Cadaveric Dissections to Determine Surface Landmarks Locating the Facial Artery for Filler Injections

2020 ◽  
Author(s):  
Tanvaa Tansatit ◽  
Elizabeth Kenny ◽  
Thirawass Phumyoo ◽  
Benrita Jitaree
Keyword(s):  
Turning Point ◽  
Arterial Injury ◽  
Reference Points ◽  
Facial Artery ◽  
Nasolabial Fold ◽  
Bony Landmarks ◽  
Lateral Channel ◽  
Filler Injections ◽  
Mouth Corner ◽  
Oral Commissure

Abstract Background The facial artery is a high-risk structure when performing filler injections at the nasolabial fold, buccal, and mandibular regions. Objectives This study aimed to establish reference landmarks locating the course of the facial artery and its essential branches. Methods Thirty-one embalmed cadavers were enrolled in this study. The course of the facial artery was observed in regard to the following reference points: masseter insertion, oral commissure, and common bony landmarks. The corner of the mouth was utilized as the landmark to measure the turning point of the facial artery. Results Seven points were established to identify the course and turning point of the facial artery. These included the anterior masseteric, lateral mental, infraorbital, medial canthal, basal alar, post-modiolar (PMP), and supra-commissural (SCP) points. The course of the facial artery deviates at least twice at the lateral mental points and at the SCP or PMP. The facial artery appeared more medially when the artery turned at the PMP and SCP. It presented through the lateral channel if the turning point was solely at the PMP. Wherever the facial artery deviates, it can be divided into 3 segments: the mandibular, buccal, and nasolabial segments. The arterial course may deviate laterally from the mouth corner towards PMP. The nasolabial segment may also deviate laterally to the basal alar point at the alar grove for 0.5 to 1 cm. Conclusions The deviation of facial artery closely relates with mandibular, buccal, and nasolabial segments. It is essential in avoiding arterial injury for physicians and surgeons who perform procedures in these areas.

A Safe Doppler Ultrasound–Guided Method for Nasolabial Fold Correction With Hyaluronic Acid Filler

2020 ◽  
Author(s):  
Won Lee ◽  
Ji-Soo Kim ◽  
Hyoung-Jin Moon ◽  
Eun-Jung Yang
Keyword(s):  
Hyaluronic Acid ◽  
Doppler Ultrasound ◽  
Rating Scale ◽  
Vascular Complications ◽  
Facial Artery ◽  
Nasolabial Fold ◽  
Filler Injection ◽  
Ultrasound Evaluation ◽  
Filler Injections ◽  
Nasolabial Folds

Abstract Background Injection of hyaluronic acid filler, a common procedure for nasolabial fold correction, poses a risk of vascular compromise, which can result in skin necrosis and blindness. Objectives The aim of this study was to examine the facial arterial pathway in real time by Doppler ultrasound to avoid arterial complications during filler injections. Methods The facial artery pathway of 40 patients (80 nasolabial folds; 2 men and 38 women; mean age, 46.5 years; range, 28-72 years) was examined by Doppler ultrasound before hyaluronic acid filler injection. On the basis of this ultrasound evaluation, the filler injection targeted the subdermal, subcutaneous, and deep to submuscular layers by bypassing the facial artery. The efficacy of the filler injection was evaluated for each patient. Results The facial artery was detected lateral to the nasolabial fold in 31% of patients; it was detected beneath the nasolabial fold in the other patients as follows: subdermal layer, 13%; subcutaneous layer, 29%; muscular layer, 24%; and submuscular layer, 4%. The mean [standard deviation] Wrinkle Severity Rating Scale score was 3.68 [0.76] before injection and 2.28 [0.78] at 3 months after injection. Two patients experienced unilateral bruising of the nasolabial fold, which resolved after 2 weeks without treatment. Conclusions Doppler ultrasound can be considered as pretreatment tool for the prevention of vascular complications during filler injections to correct nasolabial folds. Level of Evidence: 4

Anatomical Map of the Facial Artery for Facial Reconstruction and Aesthetic Procedures

