title: Zygomatico-orbital artery as a recipient vessel for microsurgical head and neck reconstruction.
abstract: The selection of recipient vessels in head and neck reconstruction is one of the key factors influencing its difficulty and outcome. We report a case of a microsurgical scalp reconstruction using the zygomatico-orbital artery as a recipient vessel.A 71-year-old woman had intractable skin ulcers on her head after neurosurgeries. Computed tomography angiography findings showed that the superficial temporal artery was obstructed and that the zygomatico-orbital artery ran forward and upward. She underwent scalp reconstruction using a free anterior lateral thigh flap. The zygomatico-orbital artery was dissected distally, cut, and turned over cranially. The diameter of the zygomatico-orbital artery was 1.2 mm. The blood flow through the zygomatico-orbital artery was sufficient. The thinned scalp area was excised, and some of the titanium devices and infectious tissues were removed. An anterior lateral thigh flap measuring 20 × 9 cm was harvested and transferred to the defect in the head. The discrepancy in calibers was within double, and the zygomatico-orbital artery fit the descending branch of the lateral circumflex femoral artery. The flap was transferred successfully.The zygomatico-orbital artery is one of the branches from the external carotid artery and supports the suprazygomatic territory. The zygomatico-orbital artery is present in 78% to 92% of people and originates from the superficial temporal artery and sometimes from the frontal branch of superficial temporal artery. The mean diameter of the zygomatico-orbital artery at origin is reported to be 1.20 mm. The zygomatico-orbital artery is another option as a recipient vessel in head and neck reconstruction.
authors.affiliation: Department of Plastic Surgery, Asahi General Hospital, Chiba, Japan. higashino-pla@umin.ac.jp
authors.forename: Takuya
authors.initials: T
authors.lastname: Higashino
authors.forename: Naoya
authors.initials: N
authors.lastname: Sawamoto
authors.forename: Rintaro
authors.initials: R
authors.lastname: Hirai
authors.forename: Masaki
authors.initials: M
authors.lastname: Arikawa
mesh_terms: D001158:Arteries / Q000601:surgery*; D005260:Female; D058752:Free Tissue Flaps / Q000098:blood supply*; D006257:Head / Q000098:blood supply* / Q000601:surgery*; D006801:Humans; D008866:Microsurgery; D008875:Middle Aged; D009915:Orbit / Q000098:blood supply*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012535:Scalp / Q000601:surgery*; D012883:Skin Ulcer / Q000209:etiology / Q000601:surgery*; D013848:Thigh / Q000601:surgery; D015050:Zygoma / Q000098:blood supply*