Anat Cell Biol.  2023 Jun;56(2):211-218. 10.5115/acb.22.262.

Anatomical study of divergences in facial artery endings

• Alharbi YA

• KMID: 2544083
• DOI: http://doi.org/10.5115/acb.22.262

Abstract

Despite several studies focusing on the facial arteries variable courses, the findings have significantly differed. The divergent findings have made it increasingly challenging to establish consistent correlations. Thus, as a vital artery, the facial artery is prone to numerous variations, which makes the identification of the variations vital to clinical practice, particularly for the orofacial and rhinoplastic surgery, and the increasingly selective chemotherapy procedures. The present research uses angiography images for analysis in studying the bilateral facial artery variations noted in patients undergoing carotid angiography for the evaluation of congenital anomalies, cerebral vascular malformations, and intra-arterial procedures. Conventional angiography was used, as it is a vital assessment tool that helps in the assessment of variations in the facial arteries and is suitable in evaluating smaller vascular anatomy, due to the perfect spatial resolution and portrayal of vascular anatomy. Thus, rather than normal ending of the facial artery as an angular artery, the study disclosed that in certain instances, the artery termination took the form of a superior labial artery with a small lateral nasal artery branch located closer to the midline compared to the normal cases. Also, the study has disclosed a conspicuous pre-masseteric branch with small branches originating from the infraorbital artery and providing potential compensation for the facial artery’s shortness. Regardless of the infrequency of such variations, it is vital that they are considered during the performance of any facial surgical procedure.

Keyword

Humans; Arteries; Angiography; Face; Head

Figure

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  Fig. 1 mages showing the distinct categories of facial arteries based on the arteries final branching. Adapted from Niemann et al. [11], and Meegalla et al. [12], with the permission of the original authors.

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  Fig. 2 Type 1A Facial artery and external carotid artery angiography of a cerebral infarction patient (female) who is 44 years old, with an angular branching of the facial artery observed without supratrochlear or a duplex branch. (A) Anteroposterior view (yellow arrow). (B) Lateral view (yellow arrow).

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  Fig. 3 Type 2 facial artery variation and external carotid artery angiography of a female moyamoya disease patient aged 40 years. (A) Anteroposterior view (yellow arrow). (B) Lateral view (yellow arrow).

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  Fig. 4 Type 3 Facial artery variation and am external carotid angiography of a 41 year old female cavernous fistula patient. For this patient, the facial artery’s superior labial branch, indicated using a yellow arrow, marks the end branch. (A) Anteroposterior view. (B) Lateral view.

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  Fig. 5 Type 4 facial artery variation and external carotid artery angiography of a dural arteriovenous fistula patient aged 57 years old. For this patient, only the facial artery’s inferior labial artery branches, indicated by the yellow arrow, can be observed, devoid of other branches. (A) Anteroposterior view. (B) Lateral view.

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  Fig. 6 Type 1C Facial artery variation and external carotid artery angiography of a female spontaneous intracranial haemorrhage patient aged 65 years. Blue arrows indicate the angular artery’s duplex, which has been separated from the facial artery’s lateral nasal branch indicated using the yellow arrows. (A) Anteroposterior view. (B) Lateral view.

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  Fig. 7 Type 2 facial artery variation and external carotid artery angiography photo of a moyamoya disease patient aged 70 years, and with maxillary artery (yellow arrow) indicating an infraorbital branching that has extended to the angular artery territory. (A) Anteroposterior view. (B) Lateral view.

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  Fig. 8 Type 2 facial artery variation and external carotid artery angiography of a male cerebral infarction patient aged 55 years old. The blue arrow indicates the angular artery’s Supratrochlear branch extended to the frontal bone, and is categorized as Type 1B, even as the infraorbital artery, indicated by the yellow arrow ends prior to reaching the angular artery’s territory and has been categorized as Type 2. (A) Anteroposterior view. (B) Lateral view.

Reference

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