From the Department of Maxillofacial and Facial Plastic Surgery, Lyon Sud Hospital; and the Department of Plastic and Reconstructive Surgery, Croix Rousse Hospital, Hospices Civils de Lyon, University Claude Bernard Lyon 1.
Plast Reconstr Surg. 2019 Apr;143(4):820e-828e. doi: 10.1097/PRS.0000000000005421.
Increased anatomical knowledge of skin vascularization, such as the recent description of angiosome and perforasome concepts, has led to important innovations in flap surgery. In this sense, few studies have been performed on face vascularization especially for facial artery perforasomes. The aim of this study was to analyze the number, size, and localization of transverse facial artery perforators and their perfusion area.
Fourteen hemifaces of fresh adult cadavers from the Department of Anatomy of Lyon University were harvested. Transverse facial artery perforators were identified, dissected, cannulated, and selectively injected with 1 ml of patent blue or contrast solution. Photography, microangiography, and computed tomography were performed. Perforator diameter and localization from the lateral canthus were measured. Exact topography and size of the perforasome were analyzed.
Twenty-three transverse facial artery perforators were identified. Mean perforator diameter was 1.01 ± 0.3 mm. Mean perforating site was 31.0 ± 8.0 mm lateral to and 38.7 ± 8.8 mm below the lateral canthus. Mean single perforasome surface area was 25.3 ± 18.34 cm and mean transverse facial artery skin territory was 40.5 ± 9.78 cm.
The transverse facial artery provides at least one perforator that can be accurately localized using a Doppler probe. Clinical applications related to the improved knowledge of transverse facial artery perforators could be as follows: (1) performing a lateral facial skin flap; (2) facial composite allotransplants; (3) face-lift procedures to improve skin perfusion; and (4) prevention of vessel injury in aesthetic procedures such as dermal filler injection or thread-lift techniques.
对皮肤血管解剖结构的深入了解，如最近描述的血管单元和穿支单元概念，为皮瓣手术带来了重要的创新。在这方面，针对面部血管，特别是面动脉穿支的研究较少。本研究旨在分析面动脉横支行穿支的数量、大小和位置及其灌注区域。
从里昂大学解剖学系采集了 14 侧新鲜成人尸体半侧头面部。识别、解剖、套管插入并选择性地将 1 毫升专利蓝或对比溶液注入面动脉横支行穿支。进行摄影、微血管造影和计算机断层扫描。测量从外眦到穿支的直径和位置。分析穿支单元的确切位置和大小。
共识别出 23 条面动脉横支行穿支。平均穿支直径为 1.01 ± 0.3 毫米。平均穿支部位位于外眦外侧 31.0 ± 8.0 毫米和下方 38.7 ± 8.8 毫米处。单个穿支单元的平均表面积为 25.3 ± 18.34 平方厘米，面动脉横支行皮肤区域的平均面积为 40.5 ± 9.78 平方厘米。
面动脉至少提供一条可以通过多普勒探头准确定位的穿支。对面动脉横支行穿支的深入了解可能有以下临床应用：（1）进行外侧面部皮瓣；（2）面部复合异体移植；（3）面部提升术以改善皮肤灌注；（4）预防美容手术（如真皮填充剂注射或线雕技术）中血管损伤。
