facial artery (FA) and a premasseteric artery (PA) were identified. Specifically, on the left side, the FA stem is divided into four branches (quadrifurcation) 4.26 mm below the lower border of the mandible. In contrast, it is divided into two branches (bifurcation) on the right side. Whether symmetrical or asymmetrical, these variants can have significant implications for rhinoplastic, maxillofacial, or reconstructive surgery. This finding underscores the crucial role of surgeons in exercising caution and paying close attention during these procedures to avoid potential damage. [ABSTRACT FROM AUTHOR]

Purpose: The literature has for too long described the arterial supply of the mandible as coming from a single artery, the inferior alveolar artery, and being of the terminal type. Rather, it appears to come from an extensive and complex arterial network dependent on the lingual, facial, and maxillary arteries and their collateral branches. Our study aims to confirm and demonstrate the arterial vascular richness of the mandible and to establish arterial mapping. Methods: The arterial vascularization of the mandible was revealed in six anatomic specimens after performing selective injections of the lingual, facial, and maxillary arteries with different dyes. A specimen was injected intra-arterially with colored latex at the level of the maxillary artery for a morphometric study. Results: Eighteen selective arterial injections were performed on six anatomic specimens. The mucocutaneous, musculoperiosteal, and intramedullary vascularizations were analyzed. Each of the arteries has a defined and delimited cutaneo-mucous vascular territory. The facial and maxillary arteries supply the musculoperiosteal vascularization of the mandible from the condyle to the symphysis. The lingual artery supplies only the inner cortex of the parasymphyseal and symphyseal regions. The facial and maxillary arteries provide intramedullary vascularization from the angle of the mandible to the parasymphysis. The vascularization of the symphysis depends on the facial artery. No staining was found in the condyle region. Neoprene latex injection was performed on an anatomic specimen, revealing a permeable anastomosis between the inferior alveolar and facial arteries. Conclusion: The arterial vascularization of the mandible is dependent on the maxillary, facial, and lingual arteries. This is a network vasculature. This study makes it possible to establish an arterial map of the mandible. The presence of an anastomosis between the inferior alveolar artery and the facial artery confirms the existence of dynamic and borrowed vascularization. Knowledge of this arterial system makes it possible to adapt maxillofacial surgical care and to anticipate possible intraoperative complications. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to establish the relationship of facial artery with nasolabial fold by color Doppler sonography and to determine facial artery variations and their relationship with age, gender, or hemifaces. Methods: The study included 188 patients (94 women, 94 men) aged 18–60 years. Overall, 376 facial arteries in both hemifaces were evaluated for the course within nasolabial fold, symmetry, and relationship with gender. Results: The mean age of the patients was 39.29 ± 12.81 years. Type A (55.7%) was the most common type in both hemifaces. There was no significant relationship between the course of facial artery and age (P >.05). Asymmetrical course of facial artery was more common in females (54.3%). In both genders, type A was the type with highest symmetry detected. Conclusions: Nasolabial fold is one of the important facial regions for filler injection. To prevent vascular injection, course of facial artery should be identified within the nasolabial fold. Type A was the most common type in both hemifaces and genders. Although the rates were close to each other, asymmetry in the course of the facial artery was observed in most of the patients. Ultrasonographic examination which is non‐invasive and non‐ionizing imaging method can be performed carefully before filler injection to determine vascular tissues. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background and Objectives: Typically, the external carotid artery (ECA) sends off separate anterior branches: the superior thyroid, lingual, and facial arteries. These could, however, form common trunks: thyrolinguofacial, linguofacial (LFT), or thyrolingual. Although known, the LFT variant was poorly detailed previously, and most authors just counted the variant. We aimed to demonstrate the individual anatomical possibilities of the LFT on a case-by-case basis. Materials and Methods: 150 archived angioCT files were used. After applying inclusion and exclusion criteria, 147 files of 86 males and 61 females were kept for this study. Results: In 34/147 cases, LFTs were found (23.12%). Bilateral LFTs were found in 13/34 cases (38.24%) and unilateral LFTs in 21/34 (61.76%) cases. Forty-seven LFTs were thus identified and further studied for different variables. Regarding the vertical topography of LFT origin, type 1a (suprahyoid and infragonial) was found in 28 LFTs (59.57%), type 1b (suprahyoid and gonial) was found in eight LFTs (17.02%), type 3 (suprahyoid and supragonial) was found in two LFTs (4.25%), type 2 (hyoid level of origin) in eight LFTs (17.02%), and type 3 (infrahyoid origin) in just one LFT (2.12%). Types of the initial course of the LFT were determined: type I, ascending, was found in 22/47 LFTs; type II, descending, in 12/47 LFTs; and type III, transverse, in 13/47 LFTs. Regarding the orientation of the first loop of the LFT, 23/47 LFTs had no loop, 4/47 had anterior loops, 1/47 had a posterior loop, 5/47 had superior loops, 5/47 had inferior loops, and 9/47 had medial loops. The position of the LFT relative to the ECA was classified as medial, anterior, or antero-medial. An amount of 12/47 LFTs were anterior to the ECA, 22/47 were antero-medial, 10/47 were medial, 2/47 were inferior, and 1/47 was lateral. Regarding their general morphology, 23/47 LFTs had a rectilinear course, 22/47 had loops, and 2/47 were coiled. A case-by-case presentation of results further demonstrated the diversity of the LFT. Conclusions: In conclusion, the morphology and topography of the LFT are individually specific and unpredictable. It can be anticipated case-by-case by surgeons on CT or MR angiograms. [ABSTRACT FROM AUTHOR]