2019 ◽  
Vol 39 (11) ◽  
pp. 1151-1162 ◽  
Author(s):  
Mateusz Koziej ◽  
Marek Trybus ◽  
Mateusz Hołda ◽  
Jakub Polak ◽  
Jakub Wnuk ◽  
...  
Keyword(s):  
Facial Reconstruction ◽  
Facial Artery ◽  
Nasolabial Fold ◽  
Good Image Quality ◽  
Computed Tomographic ◽  
The Many ◽  
Inferior Border ◽  
Orbital Rim ◽  
Aesthetic Procedures ◽  
Oral Commissure

Abstract Background The facial artery (FA) is the main blood vessel supplying the anterior face and an understanding of its anatomy is crucial in facial reconstruction and aesthetic procedures. Objectives The aim of this study was to assess the many anatomical features of the FA utilizing a multidimensional approach. Methods Head and neck computed tomographic angiographies of 131 patients (255 FAs) with good image quality were evaluated. The FA was classified according to its termination pattern, course, and location with reference to soft tissue/bone surrounding structures. Results In total, each branch was present as follows: the submental artery (44.8%), the inferior labial artery (60%), the superior labial artery (82.2%), the lateral nasal artery (25.1%), and the angular artery (42.5%). The most common FA course was the classic course, situated medially to the nasolabial fold (27.1%). In total 65.5% of the arteries were located medially to the nasolabial fold, and only 12.3% of them were totally situated lateral to the nasolabial fold. The median distance (with quartiles) from the inferior orbital rim reached the FA after the superior labial artery branched off in 50.2% of cases and was 36.6 mm (33.4; 43.3). The angle between the FA and the inferior border of the mandible was 49.8o (31.9; 72.4). The horizontal distances between the oral commissure and naris to the FA were 8.5 ± 4.0 mm and 12.1 ± 6.7 mm, respectively. Conclusions An anatomical map summarizing the major measurements and geometry of the FA was generated. The detailed anatomy and relative positioning of the FA should be considered to avoid any unexpected complications in plastic surgery.

Morphometric and Topographic Features of Stylomastoid Foramen and its Clinical Significance in Facial Nerve Block

2020 ◽  
Author(s):  
Tunç Kutoğlu ◽  
Murat Çetkin ◽  
Ömer Turan ◽  
Selin Bayko ◽  
İlda Sinem Yarkan
Keyword(s):  
Nerve Block ◽  
Reference Points ◽  
Mastoid Process ◽  
Anterior Border ◽  
Stylomastoid Foramen ◽  
Bony Landmarks ◽  
Temporal Bones ◽  
Type 3

Abstract Objective This study aims to determine the topographic localization of the stylomastoid foramen (SF) and its morphometric relationship with the surrounding bony landmarks. Design A descriptive anatomical study. Setting Anatomy Laboratory of the Faculty of Medicine. Participants Measurements were performed on 53 dry temporal bones. Main Outcome Measures On the inferior and lateral aspects of photographic images, lines and angles were defined. The most lateral end of the SF (SF1) and the transverse medial–lateral line that passes through the upper end of the anterior border of mastoid process (line 1) were used as reference points for topographic evaluation. The upper end of the anterior border of mastoid process (A) and the tip of mastoid process (B) were considered in defining angles. The dates about SF were evaluated using the ImageJ 1.46r software and digital caliper. Results SF1 was classified into three different types based on its topographical localization, stated as Type 1, Type 2, and Type 3. In Type 1, SF1 was located anterior to line 1 (54.7%). SF1 was located posterior to line 1 in Type 2 (34.0%). SF1 was located just over line 1 in Type 3 (11.3%). We also detected angular variations between these types in the inferior and lateral aspects. Conclusions The recommended angles of application are 30 degrees on the horizontal plane and 55 degrees on the sagittal plane for Type 1 when point B is considered. A needle length below 10 mm is more suitable to minimize the potential complications of the nerve block.

scholarly journals Interpretations of the Term “Watershed Line” Used as Reference for Volar Plating

2019 ◽  
Vol 09 (03) ◽  
pp. 268-274 ◽  
Author(s):  
Minke Bergsma ◽  
Job N. Doornberg ◽  
Laurent Hendrickx ◽  
Batur Hayat ◽  
Gino M.M.J. Kerkhoffs ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Soft Tissue ◽  
Meta Analysis ◽  
Optimal Location ◽  
Reference Points ◽  
Volar Plating ◽  
Bony Landmarks ◽  
Comprehensive Search ◽  
Definition Of

