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Li Yao Cong - One of the best experts on this subject based on the ideXlab platform.
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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.
Journal of the American Academy of Dermatology, 2020Co-Authors: Zhi-feng Liao, Li Yao Cong, Wei-jin Hong, Cheng-en Luo, Wen-feng Zhan, Sheng-kang LuoAbstract:Abstract Background Vascular complication 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 eyelids 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 3D CT scans were reconstructed using a validated algorithm. Results Eighty-six qualified hemifaces clearly revealed the origin, depth and anastomoses of the superior orbital vessels, which consistently deployed two 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 four 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 3D CT needs to be confirmed by standard cadaver dissection. Conclusion This study elucidated novel arterial systems and proposed considerations for upper eyelids and forehead injections.
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Topographic Analysis of the Supratrochlear Artery and the Supraorbital Artery: Implication for Improving the Safety of Forehead Augmentation.
Plastic and reconstructive surgery, 2017Co-Authors: Li Yao Cong, Tanvaa Tansatit, Weeranut Phothong, Sang Hee Lee, Rungsima Wanitphakdeedecha, Iksoo Koh, Hee Jin KimAbstract:Background:The supratrochlear and Supraorbital Artery branches from the ophthalmic Artery are the primary suppliers of blood to the forehead. Filler injection into the forehead without precise knowledge of its vascular topography poses a risk of severe complications.Methods:Twenty hemifaces from 11
Tanvaa Tansatit - One of the best experts on this subject based on the ideXlab platform.
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anatomical and ultrasound based injections for sunken upper eyelid correction
Journal of Cosmetic Dermatology, 2020Co-Authors: Tanvaa Tansatit, Thirawass Phumyoo, Benrita Jitaree, Yasmina M E Sahraoui, Joo Heon LeeAbstract:BACKGROUND A needle or a cannula can be safely used during filler injection procedures to correct a sunken upper eyelid. To date, there are no precise injection points recommended that are based on an anatomical study. OBJECTIVE This study systematically investigated the vascular pattern and depth of forehead arteries at the periorbital area of upper eyelid. METHODS Twenty cadavers were dissected in this study. Additional data were obtained from 30 healthy volunteers using Doppler ultrasound imaging with high-frequency probe. RESULTS The ophthalmic Artery divided into two opposite primary branches: the superior and inferior orbitoglabellar arteries running along the orbital rim. After the supratrochlear Artery arose from the superior orbitoglabellar Artery at the medial eyebrow, the Supraorbital Artery either divided from this Artery near the Supraorbital foramen or emerged as an individual Artery from the Supraorbital notch. The inferior orbitoglabellar Artery gave off the radix Artery superior to the medial canthal tendon. The radix Artery divided into two opposite branches: the dorsal nasal Artery going to the nose and the paracentral Artery going to the glabella. Ultrasound imaging revealed a subcorrugator space that a cannula can safely pass through. At the Supraorbital foramen/notch, the Supraorbital Artery traveled very close to the bone. Based on the anatomical data collected, the following injection points for a needle and a cannula technique are recommended. CONCLUSION Correction of a sunken upper eyelid is a dangerous procedure which should be performed only by experienced physicians. However, with precise anatomical knowledge and correct techniques, optimal outcomes can be safely achieved.
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Localization and Topography of the Arteries on the Middle Forehead Region for Eluding Complications Following Forehead Augmentation: Conventional Cadaveric Dissection and Ultrasonography Investigation.
The Journal of craniofacial surgery, 2020Co-Authors: Thirawass Phumyoo, Benrita Jitaree, Chalermquan Rungsawang, Nuttapatch Jiirasutat, Benjamart Pratoomthai, Tanvaa TansatitAbstract:Forehead augmentation with filler injection is one of the most dangerous procedures associated with iatrogenic intravascular injection resulting in the severe complications. Nonetheless, few studies have determined the explicit arterial localization and topography related to the facial soft tissues and landmarks. Therefore, this study aimed to determine an arterial distribution and topography on the middle forehead region correlated with facial landmarks to grant an appropriate guideline for enhancing the safety of injection. Nineteen Thai embalmed cadavers were discovered with conventional dissection and 14 Thai healthy volunteers were investigated with ultrasonographic examination on the middle forehead. This study found that at the level of mid-frontal depression point, the transverse distance from the medial canthal vertical line to the superficial and deep branches of Supraorbital Artery were 9.1 mm and 15.1 mm, respectively. Whereas the depths from the skin of these arteries were 4.1 mm and 4.3 mm, respectively. Furthermore, the frontal branch of superficial temporal Artery was detectable in 42.1% as an Artery entering the forehead area. At the level of lateral canthal vertical line, the vertical distance of frontal branch was 31.6 mm, and the depth from skin of the Artery was 2.7 mm. In conclusion, a proper injection technique could be performed based on an intensive arterial distribution and topography, and ultrasonographic examination before the injection is also suggested in order to restrict the opportunity of severe complications.
