Novel Classification of the Posterior Auricular Artery Based on Angiographical Appearance

Tokugawa, Joji; Cho, Narisumi; Suzuki, Hiroharu; Sugiyama, Naoya; Akiyama, Osamu; Nakao, Yasuaki; Yamamoto, Takuji

doi:10.1371/journal.pone.0128723

Cited by 9 publications

(12 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…21 However, limited studies have been conducted on its neurosurgical use. Although in 2015, Tokugawa et al 15 coined a novel classification of PAA variations based on the angiographic appearance of 424 subjects, the PAA variation is yet to be discussed for children. On the basis of our study on pediatric patients, classes 3 and 4, the 2 viable candidates for PAA-EDAS, were at 37.5% and 2.2%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Likewise, we adopted the PAA classification coined by Tokugawa et al 15 with some modifications. The alphabetic classification was changed to numeric for easier distinction between STA and PAA classes, as well as the anteriority and posteriority of classes 3 and 4 as illustrated in Fig 2 . To evaluate the postoperative technical outcomes of PAA-EDAS and STA-EDAS, we compared the degree of revascularization on follow-up transfemoral cerebral angiography between the PAA-EDAS and STA-EDAS groups based on the Matsushima grade: Grade A denotes revascularization of more than two-thirds of the MCA territory, grade B denotes revascularization of between one-and two-thirds of the MCA territory, and grade C denotes revascularization of a slight amount or none of the territory.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Anatomic Variation of the Superficial Temporal Artery and Posterior Auricular Artery in a Pediatric Moyamoya Disease Population

Lee

Kim

2021

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

BACKGROUND AND PURPOSE:In certain cases of pediatric patients with Moyamoya disease undergoing encephaloduroarteriosynangiosis (EDAS) treatment, the posterior auricular artery can be used as an alternative when the parietal branch of the superficial temporal artery is unavailable. In this study, anatomic variations of the superficial temporal and posterior auricular arteries in pediatric patients with Moyamoya disease and postoperative outcomes of posterior auricular artery-EDAS are explored.MATERIALS AND METHODS: Medical records of 572 patients with Moyamoya disease who underwent surgical procedures from 2007 to 2017 at the Seoul National University Children's Hospital were reviewed. Anatomic classifications of the superficial temporal and posterior auricular arteries were based on previous classifications. Postoperative hemodynamic changes of posterior auricular artery-EDAS were analyzed using the Matsushima grade. Also, Karnofsky Performance Scale and mRS scores of posterior auricular artery-EDAS cases were reviewed to identify postoperative clinical outcomes.RESULTS: Among 1144 hemispheres, 24 were considered posterior auricular artery-EDAS candidates (2.1%). Of those, 10 hemispheres underwent posterior auricular artery-EDAS (41.7%, in total hemispheres 0.9%). Comparing the Matsushima grades of the superficial temporal artery-EDAS and posterior auricular artery-EDAS groups showed similar postoperative revascularization. Postoperative Karnofsky Performance Scale and mRS scores of patients having undergone posterior auricular artery-EDAS did not show deterioration. CONCLUSIONS:In approximately 2% of pediatric patients with Moyamoya disease for whom the superficial temporal artery is unavailable as the EDAS donor, the posterior auricular artery can be considered an alternative. On the basis of the results, the clinical outcome of posterior auricular artery-EDAS was not inferior to that of superficial temporal artery-EDAS. Hence, we suggest an in-depth consideration of the posterior auricular artery as the donor artery if the superficial temporal artery parietal branch is unavailable.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Anatomic Variation of the Superficial Temporal Artery and Posterior Auricular Artery in a Pediatric Moyamoya Disease Population

Lee

Kim

2021

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

show abstract

“…This finding is a contrast to that reported by liu et al who in their study reported that posterior auricular artery crossed the facial nerve below in all their 10 cadaveric dissections. 9,22 We identified stylomastoid artery arising from the posterior auricular artery in all 14 cadaveric dissections. The stylomastoid artery was found to be running below the trunk of facial nerve in all our 14 cadaveric dissections.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of Using Posterior Auricular Artery as Landmark for Identification of Facial Nerve Trunk in Parotid Surgery: A Cadaver Study

