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Case 2.6
Published in Monica Fawzy, Plastic Surgery Vivas for the FRCS(Plast), 2023
You proceed with the free flap option. Which recipient vessels will you use?I will first explore the superficial temporal vessels in the pre-auricular region rather than in the temple as the vessels are of larger calibre there. The superficial temporal vein can be of small calibre and tortuous configuration.If I am not happy with the quality of the vessels, then I will proceed with an anastomosis of the facial vessels in level I of the neck – if my pedicle is long enough, as again the vessel calibre is larger than along the mandibular border, and this would decrease the risk of flap-related complications.
Facial anatomy
Published in Michael Parker, Charlie James, Fundamentals for Cosmetic Practice, 2022
This vein is best understood by first appreciating its originating branches. The most distal supply of this vein arguably comes from the superficial temporal vein. This vein is which is situated on the lateral aspect of the top of the skull and forms a venous plexus with the frontal vein from the contralateral side of the skull. It proceeds to travel inferiorly along the anterior skull before joining the frontal and superior orbital veins which drain the forehead, eyelids and glabellar complex. Proximal to these anastomoses it is referred to as the angular vein, which then travels obliquely in an inferolateral direction on the lateral aspect of the nasal bone, draining tiny perforators from the skin overlying the nasal bridge before being joined by the vein of the nasal alar, otherwise known as the nasal arch. It is worth noting that the angular vein communicates with the ophthalmic vein and subsequently through these vessels blood can drain directly into the cavernous sinus, which can allow infections or emboli from the angular vein or its tributaries to easily cause complications such as intracerebral abscesses, infarction or encephalitis.
Temporal Region and Lateral Brow
Published in Ali Pirayesh, Dario Bertossi, Izolda Heydenrych, Aesthetic Facial Anatomy Essentials for Injections, 2020
Krishan Mohan Kapoor, Alberto Marchetti, Hervé Raspaldo, Shino Bay Aguilera, Natalia Manturova, Dario Bertossi
The superficial temporal vein drains a widespread region of the scalp. It: Joins with the corresponding vein of the contralateral side, and with the supratrochlear, supraorbital, posterior auricular, and occipital veins.Has a variable number of branches in the scalp.Runs independently from the frontal and parietal branches of the superficial temporal artery, except for its proximal portion.Crosses the zygomatic arch, unites with the maxillary vein inside the parotid gland, and forms the retromandibular vein.Receives blood from the parotid veins, articular veins from the temporomandibular joint, anterior auricular veins, and the transverse facial vein.
An effective technique for managing vascular diameter discrepancies in microsurgery: tapering with a hemoclip
Published in Journal of Plastic Surgery and Hand Surgery, 2020
Zulfukar Ulas Bali, Mustafa Kursat Evrenos, Berrak Karatan, Yavuz Kececi, Levent Yoleri
Of the 12 patients, the tapering technique with a hemoclip was applied in seven patients simultaneously, for both the vein and artery, and only for vein anastomosis in five patients (Table 1). All the patients underwent a single-vein anastomosis. Reconstruction of the patients’ veins was performed with ten free ALT flaps (Figures 5 and 6) and two free osteocutaneous iliac flaps. Six superficial temporal arteries (STA) and one frontal branch of the STA were used as a recipient artery in the seven patients who underwent head and neck vein reconstruction. The recipient vein was the superficial temporal vein (STV) in four cases and the angular vein (AV) in the other three cases. In the five patients who underwent lower extremity reconstruction, this technique was used only in vein anastomosis. The diameters of the vessels were measured with a micrometer. The luminal diameters of the arteries and veins of the flap and recipient differed by 1.6- to 3-fold and 1.5- to 2.6-fold, respectively. None of the cases required re-exploration. The patients were followed up for a median of 8.4 months. No complications occurred during the follow-up period.
Surgical management of severe facial trauma after dog bite: A case report
Published in Acta Oto-Laryngologica Case Reports, 2020
Bernhard Prem, David Tianxiang Liu, Bernhard Parschalk, Boban M. Erovic, Christian A. Mueller
Another reconstructive option is the replantation of a completely bitten-off nose. While early attempts to replant totally amputated noses were unsuccessful [16], successful replantation has now been reported in several cases [17,18]. This technique requires that there be salvageable tissue after the bite, and the possibility of microanastomosis [14,18]. For example, vein grafts from a superficial temporal vein may be used [17]. The implementation of microsurgical procedures has resulted in more successful replantation [18].
Mesenchymal stromal cell-derived small extracellular vesicles restore lung architecture and improve exercise capacity in a model of neonatal hyperoxia-induced lung injury
Published in Journal of Extracellular Vesicles, 2020
Gareth R. Willis, Angeles Fernandez-Gonzalez, Monica Reis, Vincent Yeung, Xianlan Liu, Maria Ericsson, Nick A. Andrews, S. Alex Mitsialis, Stella Kourembanas
At PN4, MEx preparations (50 μl) were injected (IV) via the superficial temporal vein. MEx were diluted accordingly in dPBS to achieve a dose that corresponded to 0.5 × 106 cell equivalents. Mice which received a single “early” MEx intervention were assessed at PN60 (schematic shown in Figure 3(a)). Mice that received an “early” MEx treatment were compared to mice that received serial “late” treatments (as detailed below), and their respective controls.