Objective The objective of this systematic review is to provide an overview of all interpretations of the definition of the watershed line used in literature. Methods The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were followed for this review. A comprehensive search was performed for definitions of the watershed line given in literature. A total of 32 studies giving an explicit interpretation of the definition of the watershed line or anatomical reference for plate positioning in writing and/or imaging were included. Results In 32 studies, we found eight different landmarks used to refer to the watershed line or correct plate positioning. Five studies used two different soft tissue landmarks. Six different bony landmarks were described in 24 studies. These could further be subdivided into three anatomical interpretations, described in seven studies, in which the term “watershed line” is explained as a distinguishable anatomical line, and two surgical interpretations, described in 15 studies, which are purely reflecting the optimal location of the volar plate. One interpretation of the watershed line described in two studies combined both anatomical and surgical landmarks. Conclusion The (mis)interpretation of the definition of the term “watershed line” as described by Orbay is subject to the type of landmarks and purpose used: soft tissue or bony landmarks and an anatomical or a surgical purpose. A clear distinction can be made between interpretations using bony landmarks, as the true watershed line is defined and definitions using soft tissue landmarks, which might represent the reference points surgeons use in clinical practice.

Facial Arterial Variations in Asians: A Study on Computed Tomographic Angiography

2021 ◽  
Author(s):  
Dawei Wang ◽  
Shixuan Xiong ◽  
Ning Zeng ◽  
Yiping Wu
Keyword(s):  
Computed Tomographic Angiography ◽  
Facial Artery ◽  
Nasolabial Fold ◽  
Anatomical Landmarks ◽  
Filler Injection ◽  
Computed Tomographic ◽  
Arterial Variations ◽  
Significant Difference ◽  
Tomographic Angiography

Abstract Background A consensus on facial artery (FA) anatomy has not been established due to the discrepancies in previous studies. Objectives The purpose of this study was to assess the branches, course, and location of the FA in Asians utilizing computed tomographic angiography (CTA). Methods The CTA images of 300 FAs from 150 Asian patients were evaluated. According to the termination branch, the FA was classified as follows: type 1, FA terminates superior labial or inferior labial artery; type 2: FA terminates lateral nasal or inferior alar artery; type 3: FA terminates medial canthal artery; type 4: FA is divided into duplex branches with dominant medial canthal artery laterally. The relationship between nasolabial fold and FA was evaluated, and the distances from anatomical landmarks to FA were measured to position the course. Results 70 arteries (23.3%), 163 arteries (54.3%), 49 arteries (16.3%), and the other 18 arteries (6.0%) were classified as type 1, 2, 3 and 4, respectively. 72.3% of FAs were located medially to the nasolabial fold, and only 14.7% of arteries were lateral to the nasolabial fold. The vertical distance between FA and the inner canthus or the midpoint of inferior orbital rim decreased from type 1 to type 4 FA (P < 0.0001). No significant difference was found among the four types of FA in the distances between the mandibular angle (P = 0.1226) or oral commissure (P = 0.1030) and the FA at inferior of mandible. Conclusions The detailed findings of facial artery will provide a valuable reference for filler injection in cosmetic procedures and flap design in reconstructive surgery.

scholarly journals Three-Dimensional Description of the Angular Artery in the Nasolabial Fold

2020 ◽  
Author(s):  
Pavel Gelezhe ◽  
Victor Gombolevskiy ◽  
Sergey Morozov ◽  
Dmitry V Melnikov ◽  
Tatiana Aleksandrovna Korb ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Three Dimensional ◽  
Nasolabial Fold ◽  
3 Dimensional ◽  
Arterial Trunk ◽  
Contrast Enhanced ◽  
Nasal Ala ◽  
Enhanced Computed Tomography ◽  
Oral Commissure