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Ultrasound evaluation of arterial anastomosis of the forehead.
Journal of cosmetic dermatology, 2018Co-Authors: Tanvaa Tansatit, Thirawass Phumyoo, Benrita Jitaree, Yasmina M E Sahraoui, Worapat Sawatwong, Chalermquan Rungsawang, Nuttapatch Jiirasutat, Joo Heon LeeAbstract:BACKGROUND Color Doppler ultrasound has a potential role as an imaging guide in aiding filler injections which are blinded procedures. OBJECTIVE This study investigated the forehead arteries and provided insight into their anastomoses. This was performed by challenging their function to provide blood through these anastomoses when the main Artery was temporary occluded by compression. METHODS Three arteries were identified on each side of the forehead, the supratrochlear, the Supraorbital and the superficial temporal arteries. Under ultrasound monitoring, each target Artery and corresponding anastomosis was studied separately by compressions performed in a sequential and accumulative manner. RESULTS Data from the current study imply that accidental cannulation of either the supratrochlear Artery or the Supraorbital Artery can cause ophthalmic Artery embolization in every case recorded. If the frontal branch of the superficial temporal Artery is cannulated, the chance of blindness as a complication occurs in one fifth of volunteers. Anastomosis between both sides of the terminal branches of ophthalmic arteries creates the possibility of bilateral ocular complications when accidental cannulation occurs at one of these branches, especially the supratrochlear Artery. Thus, injury to the supratrochlear Artery carries a greater risk of complication than the Supraorbital Artery. CONCLUSION These findings emphasize that the chance of ocular complication is less when accidental cannulation occurs at the superficial temporal Artery compared with injury to the supratrochlear or the Supraorbital arteries as the terminal branches of the ophthalmic Artery. Ultrasound can assist in the identification and evaluation of all the arteries at risk, thus avoiding the occurrence of vascular complications.
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Topographic Analysis of the Supratrochlear Artery and the Supraorbital Artery: Implication for Improving the Safety of Forehead Augmentation.
Plastic and reconstructive surgery, 2017Co-Authors: Li Yao Cong, Tanvaa Tansatit, Weeranut Phothong, Sang Hee Lee, Rungsima Wanitphakdeedecha, Iksoo Koh, Hee Jin KimAbstract:Background:The supratrochlear and Supraorbital Artery branches from the ophthalmic Artery are the primary suppliers of blood to the forehead. Filler injection into the forehead without precise knowledge of its vascular topography poses a risk of severe complications.Methods:Twenty hemifaces from 11
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An Anatomic Basis for Treatment of Retinal Artery Occlusions Caused by Hyaluronic Acid Injections: A Cadaveric Study
Aesthetic Plastic Surgery, 2014Co-Authors: Tanvaa Tansatit, Prawit Apinuntrum, Thavorn PhetudomAbstract:Background In ophthalmic Artery occlusion by hyaluronic acid injection, the globe may get worse by direct intravitreal administration of hyaluronidase. Retrograde cannulation of the ophthalmic Artery may have the potential for restoration of retinal perfusion and minimizing the risk of phthisis bulbi. The study investigated the feasibility of cannulation of the ophthalmic Artery for retrograde injection. Methods In 10 right orbits of 10 cadavers, cannulation and ink injection of the Supraorbital Artery in the Supraorbital approach were performed under surgical loupe magnification. In 10 left orbits, the medial upper lid was curvedly incised to retrieve the retroseptal ophthalmic Artery for cannulation by a transorbital approach. Procedural times were recorded. Diameters of related arteries were bilaterally measured for comparison. Dissections to verify dye distribution were performed. Results Cannulation was successfully performed in 100 % and 90 % of the transorbital and the Supraorbital approaches, respectively. The transorbital approach was more practical to perform compared with the Supraorbital approach due to a trend toward a short procedure time (18.4 ± 3.8 vs. 21.9 ± 5.0 min, p = 0.74). The postseptal ophthalmic Artery exhibited a tortious course, easily retrieved and cannulated, with a larger diameter compared to the Supraorbital Artery (1.25 ± 0.23 vs. 0.84 ± 0.16 mm, p = 0.000). Conclusions The transorbital approach is more practical than the Supraorbital approach for retrograde cannulation of the ophthalmic Artery. This study provides a reliable access route implication for hyaluronidase injection into the ophthalmic Artery to salvage central retinal occlusion following hyaluronic acid injection. No Level Assigned This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .
Sheng-kang Luo - One of the best experts on this subject based on the ideXlab platform.
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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.
Journal of the American Academy of Dermatology, 2020Co-Authors: Zhi-feng Liao, Li Yao Cong, Wei-jin Hong, Cheng-en Luo, Wen-feng Zhan, Sheng-kang LuoAbstract:Abstract Background Vascular complication 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 eyelids 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 3D CT scans were reconstructed using a validated algorithm. Results Eighty-six qualified hemifaces clearly revealed the origin, depth and anastomoses of the superior orbital vessels, which consistently deployed two 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 four 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 3D CT needs to be confirmed by standard cadaver dissection. Conclusion This study elucidated novel arterial systems and proposed considerations for upper eyelids and forehead injections.
