Summary
The largest prospective cadaver study done over a 3-year period to investigate the
arterial variations of the forehead is presented. The primary goal was to find anatomical
support for various forehead flaps previously designed.
Thirty cadaver foreheads (60 hemi-foreheads) were dissected from deep to superficial
to identify arterial variations. The arteries were filled with a latex solution prior
to dissection.
The results show that the supratrochlear and dorsal nasal arteries have a relatively
constant origin. Vertical (VB), oblique (OB), medial (MB) and lateral branches (LB)
of the supraorbital artery were identified. The frontal branch of the superficial
temporal artery (FBSTA) was found to continue in the direction of the scalp at the
lateral orbital rim vertical line and gave off a transverse branch, the transverse
frontal artery (TFA), to supply the forehead. The oblique branch of the supraorbital
artery (OBSOA) most often anastomosed with either the transverse frontal artery or
the frontal branch of the superficial temporal artery at the lateral orbital rim vertical
line. A central artery (CA) was consistently found originating from the dorsal nasal
artery usually 5 mm from its origin. The central artery had a constant anastomosis with the opposite
central artery in the inferior transverse third of the forehead. The central artery
was not easily identifiable in the superior third of the forehead.
The angular artery (AA) was found to have a variable termination. The angular artery
could communicate with the supratrochlear artery (STrA) at the supraorbital rim (SOR)
or it could continue up into the forehead medial to the STrA. This artery was called
the paracentral artery (PCA).
The central artery, paracentral artery and supratrochlear artery have an important
relationship with the most prominent central vein that is relevant to flap construction.
The significance of the central artery and vein favours the median forehead flap as
anatomically superior and the prominent central vein is a constant landmark on which
to select the side of the pedicle. Clear landmarks for defining the pedicle base for
the median forehead flap are provided.
Keywords
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Article info
Publication history
Published online: February 09, 2007
Accepted:
December 9,
2006
Received:
January 25,
2006
Footnotes
☆Presented in October 2005 at the Annual Plastic and Reconstructive Surgery Congress of South Africa (APRSSA).
Identification
Copyright
© 2006 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
