Background

The facial artery perforator flap is a valuable alternative for reconstruction of small to medium defects in the central midface and provide pleasing cosmetic results, allowing reconstruction in a one-stage procedure. Since Doppler ultrasound is not applicable to distinguish perforator from source artery, anatomical studies are needed to identify perforator areas along the course of the facial artery.

Methods

Twenty facial arteries of 10 fresh anatomical head specimens were dissected. All perforators with an outer diameter of at least 0.50 mm were identified and injected with dye to color their respective vascular territories. Size and location of colored skin territories as well as the location of its perforators were documented and statistically analyzed.

Results

In total, 89 perforators were identified. The average number of perforators per facial artery was 4.45±1.15. The mean outer diameter of the perforator at the origin of the facial artery was 0,65±0.14 mm. The mean size of the colored skin territories was 577.57±488.81 mm². Perforator diameters were significantly associated with the size of its resulting perforasomes. Furthermore, perforators mostly originated in two specific areas: 3.5 cm lateral and caudal and 4.5 cm lateral and 5.5 cm caudal of the anterior nasal spine.

Conclusion

This study provides evidence of two predominant locations of emergence of facial artery perforators. Additionally, the significant correlation between perforator size and its appendant perforasomes as well as their location with reference to the anterior nasal spine as relevant osseous landmarks helps surgeons in decision making for flap design and surgery.

中文翻译：

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面动脉穿支和穿孔体的热点，更容易皮瓣引导：一项解剖学研究

背景

面动脉穿支皮瓣是重建中面部中小到中度缺损的一种有价值的替代方案，并提供令人愉悦的美容效果，允许在一阶段手术中进行重建。由于多普勒超声不适用于区分穿支和源动脉，因此需要进行解剖学研究来识别沿面动脉走行的穿支区域。

方法

解剖了 10 个新鲜头部解剖标本的 20 条面部动脉。所有外径至少为 0.50 毫米的穿支均被识别并注射染料以为其各自的血管区域着色。记录并统计分析有色皮肤区域的大小和位置以及其穿支的位置。

结果

总共发现了 89 个穿支。每条面动脉的平均穿支数为4.45±1.15。面动脉起点处穿支的平均外径为0.65±0.14 mm。有色皮肤区域的平均尺寸为577.57±488.81mm ²。穿支直径与其产生的穿孔体的大小显着相关。此外，穿支主要起源于两个特定区域：前鼻棘外侧和尾部3.5厘米以及外侧4.5厘米和尾部4.5厘米。

结论

这项研究提供了面动脉穿支出现的两个主要位置的证据。此外，穿支尺寸与其附属穿孔体之间的显着相关性以及它们相对于前鼻棘作为相关骨标志的位置有助于外科医生做出皮瓣设计和手术决策。