The external carotid artery is the main artery of the head and neck region. It has eight branches, and there are various variations in the emergence and distribution of these branches. In particular, frequent changes can be observed in the emergence of facial artery, and lingual artery. Knowledge of the vascular anatomy of the lingual artery and facial artery is important in terms of neck surgery and radical treatments. For this reason, in the present case report we aimed to report a case with linguofacial trunk and its morphometric and morphological features. [ABSTRACT FROM AUTHOR]

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 6 months 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 48.26 min in Group A, and 46.2 min 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 44.6 ml, and 45.8 ml 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. [ABSTRACT FROM AUTHOR]

The bony notch on the inferior border of the mandible, anterior to the attachment of the masseter muscle, where the facial vessels commonly pass, has been called different names in the literature, e.g., premasseteric notch, antegonial notch, and notch for the facial vessels. Interestingly, various disciplines have leaned toward different names for this notch. Therefore, to aid in consistent communication among professionals, the present study aimed to analyze usage of these varied terms and make recommendations for the best terminology. Based on the adjacent anatomical structures used to name this notch, three groups were analyzed in this study, a group using masseter in the term, a group using gonion in the term, and a group using facial vessels in the term. A literature search found that the group using gonion in the term was found most in the literature. The orthodontics field used gonion in the term the most (29.0%: 31/107) followed by the oral and maxillofacial surgery field (14.0%: 15/107), the plastic surgery field (4.7%: 5/107), and the anatomy field (3.7%: 4/107). The dental field used gonion in this term the most (43.9%: 47/107) and the medical field used facial vessels in the term the most (33.3%: 6/18). Based on these results, the use of gonial terms for this notch seems to be preferred. [ABSTRACT FROM AUTHOR]

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 ± 0.36 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). 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. [ABSTRACT FROM AUTHOR]

Introduction: The facial artery (FA) was observed with distinctive variations and anomalous, which occur during the embryological developmental process due to the ablation of neural crest cells that impact embryonic aortic arch vessels, resulting in distinctive branching patterns. Therefore, this study aimed to investigate the types, clinical importance, localization, and differences of FA in fixed cadavers according to gender and body side. Methods: The current study was conducted on 19 formalin-fixed cadavers (68.4% males, n = 13; 31.6% females, n = 6). The types, variations, prevalence, and distance to nearby surgical landmarks of FA were recorded on both sides. Measurements were taken with a surgical microscope (Zeiss Meditec, Berlin, Germany) and a digital caliper (INCA, DCLA-0605, 0.6–150 mm). Results: Angular type % 73.1 (n = 14, right; n = 19, left), labial type % 5.3 (n = 1, right), alar type % 5.3 (n = 1, right), and nasal type % 5.3 (n = 1, right) were detected. The following parameters were significant according to gender; the distance between the ala of the nose and the origin of the FA on both sides (p = 0.007 right; p = 0.018 left), the diameter of FA at the cheilion (p = 0.019 left), diameters of the superior and inferior labial arteries at their origin (p = 0.031 right; p = 0.025 right) and PO lines. Conclusion: The significant differences in gender according to the distance of the FA and its branches from the origin should be considered to reduce complications during surgery. The differences in studies according to the types and variations of FA may be due to the scale of the study, gender, or study design.

