Department of Plastic, Reconstructive and Maxillofacial Surgery, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France.
Aesthetic Plast Surg. 2020 Apr;44(2):530-534. doi: 10.1007/s00266-019-01447-w. Epub 2019 Jul 30.
Hyaluronic acid (HA) injections involve a risk of vascular complications. Transillumination (TL) is a noninvasive technique that appears to allow preliminary detection of superficial vascular structures of the face to avoid intravascular HA injection. The purpose of our study was to test the efficacy of TL in terms of its sensitivity to locate vessels in the areas undergoing treatment and to reduce post-injection vascular complications.
We conducted a prospective study enrolling 72 patients who consulted for HA injections to treat facial wrinkles. We used TL on one side of the face to obtain a vascular mapping of the face. The area undergoing testing was randomized for the TL technique. The primary study endpoint was sensitivity for identifying subcutaneous veins and the differences in complication rates between the side of the face where TL was used to guide the injection and the side of the face where no vascular exploration method was used.
TL sensitivity for locating the superficial temporal vein was 100%, 91% for the supratrochlear, supraorbital and infraorbital veins, and 95% for the dorsal nasal veins (p < 0.01). The complication rate was higher on the side of the face where no vascular exploration method was used (22.2% vs 2.7%; p = 0.010046).
Our preliminary findings validate our hypothesis concerning the advantage of using TL to identify superficial veins before performing injections. This method is simple and affordable, and the learning curve is small.
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透明质酸（HA）注射存在血管并发症的风险。透照（TL）是一种非侵入性技术，似乎可以初步检测面部的浅层血管结构，以避免血管内 HA 注射。我们研究的目的是测试 TL 在定位治疗区域血管方面的敏感性，以减少注射后血管并发症。
我们进行了一项前瞻性研究，纳入了 72 名因 HA 注射治疗面部皱纹而就诊的患者。我们在一侧面部使用 TL 对面部进行血管测绘。接受测试的区域随机接受 TL 技术。主要研究终点是识别皮下静脉的敏感性以及在使用 TL 技术指导注射的面部与未使用血管探查方法的面部之间的并发症发生率差异。
TL 定位颞浅静脉的敏感性为 100%，定位滑车、眶上和眶下静脉的敏感性为 91%，定位鼻背静脉的敏感性为 95%（p<0.01）。未使用血管探查方法的面部的并发症发生率更高（22.2% vs 2.7%；p=0.010046）。
我们的初步发现验证了我们的假设，即在进行注射之前，使用 TL 识别浅层静脉具有优势。这种方法简单、经济实惠，学习曲线短。
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