Termination points of the facial artery—A meta‐analysis

Abstract

The facial artery (FA) is the main artery supplying the anterior face, making this artery a very important structure to consider while performing plastic and reconstructive procedures. The literature shows discrepancies in anatomical classifications and the frequency of occurrence of individual variations. Therefore, the goal of this meta‐analysis is to provide surgeons with helpful knowledge about the variety of the termination of FA. Articles with data about the termination of the FA were found in major online medical databases such as PubMed, Scopus, Embase, Web Of Science, and Cochrane Library. A total of 1346 articles were initially evaluated by two independent reviewers. Out of those, 24 articles matched the required criteria, and were used in this meta‐analysis. A total of 2119 studied FAs were included in this study. The FA termination patterns were divided into five previously classified types. The data show that the FA terminates most frequently as the lateral nasal or angular artery with the prevalence for this group being 69.81% (95% confidence interval [CI]: 59.83%–78.94%). Authors believe that this is the most accurate and up to date study regarding termination patterns and the prevalence of the FA. The results of this meta‐analysis could provide a helpful tool for surgeons preforming plastic and cosmetic procedures, especially when injecting dermal fillers or choosing and preforming facial flaps. Detailed anatomical knowledge about the FA may prevent potential surgical complications.

Branching Patterns and Variations of Facial Artery and Clinical Importance: A Cadaveric Study

“…The literature shows discrepancies in classifications according to the types, incidence, and termination patterns of FA [6] (Table 6). The termination pattern of the FA varies in the literature, including the superior labial (SL), LNA, AA, and others [1,6]. Early termination of the FA has also been reported in the submental, inferior labial (IL), and alar arteries [6].…”

“…The termination pattern of the FA varies in the literature, including the superior labial (SL), LNA, AA, and others [1,6]. Early termination of the FA has also been reported in the submental, inferior labial (IL), and alar arteries [6]. Koh et al [24] reported that 54.5% of the 44 specimens were symmetrical.…”

“…Although there were five types of FA in Mitz's classification [9], Dupoirieux et al [26] found the following types in their dissections: angular (20%), nasal dorsal (45%), and coronal labial (35%). The literature contains several descriptions of the course of the FA [6,7,27]. Furukawa et al [27] found four different branches of the FA: type 1 (SL 34.2%), type 2 (nasolabial 40%), type 3 (LNA, 24%), and type 4 (AA, 2%).…”

“…Eighty-four percent of type 3 FA predominated at the facial-submental artery bifurcation [27]. It was reported that FA termination patterns were observed to be grouped into five categories [6]. However, some studies reported six or more types (with subtypes) due to the variable course and individual differences in termination patterns [28].…”

“…The development of the FA consists of three stages which cause several discrepancies such as enlargement, agenesis of the FA, hypoplasia, or different branching patterns [4]. During the 4-5th weeks of the embryological development process, the aortic sac effectuates the aortic arches; the third aortic arch gives rise to the ECA, where the origin of FA [6]. The variations of the FA eventuate due to the ablation of neural crest cells that impact embryonic aortic arch vessels [4].…”