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.

Pseudoaneurysms of facial artery usually arise from the distal part of the vessel. Only 4 cases were described in the literature involving the proximal part of facial artery. We present a case of a traumatic pseudoaneurysm involving the proximal part of facial artery. A 50-year-old man was referred to our department for a progressively growing submandibular mass. He was injured by a sharp object during a car crash 30 days ago. After 3 weeks, the patient noted the appearance of a subcutaneous mass in the left submandibular area. Physical examination revealed a freely movable, painful, and pulsatile swelling. Ultrasound and computerized tomography scan showed a nodular lesion in the left submandibular area in continuity with the facial artery. The diagnosis of pseudoaneurysm of facial artery was suspected. The patient was treated by surgery. The pseudoaneurysm was resected with ligation of the proximal and distal ends of the facial artery. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to identify variations in the origins of the anterior branches of the external carotid artery (ECA) and to propose an update of the current classification. Methods: The study included 100 carotids arteries from fifty human donors. Classification of anterior branches of external carotid artery was performed according to Vaz'quez et al. (2009). Results: The configuration origins of anterior branches were found as follows: Type I, 82%; Type II, 1%; Type III, 16%. No Type IV was observed. The study identified seven subgroups of anterior branch variations in the external carotid artery. The most frequently observed variations were Subtype Ia in 40% (n = 20) of cases on the right side and Subtype Ib in 38% (n = 19) on the left side. In addition, a rare and previously unclassified configuration was observed in a 72-year-old male donor, where the carotid artery was pentafurcated on the left side. Conclusions: In conclusion, the presence of anatomical variants not previously included in the anterior external carotid artery branching classifications supports the consideration of a revision to the present classification system. [ABSTRACT FROM AUTHOR]

Introduction The reconstruction of intraoral soft tissue and bony defects is important to restore function and esthetics. For large defects, there is a need for regional pedicled flaps or free flaps. The hard palate separates the nasal and oral cavities. Due to the small remaining surface area between the flap and the palate after surgical resections, an optimal blood supply to the flap is required for reconstructions of the hard palate. Case Report This article demonstrates the immediate reconstruction with submental island flap of a patient with partial maxillectomy after wide excision of maxillary adenoid cystic carcinoma and discusses a brief overview of this flap. Conclusion The submental island flap is an effective and reliable method for intraoral reconstruction of large softtissue defects in the oral cavity. Morbidity at the donor site is low and the remaining scar is unremarkable. Head and neck surgeons familiar with the facial artery and its branching pattern make this flap an appropriate choice for clinical practice. [ABSTRACT FROM AUTHOR]