Abstract Background Due to its arterial vasculature, the nasolabial sulcus is one of the most challenging facial regions to treat when trying to ameliorate the signs of facial aging. Objectives The aim of the present study was to provide data on the 3-dimensional course of the angular artery within the nasolabial sulcus in relation to age, gender, and body mass index to increase safety during minimally invasive treatments. Methods Thee hundred nasolabial sulci from 75 males and 75 females of Russian Caucasian ethnic background (mean [standard deviation] age, 45.7 [18.7] years; mean body mass index, 25.14 [4.9] kg/m2) were analyzed. Bilateral multiplanar measurements were based on contrast-enhanced computed tomography cranial scans. Results Up to 3 arteries could be identified within the nasolabial sulcus: ~90% contained 1 arterial trunk, ~9% had 2 trunks, and ~1% had 3 trunks; females had more arteries than men. The artery is located at mean depths of 21.6 mm at the oral commissure and 8.9 mm at the nasal ala. The angular artery was lateral to the nasolabial sulcus in 100% of cases; the smallest distance between the artery and the nasolabial sulcus was at the oral commissure (11.91 [7.9] mm) and the greatest was at the nasal ala (13.73 [3.9] mm). Conclusions In contrast to current concepts, the angular artery is not located strictly subdermal to the nasolabial sulcus but at a variable depth, and in 100% of the investigated cases lateral to the nasolabial sulcus. With increasing age, the depth and lateral distance between arteries and sulci reduces significantly, underscoring the need for special caution when injecting this site.

scholarly journals Evaluating a harvest control rule to improve the sustainability of Japanese fisheries

2020 ◽  
Author(s):  
Hiroshi Okamura ◽  
Momoko Ichinokawa ◽  
Ray Hilborn
Keyword(s):  
Management Strategy ◽  
Turning Point ◽  
Reference Points ◽  
Control Rule ◽  
Strategy Evaluation ◽  
Management Procedure ◽  
The World ◽  
Harvest Control Rule ◽  
Stock Recruitment ◽  
Future Status

AbstractFisheries management in Japan is currently at a turning point. MSY based reference points have historically been rejected because of impacts on the fishing industry that would result from their adoption. We propose and evaluate a new harvest control rule (HCR) that uses the biological reference points based on sustainable yield from the stochastic hockey-stick stock recruitment relationship. Management strategy evaluation simulations conditioned on data from Japanese stocks demonstrate that the new HCR avoided recruitment overfishing while providing stable and near maximum catch. The new HCR outperformed Japan’s traditional HCR in terms of conservation, and it outperformed an alternative HCR which is widely used around the world in terms of initial catch reduction and future catch variation. For forecasting and hindcasting simulations, the new HCR showed considerable improvements over traditional HCRs in terms of biomass and catch. This new management procedure can improve the current and future status of many overfished stocks in Japan as well as increase economic efficiency and better protect ecosystems.

Intraarterial Degradation of Calcium Hydroxylapatite Using Sodium Thiosulfate – An In Vitro and Cadaveric Study

2021 ◽  
Author(s):  
Mariya Yankova ◽  
Tatjana Pavicic ◽  
Konstantin Frank ◽  
Thilo L Schenck ◽  
Kate Beleznay ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Direct Contact ◽  
Sodium Thiosulfate ◽  
In Vitro Models ◽  
Facial Artery ◽  
Experimental Setting ◽  
Calcium Hydroxylapatite ◽  
Filler Injections ◽  
Soft Tissue Filler

Abstract Background The most severe complications following soft tissue filler injections result from the intraarterial administration of the filler product. Although hyaluronic acid–based filler can be trans-arterially dissolved with hyaluronidase, no information is available on calcium hydroxylapatite (CaHA)-based fillers. Objective The authors sought to test whether CaHA-based fillers can be trans-arterially dissolved by sodium thiosulfate (STS) when evaluated in cadaveric and in vitro models. Methods Human cadaveric facial arterial segments were each filled with 0.2 cc of commercially available CaHA product and submerged for 24 hours in 4 different STS-containing solutions: 10 cc STS (300 mg/cc) (pure, 1:1 dilution, 1:2 dilution), 0.9% saline and 10 cc STS (300 mg/cc), and 300 IU (bovine) hyaluronidase in a 1:1 ratio. Results Intraarterial CaHA was detected in human facial artery segments after 24 hours independent of the STS concentration employed. Submerging the arterial segments in STS (300 mg/cc) and 300 IU (bovine) hyaluronidase (1:1 ratio) also did not dissolve the intraarterial CaHA product. Gray scale analyses did show, however, that increasing concentrations of STS resulted in increased disintegration of CaHA in an in vitro experimental setting. Conclusions The results of this study indicate that STS is limited in its potential to dissolve intraarterial CaHA of cadaveric human facial arteries, despite the fact that it appears effective when in direct contact with the CaHA. Adverse events caused by intraarterial administration of CaHA-based fillers still lack a suitable antidote.

