The Vascular System of the Angular Artery: Anatomical Study and Clinical Application.

Woo, JongSeol; Kim, Da Arm; Oh, Sang Ha; Kim, Dong Woon

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2008;35(6):669-674.
Published online November 1, 2008.

The Vascular System of the Angular Artery: Anatomical Study and Clinical Application.

JongSeol Woo, Da Arm Kim, Sang Ha Oh, Dong Woon Kim

¹Department of Plastic & Reconstructive Surgery, College of Medicine, Chungnam National University, Daejeon, Korea. djplastic@cnu.ac.kr
²Department of Anatomy, College of Medicine, Chungnam National University, Daejeon, Korea.

Abstract

PURPOSE
Although there are many ways to perform midface reconstruction, several difficulties exist for selecting the appropriate method, because of its anatomical and functional complexities, donor site morbidities, and poor aesthetic results. Various flaps based on the angular artery can overcome these limitations of the traditional reconstruction methods. The purpose of this study is to suggest an alternative reconstructive method for the midface using various flaps based on the angular artery. METHODS: We investigated the relationship between the angular artery and its surrounding structures through cadaveric studies and then applied the findings clinically. As a result, we were able to perform reconstruction with a retroangular flap for defects of the lower half of the nose and the lower eyelid. In addition, defects of the upper half of the nose and the medial canthal area were reconstructed by using island composite glabellar flap.
RESULTS
The angular artery was reliable as a pedicle, whether it was used antegrade or retrograde. All the wounds were successfully closed, with the exception of minor complications such as partial skin necrosis and flap bulkiness. The aesthetic outcomes for the donor and recipient sites were satisfactory.
CONCLUSION
The angular artery has diverse relationships with its surrounding structures according to its course of travel, and if a surgeon has a precise understanding of its anatomical location, we believe that retroangular flap and island composite glabellar flap may improve the treatment of midface defects.

Keywords: Reconstruction of midface defects; Angular artery; Retroangular flap; Island composite glabellar flap

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