Background: Supratrochlear (STA), supraorbital (SOA), and dorsal nasal artery (DNA) branches from the ophthalmic artery and angular artery (AA) from the facial artery are the primary suppliers of blood to the upper face. Filler injection without precise knowledge of its vascular topography poses a risk of severe complications. Methods: Seventy-four hemifaces from 37 subjects with a median age of 25.0 (21.0, 35.0) years and a median body mass index of 21.2 (20.0, 25.4) kg/m2 underwent high-frequency ultrasound tests between March 2022 and April 2022. The bilateral location, depth, peak systolic velocity (PSV), and inner diameter (ID) of the four periorbital arteries (STA, SOA, DNA, AA) were measured. Results: The average ID ranges from 0.6~1.0 mm, and the average PSV ranges from 9.2~24.9 cm/s. All arteries detected passed through the superficial subcutaneous fascia. Most subjects' STAs traveled within 1.0 to 2.0 cm from the midline (left 96.8%, right 93.8%), while SOAs were mainly concentrated within 2.0 to 4.0 cm (left 83.9%, right 81.3%). STAs were more superficial and had a larger internal ID and PSV than SOAs (p<0.001). Except for the ID of the right SOA2 being significantly larger than that of the left SOA2 (p<0.05), no dominant side was found. The depth of STAs and SOAs was moderately correlated with BMI (p<0.05), except for STA1 on the left side. The course of AAs presented a high variability. Conclusion: These findings emphasize that the periorbital arteries carry with it a likelihood of ocular complication risks during injection. Targeting the supraperiosteal layer in the STA area and the supramuscular layer in the SOA area of the inferior forehead during injection seems reasonable, and an area within 1.0~2.0 cm from the midline should be avoided. Additionally, the high variability of AAs will enhance the understanding of the anatomy of the facial artery terminals. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Background and Objectives: Typically, the external carotid artery (ECA) sends off separate anterior branches: the superior thyroid, lingual, and facial arteries. These could, however, form common trunks: thyrolinguofacial, linguofacial (LFT), or thyrolingual. Although known, the LFT variant was poorly detailed previously, and most authors just counted the variant. We aimed to demonstrate the individual anatomical possibilities of the LFT on a case-by-case basis. Materials and Methods: 150 archived angioCT files were used. After applying inclusion and exclusion criteria, 147 files of 86 males and 61 females were kept for this study. Results: In 34/147 cases, LFTs were found (23.12%). Bilateral LFTs were found in 13/34 cases (38.24%) and unilateral LFTs in 21/34 (61.76%) cases. Forty-seven LFTs were thus identified and further studied for different variables. Regarding the vertical topography of LFT origin, type 1a (suprahyoid and infragonial) was found in 28 LFTs (59.57%), type 1b (suprahyoid and gonial) was found in eight LFTs (17.02%), type 3 (suprahyoid and supragonial) was found in two LFTs (4.25%), type 2 (hyoid level of origin) in eight LFTs (17.02%), and type 3 (infrahyoid origin) in just one LFT (2.12%). Types of the initial course of the LFT were determined: type I, ascending, was found in 22/47 LFTs; type II, descending, in 12/47 LFTs; and type III, transverse, in 13/47 LFTs. Regarding the orientation of the first loop of the LFT, 23/47 LFTs had no loop, 4/47 had anterior loops, 1/47 had a posterior loop, 5/47 had superior loops, 5/47 had inferior loops, and 9/47 had medial loops. The position of the LFT relative to the ECA was classified as medial, anterior, or antero-medial. An amount of 12/47 LFTs were anterior to the ECA, 22/47 were antero-medial, 10/47 were medial, 2/47 were inferior, and 1/47 was lateral. Regarding their general morphology, 23/47 LFTs had a rectilinear course, 22/47 had loops, and 2/47 were coiled. A case-by-case presentation of results further demonstrated the diversity of the LFT. Conclusions: In conclusion, the morphology and topography of the LFT are individually specific and unpredictable. It can be anticipated case-by-case by surgeons on CT or MR angiograms.

Introduction: the present study reports three unusual cases of a supernumerary septal branch (SSB) originated directly from the facial artery and with a horizontal course towards the nasal septum. In addition, possible repercussions to nasal trauma and to procedures on orofacial harmonization were discussed. Analyzes were carried out by means of dissection of the facial artery, the SSB, the superior labial artery and the septal branch of the superior labial artery. Five measures were taken for each case using a digital caliper. The course and depth of both the SSB and the regular septal branch were registered and reported. The presence of a SSB, especially with an atypical origin, shows the importance of solid anatomical knowledge for the areas of orofacial harmonization and nasal trauma. Dental surgeons, plastic surgeons, and other healthcare professionals that performed procedures on the nose and upper lip areas may benefit from the findings of the present study. [ABSTRACT FROM AUTHOR]

Detailed knowledge about the normal anatomy and its variations is a necessity in good clinical and surgical practice. The case we are reporting here shows a rare configuration origin of the superior thyroid, lingual and facial arteries arising directly from a pentafurcated common carotid artery. A fresh frozen latex-infiltrated cadaver was dissected. The superior thyroid artery, the lingual artery and the facial artery were found to be directly detached from the common carotid artery as terminations of the five terminal rami variations. The current classifications of anatomical variants are discussed in detail in relation to this case. [ABSTRACT FROM AUTHOR]

