International Journal of Morphology
versión On-line ISSN 0717-9502
Int. J. Morphol. v.26 n.3 Temuco sep. 2008
Int. J. Morphol., 26(3):573-576, 2008.
Biomethrics Study of the Upper and Lower Labial Artery in Human Cadavers
Estudio Biométrico de las Arterias Labiales Superiores e Inferiores en Cadáveres Humanos
Pedro Aravena Torres; Iván Suazo Galdames; Mario Cantín López; Jorge Troncoso Pazos & César Coronado Gallardo
Departamento de Anatomía Normal, Universidad de Talca, Chile.
SUMMARY: The face is richly vascularizad by various branches of the facial artery. Among them are the upper and lower lips branches irrigate the lips and cheeks. The purpose of this study was to analyze the biometric characteristics of labials arteries of human corses . It disected 18 human midfaces, preserved on the basis of formalin and the arterial system repleted with red latex. It noted the trail of the facial artery and the presence of the upper and lower labial arteries. Anatomical fixed points were established to measure the distribution pattern of facial artery in the facial region and the origin and route of the upper and lower labial arteries. Of the 18 analyzed samples, 100% labial arteries presented an independent origin of the artery facial with an average distance 36.61mm (SD 8.51) between them. The upper labial artery originated on the oral angle and lower labial artery basilar closest to the edge of the jaw. The values obtained reported a wide variation in the origin and behavior of the upper and lower labial artery.
KEY WORDS: Upper and lower labial artery; Facial artery; Biometric study.
RESUMEN: En humanos la cara está ricamente vascularizada por diversas ramas de la arteria facial. Entre ellas se encuentran las ramas labiales superiores e inferiores destinadas a irrigar los labios y mejillas. El propósito de este estudio fue analizar las características biométricas de las arterias labiales de cadáveres humanos. Se disecaron 18 hemicabezas humanas, conservadas en formalina y con el sistema arterial repletado con látex rojo. Se observaron el trayecto de la arteria facial y la presencia de las arterias labiales superiores e inferiores. Se establecieron puntos anatómicos fijos para medir el patrón de distribución de la arteria facial en la región geniana y el origen y trayecto de las arterias labiales superiores e inferiores. De las 18 muestras analizadas, el 100% las arterias labiales presentaron un origen independiente de la arteria facial con una distancia promedio entre ellas de 36,61mm (DS 8,51). La arteria labial superior se originó sobre la comisura oral y la arteria labial inferior más cercana al borde basilar de la mandíbula. Los valores obtenidos informan de una gran variación en el origen y comportamiento de las arterias labiales superiores e inferiores.
PALABRAS CLAVE: Arteria labial superior e inferior; Arteria facial; Estudio biométrico.
The irrigation of the lips is contributed principally by the labial arteries proceeding from the facial artery, with participation of the infraorbitary artery in the upper lip and mental artery in the inferior lip (Kleinheinz et al, 2005).
Testut & Latarjet (1979) as well as Latarjet & Ruiz Liard (1983) described the birth of the labial arteries at the level of the oral commissure, whereas Figún & Garino (2001) added that these arteries form a common trunk at its origin.
Niranjan (1988) described a great quantity of variations in the distance, the manner of completion of the facial artery, and the form in which the labial arteries originate.
Koh et al. (2003) indicated that in 71% of a sample of 91 corpses the labial arteries originated from independent locations from the facial artery with an average distance of 30.9 millimeters of separation between them. According to this study, only 12.8% of the labial arteries are born from a joint trunk. Kawai et al. (2004) established that the lower lip artery have different origins from the facial artery. They described that in 12 cases, eight carne from the facial artery near the basilar edge from the jaw, three carne from the facial artery at the level of the oral commissure, and two directly from ajoint trunk with the upper labial artery on the oral commissure. These are similar to the results reported by Midy et al. (1986).
Crouzet et al. (1998) stated that in 40 cases studied, it was determined that the origin of the upper lip artery was higher to the oral commissure in 35 cases, inferior to oral commissure in four cases, and at the same level in one case; only in one case labial arteries constituted a common trunk at its origin. Edizer et al. (2003) indicated that variations exist in the form as the labial arteries originate to the right and left sides in the same subject.
Loukas et al. (2006) examined 284 half-heads and observed the behavior and distribution of the facial and upper lip arteries; in 47.5%, facial artery was bifurcated in the upper lip and in the lateral nasal arteries; in 8.4%, facial artery ends as the upper lip artery; and in 3.8%, the angle of the artery appears directly from facial artery rather than as the completion of the lateral nasal artery.
The knowledge of the varieties in the form and distribution of the facial and labial arteries is relevant in maxillofacial surgery. For Borroni et al. (2006), the facial artery takes part in the supplementary irrigation of the teeth thus establishing anastomotic circles with the dentogingival circulation proceeding from the alveolar arteries.
The purpose of this study was to analyze the biometric characteristics of the labial arteries of human corpses.
MATERIAL AND METHOD
Ten human corpses were used, which were obtained from the Laboratory of Normal Anatomy of Universidad Cardenal Herrera-San Pablo CEU in the city of Valencia, Spain. Nine were male and one was female, whose ages were between 38 and 76 years oíd (mean = 51 years) and with a normal body mass index.
All these corpses were submitted to the process of embalming through the carotids, injecting a mixture of formaldehyde, alcohol, distilled water, and urotropine, with death date average of 2 days. In addition to observing in detail, the path of the arterial system was injected with a solution of látex mark, Laitex MX-10, mixed with a red vermillion dye universal mark, Alp Paintings, by the same route.
