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A case series: 3-dimensional computed tomographic study of the superior orbital vessels: Superior orbital arcades and their relationships with the supratrochlear artery and supraorbital artery - 10/04/21

Doi : 10.1016/j.jaad.2020.06.082 
Zhi-Feng Liao, BSc a, b, Wei-Jin Hong, MD, PhD b, Li-Yao Cong, DDS, PhD b, Cheng-En Luo, BSc b, Wen-Feng Zhan, MD c, Jia-Qia Ke, BSc d, Sheng-Kang Luo, MD, PhD b, a,
a Second School of Clinical Medicine, Southern Medical University, Guangzhou City, People's Republic of China 
b Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, Guangzhou City, People's Republic of China 
c Department of Radiology, Guang Dong Second Provincial General Hospital, Guangzhou City, People's Republic of China 
d Department of Neurology, Integrated Hospital of Traditional Chinese Medicine, The Third School of Clinical Medicine, Southern Medical University, Guangzhou City, People's Republic of China 

Correspondence to: Sheng-Kang Luo, MD, PhD, Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, 466 Middle Xin Gang Road, Guangzhou City, Guangdong Province 510317, China.Department of Plastic and Reconstructive SurgeryGuangdong Second Provincial General Hospital466 Middle Xin Gang RoadGuangzhou CityGuangdong Province510317China

Abstract

Background

Vascular complications from periorbital intravascular filler injection are major safety concerns.

Objective

To thoroughly describe the superior orbital vessels near the orbital rim and propose considerations for upper eyelid and forehead injections.

Methods

Fifty-one cadaver heads were infused with lead oxide contrast media through the external carotid artery, internal carotid artery, and facial and superficial temporal arteries. Computed tomography (CT) images were obtained after contrast agent injection, and 3-dimensional CT scans were reconstructed by using a validated algorithm.

Results

Eighty-six qualified hemifaces clearly showed the origin, depth, and anastomoses of the superior orbital vessels, which consistently deployed 2 distinctive layers: deep and superficial. Of all hemifaces, 59.3% had deep superior orbital vessels near the orbital rim, including 44.2% with deep superior orbital arcades and 15.1% with deep superior orbital arteries, which originated from the ophthalmic artery. Additionally, 97.7% of the hemifaces had superficial superior orbital arcades, for which 4 origins were identified: ophthalmic artery, superior medial palpebral artery, angular artery, and anastomosis between the angular and ophthalmic arteries.

Limitations

The arterial depth estimated from 3-dimensional CT needs to be confirmed by standard cadaver dissection.

Conclusion

This study elucidated novel arterial systems and proposed considerations for upper eyelid and forehead injections.

Il testo completo di questo articolo è disponibile in PDF.

Key words : 3-dimensional computed tomography, filler injection, sunken upper eyelid injection, superior orbital arcade, superior orbital vessel, supraorbital artery, supratrochlear artery

Abbreviations used : 3D, CT, ECA, ICA


Mappa


 Drs Liao and Hong are cofirst authors.
 Funding sources: None.
 Conflicts of interest: None disclosed.
 IRB approval status: Approved by the Guangdong Second Provincial General Hospital Ethics Committee (#20200310-01-02-YXKXYJ-LW).
 Reprints not available from the authors.


© 2020  American Academy of Dermatology, Inc.. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 84 - N° 5

P. 1364-1370 - maggio 2021 Ritorno al numero
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