Mönckeberg medial calcinosis (MMC) is a potentially serious vasculopathy involving calcification of the arterial tunica media of the extremities, heart, and other viscera. There are a limited number of cases reported in the dental literature, usually associated with the facial artery. Although MMC is often discerned as an occult radiologic finding in middle‐aged adults, its presence may serve as a harbinger for end‐stage renal disease, diabetes, other pathologic processes, and possible regional hypoperfusion. The objective of this report is to feature an elderly patient with MMC of the facial and infraorbital arteries. In addition, a brief review of published cases of MMC and its differential diagnosis have been provided. It is recommended that affected patients be referred for a comprehensive medical assessment. Timely discovery of calcified arteries may improve patient outcomes. [ABSTRACT FROM AUTHOR]

Introduction: The superior labial artery (SLA) is a facial artery (FA) that drains into the peri-oral region (dangerous area of face). Owing to the recent rise in the demand for reconstructive procedures and filler injections in this region, it is important to understand its arterial topography. This paper aims to study the embranchment pattern of the labial arteries in the eastern Indian population. Method: An observational study using conventional dissection and dry dye injection methods was conducted to visualize the facial and superior labial arteries in 56 hemifaces. The origin, morphometry (length and diameter), branching pattern, and termination of the arteries were recorded and compared with the existing data. Results: Two hemifaces were excluded from analysis (vessels damaged in dissection); in the remaining 54, a single SLA was present in all samples originating at a mean distance of 1.29 ± 0.32 cm from oral commissure (68.51% originating above). Lee type II (independent SLA giving off alar branch) was the predominant pattern (56.2%), followed by type I (independent SLA and alar branches, 33%) and type III (FA terminating as SLA, 10.8%). The average length of SLA was 4.75 ± 1.28 cm and 4.56 ± 0.78 cm on the right and left sides, respectively. Conclusion: The SLA is highly variable in occurrence, course, and depth, sometimes even occurring unilaterally; therefore, any intervention in this region should be done with caution. Since the SLA was not found subcutaneously at the vermillion border, the intradermal and the subcutaneous injections used here are relatively safer. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

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., (© 2023 American Association of Clinical Anatomists and British Association of Clinical Anatomists.)

Pseudoaneurysm is a rare vascular complication of trauma, causing an incomplete tear of the vessel wall. We present a clinical case report arising from the distal branch of facial artery in an infant. Facial artery pseudoaneurysm is a rare complication of facial trauma and can easily be misdiagnosed especially in the paediatric age group. Prompt investigation and diagnosis with timely and apt intervention is the key to the successful management of facial artery pseudoaneurysm.

Anatomical knowledge of the facial vasculature is crucial for successful plastic, reconstructive, and minimally invasive procedures of the face. The facial artery is palpated as it crosses the inferior mandibular rim immediately anterior to the insertion of the masseter muscle. This point is also helpful in locating the course of the mandibular branch of the facial nerve. After crossing the mandibular rim, the facial artery and vein then follow an anterosuperior course in the direction of the oral commissure. Near the angle of the mouth, the inferior labial artery and then the superior labial artery branch off medially The facial vein, also referred to as the anterior facial vein, is a paired vessel and the main vein of the face. The facial veins stem from the angular veins on each side of the root of the nose. Some sources claim that the angular vein, which arises from the confluence of the supratrochlear and supraorbital veins, is only an initial segment of the facial vein.

Background: The aim of this study was to identify variations in the origins of the anterior branches of the external carotid artery (ECA) and to propose an update of the current classification. Methods: The study included 100 carotids arteries from fifty human donors. Classification of anterior branches of external carotid artery was performed according to Vaz’quez et al. (2009). Results: The configuration origins of anterior branches were found as follows: Type I, 82%; Type II, 1%; Type III, 16%. No Type IV was observed. The study identified seven subgroups of anterior branch variations in the external carotid artery. The most frequently observed variations were Subtype Ia in 40% (n = 20) of cases on the right side and Subtype Ib in 38% (n = 19) on the left side. In addition, a rare and previously unclassified configuration was observed in a 72-year-old male donor, where the carotid artery was pentafurcated on the left side. Conclusions: In conclusion, the presence of anatomical variants not previously included in the anterior external carotid artery branching classifications supports the consideration of a revision to the present classification system.