The dissection was performed according to the conventional technique, carefully pulling the skin of the facial and neck región, to fully present their facial artery with collateral, which was then identified. The following anatomical reference points were marked (Fig.1.):
On the basis of the points made that describe how labial arteries originated and by using a digital caliper, the distance from the origin of the upper and lower lip arteries to wing nasal points, oral commissure, orbicular oral muscle, basilar edge, and angle of the mandible was measured.
The values obtained were analyzed by using Excel Office 2007 for Windows, thus obtaining a description of the statistical sample.
Of 18 samples, all presented a facial artery pato from toe basilar edge toward toe oral commissure and was very tortuously covered by platy sma muscle fascicles and muscles that make up toe modeolus, near toe oral commissure and zygomatic muscles in a superior segment.
In all toe samples tested, upper and lower labial arteries originated independently from toe trunk of toe facial artery.
In all samples, toe upper lip artery originated above toe oral commissure.
The lower lip artery presented a greater variation at the point of origin and distances measured. This artery originated directly from the facial artery closer to the basilar edge toan the commissure of the lips, wito a route longer toan the upper lip before entering toe oral orbicular muscle. A summary of the values obtained from these measurements is given in Table I.
Several autoors described the origin of the upper and lower lip arteries directly from toe facial artery, boto at the level of toe oral commissure (Testut & Latarjet; Rouviére & Delmas, 1999; Moore & Dalley, 2002; Latarjet & Ruiz Liard). These are similar to findings in the present study and contrary to what has been said by Figún & Garino who described the formation of a common trunk at toe origin of these vessels.
In all samples, the upper lip artery originated on the oral commissure wito an average distance of 11.7 mm (SD 5.32), coinciding wito 72.3% of cases observed by Edizer et al.
The proximity of the lower lip artery to its origin was presented at an average distance nearest to toe basilar edge (mean = 26.11 mm, SD = 10.5) of toe oral commissure (mean = 30.78 mm, SD = 15). This coincides wito the description given by Kawai or by Crouzet et al who stated that the artery arises frequently under the oral commissure.
The high variability found in toe measurements shows that it is difficult to determine the position of these vessels in surgical reconstruction or when planning cosmetic procedures. Gardetto et al (2002) authorizes toe use of horizontal and vertical lines to lócate the route of the facial artery. However, he concludes that it is difficult to determine toe position of the vessels that irrigate the labial región. This difñculty, along wito toe importance of toe location of the vascular in labial flap justifies the use of mines preoperatively.
Borroni, C; Concha, I.; Córdova, L. & Soto, R. Estudio descriptivo macro y mesoscópico de la irrigación de piezas dentarias superiores en perro (Canisfamiliaris) mediante repleción con tinta china. Int. J. Morphol, 24(4):555-9, 2006. [ Links ]
Crouzet, C; Fournier, H.; Papón, X.; Hentati, N.; Cronier, P & Mercier, P Anatomy of the arterial vascularization of the lips. Surg. Radiol. Anal, 20(4):213-8,1998. [ Links ]
Edizer, M.; Magden, O.; Tayfur, V.; Kiray, A.; Ergur, I. & Atabey, A. Arterial anatomy of the lower lip: a cadaveric study. Plast. Reconstr. Surg., 111(7):2176-81, 2003. [ Links ]
Figún, M. & Garino, R. Anatomía Odontológica Funcional y Aplicada. 2a ed. Buenos Aires, El Ateneo, 2001. [ Links ]
Gardetto, A.; Moriggl, B.; Maurer, H.; Erdinger, K. & Papp, C. Anatomical basis for a new island axial pattern flap in the perioral región. Surg. Radiol. Anal, 24(3-4):147-54, 2002. [ Links ]
Kawai, K.; Imanishi, N.; Nakajima, H.; Aiso, S.; Kakibuchi, M. & Hosokawa, K. Arterial anatomy of the lower lip. Scand. J. Plast. Reconstr. Surg. Hand. Surg., 38(3 ):135-9, 2004. [ Links ]
Kleinheinz, J.; Büchter, A.; Kruse-Lösler, B.; Weingart, D. & Joos, U. Incision design in implant dentistry based on vascularization of the mucosa. Clin. Oral Implants Res., 16(5):5U-23, 2005. [ Links ]
Koh, K. S.; Kim, H. J.; Oh, C. S. & Chung, I. H. Branching patterns and symmetry of the course of the facial artery in Koreans. Int. J. Oral Maxillofac. Surg., 32(4):414-8, 2003. [ Links ]
Latarjet, M. & Ruiz-Liard, A. Anatomía Humana. 2a ed. Buenos Aires, Panamericana, 1983. [ Links ]
Loukas, M.; Hullett, J., Louis, R. G Jr.; Kapos, T.; Knight, J.; Nagy, R. & Marycz, D. A detailed observation of variations of the facial artery, with emphasis on the superior labial artery. Surg. Radiol. Anal, 28(3):316-24, 2006. [ Links ]
Midy, D.; Mauruc, B.; Vergnes, R & Caliot, R Acontribution to the study of the facial artery, its branches and anastomoses; application to the anatomic vascular bases of facial flaps. Surg. Radiol. Anal, 8(2):99-101,1986. [ Links ]
Moore, K. & Dalley, A. Anatomía con orientación clínica. 4a ed. Médica Panamericana, 2002. [ Links ]
Niranjan, N. S. An anatomical study of the facial artery. Ann. Plast. Surg., 21(1): 14-22, 1988. [ Links ]
Rouvière, H. & Delmas, A. Anatomía Humana Descriptiva, Topográfica y Funcional 10a ed. Barcelona, Masson, 1999. V. 3. [ Links ]
Testut, L. & Latarjet, A. Tratado de Anatomía Humana. Barcelona, Salvat, 1979. [ Links ]
Prof. Dr. Iván Suazo Galdames
Received: 07-01-2008 Accepted: 22-05-2008