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Facial anatomy
Published in Michael Parker, Charlie James, Fundamentals for Cosmetic Practice, 2022
The facial vein is a direct communication of the angular vein which commences at the root of the nose (between the eyebrows). It is located inferiorly to the facial artery, yet its course is far straighter than its arterial companion. It travels inferolaterally to the zygomaticus major and minor muscles and along the anterior aspect of the masseter. As it passes inferiorly it gains tributaries from the superior and inferior labial veins which drain the upper and lower lips, respectively. It proceeds to traverse the body of the mandible before curving backwards deep to the platysma muscle. Once it has reached the platysma, the facial vein is joined by the anterior division of the temporo-maxillary vein to form the common facial vein, which itself drains into the external jugular vein. See Figure 3.11.
Perioral Region
Published in Ali Pirayesh, Dario Bertossi, Izolda Heydenrych, Aesthetic Facial Anatomy Essentials for Injections, 2020
Krishan Mohan Kapoor, Philippe Kestemont, Jay Galvez, André Braz, John J. Martin, Dario Bertossi
The facial vein lies lateral to the artery and runs a more direct course on the face. At the level of the anterior border of the masseter, the two vessels are very close to each other, with the facial vein more lateral, whilst in the neck the vein lies more superficial to the artery. During its course the facial artery supplies multiple branches to the facial muscles and skin. The perioral branches are the superior and inferior labial arteries and lateral nasal artery. The facial artery distal to the lateral nasal artery is called the angular artery.
The Neck
Published in Kenneth D Boffard, Manual of Definitive Surgical Trauma Care: Incorporating Definitive Anaesthetic Trauma Care, 2019
Having made the sternocleidomastoid muscle incision, platysma is divided, and the sternomastoid is retracted laterally to expose the fascial sheath covering the internal jugular vein. The vein cannot be mobilized until the common facial vein is divided. Omohyoid muscle is the only strap muscle that crosses the carotid sheath obliquely, and acts as a landmark for the common carotid artery. Lateral retraction of the jugular vein and underlying carotid artery allows access to the trachea, oesophagus, and thyroid, and medial retraction of the carotid sheath and its contents will allow the dissection to proceed posteriorly to the prevertebral fascia and vertebral arteries. Posterior to the carotid sheath, the sympathetic chain lies on longus colli, which separates it from the transverse processes of the cervical vertebrae (Figure 7.4).
Orbital cellulitis, sinusitis and intracranial abnormalities in two adolescents with COVID-19
Published in Orbit, 2020
Roger E. Turbin, Peter J. Wawrzusin, Nicole M. Sakla, Christin M. Traba, Kristin G. Wong, Neena Mirani, Jean A. Eloy, Esther A. Nimchinsky
CT imaging demonstrated opacification of the right paranasal sinuses, with clear sinuses on the left. The sinuses were filled with hypodense fluid, and there was evidence of subtle invasion of the right periantral fat (Figure 3). There was also thrombophlebitis of the right superior ophthalmic vein (SOV). MRI imaging on day 1 of admission (Figure 3) showed acute sinusitis, predominantly involving the right frontal ethmoid and maxillary sinuses, with diffusion restriction concerning for bacterial superinfection. The right orbit had marked enhancement of the periorbita, nasolacrimal area, extensive intra and extraconal fat infiltration and enhancement without organized abscess. SOV thrombus extended retrograde toward the facial vein, sparing the orbital apex, cavernous sinus and dural venous sinuses. The right optic nerve was straightened with traction and tenting of the posterior globe in the setting of the orbital edema and proptosis. Pachymeningeal enhancement was noted over both frontal lobes, with formation of a small epidural abscess just posterior to the right frontal sinus, 1.6 cm in greatest dimension.
Unfavorable outcomes in microsurgery: possibilities for improvement
Published in Journal of Plastic Surgery and Hand Surgery, 2019
Paolo Cariati, Almudena Cabello Serrano, Fernando Monsalve Iglesias, Maria Roman Ramos, Jose Fernandez Solis, Ildefonso Martinez Lara
It is important to emphasize that only 8 of the 65 (12.3%) oncological patients received RT before reconstructive surgery in our series. Specifically, five patients from Group 1 and 3 patients from Group 2 had previously been treated with ablative surgery and postoperative radiotherapy. Hence, the quality and quantity of the vessels was acceptable in most cases. In Group 1, the facial artery was used in 86.7% of cases (n = 46), followed by the cranial thyroid artery (11.3%; n = 6), and external carotid artery (1.8%; n = 1). All arterial anastomoses were end to end. Regarding the veins, the facial vein was the most used followed by the external jugular vein. We tried to use two veins whenever possible. Also, all venous anastomoses were end to end. In Group 2, the facial artery was also the artery most frequently used (77.7%; n = 14) followed by the external carotid artery (22.2%; n = 4). No arterial anastomoses were performed with the cranial thyroid artery in this group. The external carotid artery was used after an intraoperative spasm of the facial artery in two cases and in the salvage surgery of a fibula flap 12 h after primary reconstructive surgery. In only one case was the first choice. The facial vein was the one most commonly used, followed by the external jugular vein. All arterial and venous anastomoses were end-to-end also in this group.
Percutaneous transorbital embolization of a carotid cavernous fistula
Published in Baylor University Medical Center Proceedings, 2019
Lance J. Lyons, Sarah A. Smith, Orlando Diaz, Humberto Diaz, Aroucha Vickers, Claudia Prospero, Andrew G. Lee
The patient presented a year later with acute vision loss to hand motions, marked lid edema, extensive conjunctival chemosis, and complete ophthalmoplegia in the left eye. The exam of the right eye was normal. Intraocular pressure was markedly elevated in the left eye. There was a left relative afferent pupillary defect. An emergent lateral canthotomy and inferior cantholysis were performed. Computed tomography (CT) scan suggested a partially thrombosed superior ophthalmic vein (SOV) and cavernous sinus. Catheter angiography confirmed a CCF involving the intercavernous sinus draining directly into the left cavernous sinus and partially thrombosed SOV. Attempted transarterial embolization was aborted, because the risk of ischemic nerve damage and resultant cranial nerve palsies was high. Transvenous embolization was not feasible because thrombosis in the retro-orbital segment of the SOV prevented vessel access by direct and indirect (via facial vein) approaches (Figure 1). Attempts to cannulate the inferior petrosal sinus and pterygomaxillary plexus failed due to the presence of bilateral thromboemboli.