Background: Commonly, arterial anatomic variants are reported as single entities. However, different such variants can occur in a single patient. Materials and methods: During a retrospective study of computed tomography angiograms of 52 adult patients, 2 cases were found with unilateral maxillofacial trunks. In each case different other anatomic variants were documented. Results: The maxillofacial trunk in the first case was associated with bilateral posterior kinks of the internal carotid artery which passed beyond the transverse processes of the atlas vertebra and indented and displaced the internal jugular veins. Common carotid origins of the superior thyroid arteries were found, as well as a high origin of the contralateral facial artery. In the second case a plethora of variants were associated with a unilateral maxillofacial trunk: 1) direct occipital- vertebral arterial anastomosis; 2) ipsilateral atresia of the distal vertebral artery and of the A1 segment of the anterior cerebral artery; 3) bilateral atresia of posterior communicating arteries; 4) linguofacial and labiomental trunks; 5) terminal trifurcation of the external carotid artery. Conclusions: The arterial anatomical variants of the head and neck should be carefully documented prior to specific surgical and interventional procedures, as well as for understanding the compensatory anatomical pathways of circulatory insufficiencies. [ABSTRACT FROM AUTHOR]

Free functional muscle transfer (FFMT) is a salvage procedure recommended in cases of brachial plexus injury with late presentations or failures of primary nerve reconstruction. The workhorse for most authors is the gracilis, and the most common indication is the restoration of elbow flexion. For successful revascularization of the muscle, donor vessels must be in proximity of the site of the muscle fixation and allow direct coaptation to a donor nerve, ideally without the use of nerve grafts. A major problem occurs when patients have sustained concomitant vascular injuries to the subclavian and/or axillary arteries and had previous surgical dissections in the area where the most common vascular pedicles are located. The authors report the use of the rerouted facial vessels as donors in these complex cases. The surgical technique is presented, along with three cases where the procedure was used. The flaps survived in all the patients and grade > 3/5 muscle contraction was observed in the two patients who had adequate follow-up. Conclusion: the use of the facial vessels as donor vessels is an option to revascularize a FFMT in the setting of severe vascular injury to the subclavian and axillary arteries.

Facial artery is a branch of the external carotid system extending from the upper neck to the nasion. Various flaps are described in the literature based on the facial artery and vein in the neck and face to reconstruct the head-and-neck cancer defects, either superiorly based or inferiorly based. This article summarizes the flaps and their variations based on the facial arteriovenous system. The flap harvest techniques, the indications, advantages and the limitations of the nasolabial flap, facial artery myomucosal flap, and submental flap are described, with appropriate case demonstrations. Variations of the flaps are also discussed.

Background: This paper reports a rare anatomical variant of the facial artery (FA) - namely, a double FA pattern - which has significant implications in a wide range of surgical and aesthetic medicine disciplines., Case: The study involves a case report and literature review of the FA and its variants. The case is that of a 61-year-old female cadaver with a unilateral FA variant branching pattern discovered during a cadaveric dissection for an anatomy course., Discussion: The dissection revealed an unusual supply of the typical FA distribution by two separate branches from either side of the maxillary artery. The first branch, termed FA1, followed a typical FA course arising from the external carotid to supply the lower portion of the face via lingual, inferior labial, and mental arterial branches. The second branch, termed FA2, arose superior to the maxillary artery near the origin of a typical transverse facial artery, to supply the upper portion of the face via superior labial, lateral nasal, and angular arterial branches. No direct communication between the two branches was observed grossly via dissection. The observed branching pattern has not previously been reported in literature and has critical implications for surgical planning and intervention., Conclusion: This study emphasizes the importance of understanding variant FA anatomy in procedures requiring precise anatomical knowledge of arterial supply to the face. Duplicate and/or secondary facial arteries necessitate careful consideration for their potential consequences on the success of surgery of the head and neck, dermal fillers, and embolization for epistaxis procedures., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