Lars-olof Hattenbach - One of the best experts on this subject based on the ideXlab platform.
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Experimental Percutaneous Cannulation of the Supraorbital Arteries: Implication for Future Therapy
Investigative ophthalmology & visual science, 2005Co-Authors: Oliver K Schwenn, Eike Gunther Wüstenberg, Moritz A Konerding, Lars-olof HattenbachAbstract:Purpose There is some evidence to suggest that thrombolysis has a beneficial effect in retinal vessel occlusion. However, there is concern that this therapeutic approach carries the risk of hemorrhage. Retrograde cannulation of the Supraorbital arteries followed by irrigation with fibrinolytic agents may have the potential to minimize the risk of major complications. The study was conducted to investigate the anatomic and sonographic features of the Supraorbital arteries. Methods This cadaver dissection study was performed on the orbits of 12 cadaveric specimens. In each orbit, the Supraorbital region was dissected, followed by cannulation of the Supraorbital vessels and injection of ink. In six orbits, the orbital vessels and the distribution of the injected ink were investigated. Continuous-wave Doppler sonographic analysis of the supratrochlear and the Supraorbital Artery was performed in 40 orbits of 20 volunteers to measure the distance between the arteries and the midline. Results Cannulation with retrograde injection of ink was successfully performed in both the supratrochlear and the Supraorbital arteries. The supratrochlear Artery exhibited a more superficial course and a larger diameter than the Supraorbital Artery (1.08 +/- 0.19 mm vs. 0.86 +/- 0.19 mm [SD]). Dissection to the orbital apex revealed a spread of ink into the ophthalmic and the central retinal arteries. The average distance between the exit of the supratrochlear Artery and the midline was found to be 16.4 +/- 1.7 mm (range, 13-20). The average distance between the exit of the Supraorbital Artery and the midline measured 26.5 +/- 2.6 mm (range, 23-35). Conclusions The findings of this anatomic and sonographic study support the concept of percutaneous Supraorbital vessel cannulation as a potential approach to thrombolysis in retinal vessel occlusion. The supratrochlear Artery appears to provide the most reliable access route.
Qiang Sun - One of the best experts on this subject based on the ideXlab platform.
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The application of forward and reversal flow axial island flap based on the superficial temporal Artery in the orbital skin defects
Zhonghua zheng xing wai ke za zhi = Zhonghua zhengxing waike zazhi = Chinese journal of plastic surgery, 2005Co-Authors: Yongsheng Zheng, Zong-ji Chen, Qiang SunAbstract:OBJECTIVE To investigate the application of forward and reversal flow axial island flap in the orbital skin defects. METHODS According to the distribution of superficial temporal Artery as well as the anastomoses with the branches of Supraorbital Artery and supratrochlear Artery, etc, the frontal, scalp, preauricular and postauricular island flaps were designed. The flaps were displaced through subcutaneous tunnel to cover all kinds of orbital skin defects. RESULTS 13 cases of forward flow flap and 9 of reversal flow flap out of 22 cases in all were observed. One postauricular reversal flow axial island flap showed the obstruction of venous refluence in early postoperative stage, however, after active treatment, mere the distal epidermal necrosis was revealed. There were six re-operations on the postoperative flap hypertrophy. The others were in good shape and functional state. CONCLUSIONS The superficial temporal Artery is one of most vital blood supply in the upper face. It has wide anastomoses with the Supraorbital Artery and supratrochlear Artery. As the colors and the nature of the frontal, preauricular and post auricular skin are close to orbital skin, the application of forward and reversal flow axial island flap based on the superficial temporal Artery can be used in the reconstruction of all kinds of orbital skin defects.
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Eyelid reconstruction with a reversal flow axial preauricular island flap based on the Supraorbital Artery
Zhonghua zheng xing wai ke za zhi = Zhonghua zhengxing waike zazhi = Chinese journal of plastic surgery, 2001Co-Authors: Yongsheng Zheng, Qiang SunAbstract:Objective In order to find an ideal flap to reconstruct the eyelid defect, we have explored the possibilities to reconstruct eyelid with a reversal flow axial preauricular island flap based on the Supraorbital Artery. Methods According to Chen's theory on "reversal flow axial flap", we designed and applied the reversal flow axial preauricular island flap based on the Supraorbital Artery, which could nourish the flap by anastomotic branches between the Supraorbital Artery and the frontal branch of the superficial temporal Artery. Results We have successfully reconstructed 7 cases of eyelid defect with this method since 1997. The size of the flaps ranged from 4.0 cm x 2.4 cm to 2.0 cm x 1.8 cm and good result were revealed with 1-2 years follow up. Conclusions The flap has a stable and reliable blood supplying. It is an ideal flap to reconstruct the eyelid defect for texture and color similarity of the eyelid and preauricular skin.