Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
Department of Anatomy, Tokyo Medical University, Tokyo, Japan.
Microsurgery. 2025 Jan;45(1):e70004. doi: 10.1002/micr.70004.
Intraoral anastomosis is a widely used technique for microvascular alveolar ridge augmentation and midface reconstruction. However, the predictable anatomical positioning of facial structures, such as the vessels, parotid duct, and facial nerve in the buccal region, has remained unclear. Therefore, we aimed to obtain the anatomical characteristics of these locations to establish surgical landmarks for the intraoral anastomosis of facial vessels.
A total of 26 sides from 13 formaldehyde-fixed cadavers approximately a month after fixation with a mean age at death of 86.6 ± 11.2 years (range: 55-104 years) were anatomically examined. Facial vessels, nerves, and the parotid duct were dissected intraorally. From the oral cavity side, the X-axis was defined as the line from the labial commissure to the lowest point of the intertragic notch.
From the oral cavity side, all branches of the facial nerve were found under the facial artery and vein. The positioning order along the X-axis was the facial artery, vein, and parotid duct exit. The facial artery was 21.3 ± 2.2 mm and the facial vein was 39.2 ± 2.7 mm from the labial commissure. Ninety-two percent of facial veins were found within 15-20 mm of the facial artery on the X-axis. The parotid duct exit was 46.8 ± 2.0 mm from the labial commissure. In the buccal region, the vessel calibers of the facial artery and vein were 1.8 ± 0.2 and 2.1 ± 0.2 mm, respectively.
Knowledge of the anatomical relations among the facial artery, vein, parotid duct, and facial nerve from the oral cavity side can enhance the safety and efficacy of midface reconstruction surgeries involving intraoral anastomosis procedures.
口腔内吻合术是一种广泛应用于微血管牙槽嵴增量和中面部重建的技术。然而，面部结构如血管、腮腺管和颊部面神经的可预测解剖定位仍不清楚。因此，我们旨在获得这些位置的解剖特征，为面部血管的口腔内吻合术建立手术标志。
共解剖了 13 具福尔马林固定约一个月后的尸头的 26 侧（平均死亡年龄 86.6±11.2 岁，范围：55-104 岁）。经口腔内解剖了面部血管、神经和腮腺管。从口腔侧，X 轴定义为唇联合至颞骨下切迹最低点的连线。
从口腔侧，所有面神经分支均位于面动脉和静脉下方。沿 X 轴的定位顺序为面动脉、静脉和腮腺管出口。面动脉距唇联合 21.3±2.2mm，面静脉 39.2±2.7mm。92%的面静脉在 X 轴上距面动脉 15-20mm 范围内。腮腺管出口距唇联合 46.8±2.0mm。在颊部，面动脉和静脉的血管直径分别为 1.8±0.2mm 和 2.1±0.2mm。
从口腔侧对面动脉、静脉、腮腺管和面神经之间解剖关系的了解，可以提高涉及口腔内吻合术的中面部重建手术的安全性和疗效。