Reference Coordinate System Requirements for Geophysics

1975 ◽  
Vol 26 ◽  
pp. 87-92
Author(s):  
P. L. Bender
Keyword(s):  
Coordinate System ◽  
Polar Motion ◽  
Main Part ◽  
Measurement Techniques ◽  
Reference Points ◽  
Angular Motion ◽  
Coordinate Systems ◽  
Axis Of Rotation ◽  
The Earth ◽  
Fixed System

AbstractFive important geodynamical quantities which are closely linked are: 1) motions of points on the Earth’s surface; 2)polar motion; 3) changes in UT1-UTC; 4) nutation; and 5) motion of the geocenter. For each of these we expect to achieve measurements in the near future which have an accuracy of 1 to 3 cm or 0.3 to 1 milliarcsec.From a metrological point of view, one can say simply: “Measure each quantity against whichever coordinate system you can make the most accurate measurements with respect to”. I believe that this statement should serve as a guiding principle for the recommendations of the colloquium. However, it also is important that the coordinate systems help to provide a clear separation between the different phenomena of interest, and correspond closely to the conceptual definitions in terms of which geophysicists think about the phenomena.In any discussion of angular motion in space, both a “body-fixed” system and a “space-fixed” system are used. Some relevant types of coordinate systems, reference directions, or reference points which have been considered are: 1) celestial systems based on optical star catalogs, distant galaxies, radio source catalogs, or the Moon and inner planets; 2) the Earth’s axis of rotation, which defines a line through the Earth as well as a celestial reference direction; 3) the geocenter; and 4) “quasi-Earth-fixed” coordinate systems.When a geophysicists discusses UT1 and polar motion, he usually is thinking of the angular motion of the main part of the mantle with respect to an inertial frame and to the direction of the spin axis. Since the velocities of relative motion in most of the mantle are expectd to be extremely small, even if “substantial” deep convection is occurring, the conceptual “quasi-Earth-fixed” reference frame seems well defined. Methods for realizing a close approximation to this frame fortunately exist. Hopefully, this colloquium will recommend procedures for establishing and maintaining such a system for use in geodynamics. Motion of points on the Earth’s surface and of the geocenter can be measured against such a system with the full accuracy of the new techniques.The situation with respect to celestial reference frames is different. The various measurement techniques give changes in the orientation of the Earth, relative to different systems, so that we would like to know the relative motions of the systems in order to compare the results. However, there does not appear to be a need for defining any new system. Subjective figures of merit for the various system dependon both the accuracy with which measurements can be made against them and the degree to which they can be related to inertial systems.The main coordinate system requirement related to the 5 geodynamic quantities discussed in this talk is thus for the establishment and maintenance of a “quasi-Earth-fixed” coordinate system which closely approximates the motion of the main part of the mantle. Changes in the orientation of this system with respect to the various celestial systems can be determined by both the new and the conventional techniques, provided that some knowledge of changes in the local vertical is available. Changes in the axis of rotation and in the geocenter with respect to this system also can be obtained, as well as measurements of nutation.

The Effect of Oxidized Cholesterol on the Aorta of Rabbits- Scanning Electron Microscopic Observations

1982 ◽  
Vol 40 ◽  
pp. 340-341
Author(s):  
S. K. Pena ◽  
C. B. Taylor ◽  
J. Hill ◽  
J. Safarik
Keyword(s):  
Cholesterol Biosynthesis ◽  
Cholesterol Content ◽  
Arterial Injury ◽  
Electron Microscopic ◽  
Aortic Smooth Muscle ◽  
Oxidized Cholesterol ◽  
Initial Event ◽  
Membrane Structure And Function ◽  
Scanning Electron Microscopic ◽  
And Function

Introduction: Oxidized cholesterol derivatives have been demonstrated in various cell cultures to be very potent inhibitors of 3-hvdroxy-3- methylglutaryl Coenzyme A reductase which is a principle regulator of cholesterol biosynthesis in the cell. The cholesterol content in the cells exposed to oxidized cholesterol was found to be markedly decreased. In aortic smooth muscle cells, the potency of this effect was closely related to the cytotoxicity of each derivative. Furthermore, due to the similarity of their molecular structure to that of cholesterol, these oxidized cholesterol derivatives might insert themselves into the cell membrane, alter membrane structure and function and eventually cause cell death. Arterial injury has been shown to be the initial event of atherosclerosis.

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