Background and Objectives: Vascular variations appear as morphologically distinct patterns of blood diverging from the most commonly observed vessel patterns. The facial artery is considered to be the main vessel for supplying blood to the anterior part of the face. An anatomical understanding of the facial artery, its course, its topography, and its branches is important in medical and dental practice (especially in neck and face surgery), and is also essential for radiologists to be able to interpret vascular imaging in the face following angiography of the region. A profound knowledge of the arteries in the region will aid in minimizing the risks to the patient. Materials and Methods: In our publication a narrative literature review and a case report are presented. Results: A rare case of a facial artery pattern has been described anatomically for the first time with respect to its course and branching. This variation was found on the left side of a 60-year-old male corpse during anatomical dissection. The anterior branch of the facial artery arched in the direction of the labial angle, and there divided into the inferior and superior labial arteries. At the same time, the posterior branch coursed vertically and superficially to the masseter muscle. It here gave off the premasseteric branch, and continued towards the nose, where it ran below the levator labii superioris and the levator labii superioris alaeque nasi muscles and terminated at the dorsum nasi. Conclusions: Our review of the literature and the case report add to knowledge on the facial artery with respect to its topographical anatomy and its branching and termination patterns, as well as the areas of supply. An exact knowledge of individual facial artery anatomy may play an important role in the planning of flaps or tumor excisions due to the differing vascularization and can also help to prevent artery injuries during aesthetic procedures such as filler and botulinum toxin injections. [ABSTRACT FROM AUTHOR]

In the Video S1, a modified technique for submandibular gland resection in benign disease is shown. The main plane of dissection is below the fascia and immediately superficial to the fibrous capsule of the gland. The video shows the surgical steps and the structures that become evident along the procedure and illustrates some tips and tricks. Facial vessels are dissected, easily spared, and not ligated as it occurs in the classical technique. This technical variant is minimally invasive, respectful of anatomy, and through preservation of the fascial layer investing the gland aims at reducing the risk of injury to the marginalis mandibulae branch of the facial nerve, which lies within the fascia itself. [ABSTRACT FROM AUTHOR]

Background: As deep nasolabial folds (NLF) are associated with facial aging, there is an increasing demand for esthetic correction with filler injections. Understanding the anatomy of the angular artery (AA) and facial artery (FA) around the NLF region is essential for ensuring the safety of dermal filler injections into the NLF. The purpose of this study was to provide detailed vascular anatomical information on the course and depth of AA and FA around NLF using Doppler ultrasound on live cases. Methods: FA was observed from the origin level adjacent to the mandible corpus to the end of its terminal branch AA in 168 hemifaces of 84 cases with Doppler ultrasonography. Results: We made a classification of the FA course based on the NLF. The minimum and maximum depths of the FA along its course were measured in 84 cases. The results showed that its course may be highly superficial (2.5 mm at the mandibular origin, 3.7 mm at the cheilion, 3.7 mm at the nasal ala) or it may follow a very deep course near the periosteum (15.0 mm at the mandibular origin, 18.7 mm at the cheilion, 23.5 mm at the nasal ala). FA depth was varied between 5.98 mm and 6.62 mm at the mandibular origin, between 8.36 mm and 9.20 mm at the cheilion, between 9.52 mm and 10.51 mm at the nasal ala at a 95% confidence interval. Conclusions: This study suggests that there is no absolutely safe depth or region for nasolabial fold filler injections. [ABSTRACT FROM AUTHOR]

Objective: The main artery in the blood supply of the head and neck region is the external carotid artery (ECA), and it's branches are superior thyroid artery, ascending pharyngeal artery, lingual artery (LA), facial artery (FA), occipital artery, posterior auricular artery, superficial temporal artery maxillary artery. Variations are observed in the origin of these arteries from the ECA. This study aims to present the unilateral linguofacial trunk (LFT) case. Case: During the routine neck dissections performed in the Anatomy Laboratory of Dokuz Eylul University Faculty of Medicine, it was observed that the LA and FA originating from the ECA on the right side in a 67-year-old male cadaver fixed with formaldehyde, originated from a common trunk. The length of this trunk was measured as 9.19 mm. The distance of the point where the LFT originated from the ECA to the carotid bifurcation was 21.44 mm, and the vertical distance to the horizontal plane passing over the carotid bifurcation was 16.23 mm. The vertical distances of the point where the LFT originated from the ECA and divided into LA and FA to the horizontal plane passing over the hyoid bone were 13.15 mm and 24.30 mm, respectively. Conclusion: Variations in the branching of the ECA are important in terms of surgery and radiology. Previous studies have reported that LFT occurs in a wide range, between 6% and 20%. Clinicians must be aware of these variations when performing head and neck surgery, maxillofacial surgery, radiological and diagnostic procedures. [ABSTRACT FROM AUTHOR]