Reddy¹,

Verma²,

Devarapalli³

et al. 2020

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

Introduction: Despite good surgical knowledge of the anatomy of parotid gland and meticulous surgical technique, the incidence of facial palsy in parotid surgeries is up to 26.7% transient and 1.7% complete facial palsy(1). The risk of facial palsy increases further in malignant and revision cases. Method: Superficial parotidectomy was done in 14 cadaveric hemi faces in 10 cadavers. Posterior auricular artery and its stylomastoid branch was dissected and facial nerve trunk was identified in all cases. The relationship of posterior auricular artery along with its stylomastoid branch with the facial nerve trunk was studied and recorded. Result: Posterior auricular artery was found running inferior to the facial nerve trunk in 12 cadaveric dissection while the posterior auricular artery was found crossing below the main trunk of facial in 2 cadaver dissection. The average distance between PAA and facial nerve trunk was 7 mm (2-14 mm) Stylomastoid artery was found arising from Posterior auricular artery in 12 of 14 and it was found running medial to the facial nerve trunk in all the 8 cadavers. Conclusion: Post auricular artery can be used as another landmark for identification of the main trunk of facial nerve in parotid surgeries.

show abstract

“…Tokugawa et al 15 recently proposed a classification of PAA based on their angiographic appearance; this research was based on angiograms made because of intracranial pathologies to 234 patients. These authors proposes 4 types of PAA with their respective frequency: type A (15.1%), PAA terminates between its origin and the center of the external auditory canal; type B (34.9%), PAA terminates between the center of the external auditory canal and the top of the helix; type C (48.8%), PAA terminates between the top of the helix and the vertex; and type D (1.2%), PAA reaches up to the vertex.…”

Section: Discussionmentioning

confidence: 99%

Anatomical and Clinical Study of the Posterior Auricular Artery Angiosome: In Search of a Rescue Tool for Ear Reconstruction

Díaz

Sánchez

2016

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Background:The retroauricular tissues have been used for a long time for ear reconstruction, but the anatomical bases of flaps of this region are not completely clear. The aim of this study was to estimate blood supply area and location of this on the skin and fascia retroauricular dependent of posterior auricular artery (PAA) to establish safe margins to design flaps for auricular reconstruction.Methods:Dissection under magnification (×3.5) of the PAA through a cervical approach; injection of methylmethacrylate in the PAA as a staining technique; retroauricular approach to identify the territory of irrigation of PAA in the retroauricular skin and fascia; measuring and location of the stained area; and report of 2 cases of ear reconstruction with fasciocutaneous and fascia flaps based on PAA, designed according to the anatomical study.Results:In a sample of 10 cadaveric specimens, the PAA irrigated an area of the retroauricular skin and fascia of 10.7 cm length × 7.07 cm wide equivalent to 60.44 cm2 (95% CI, 37.07–83.81), with a distribution posterior to external auditory canal of 7.15 cm (95% CI, 5.53–8.77) and posterior to the helix insertion of 6.12 cm (95% CI, 4.89–7.35). In the 2 patients treated with fascia and fasciocutaneous flaps based on the PAA, these were good options for ear reconstruction.Conclusion:A fascia or fasciocutaneous flap from the retroauricular region based on PAA within the dimensions and location found in this study will be a safe option for reconstruction of the ear.

show abstract

Novel Classification of the Posterior Auricular Artery Based on Angiographical Appearance

Cited by 9 publications

References 12 publications

Anatomic Variation of the Superficial Temporal Artery and Posterior Auricular Artery in a Pediatric Moyamoya Disease Population

Anatomic Variation of the Superficial Temporal Artery and Posterior Auricular Artery in a Pediatric Moyamoya Disease Population

Feasibility of Using Posterior Auricular Artery as Landmark for Identification of Facial Nerve Trunk in Parotid Surgery: A Cadaver Study

Anatomical and Clinical Study of the Posterior Auricular Artery Angiosome: In Search of a Rescue Tool for Ear Reconstruction

Contact Info

Product

Resources

About