title: Anatomical study of the vascular territories of the maxilla: role of the facial artery in allotransplantation.
abstract: BACKGROUND
  Facial composite tissue allotransplantation has recently become a surgical option. The maxilla, which forms the upper jaw and plays an important role in facial allotransplantation, consists of the maxillary and facial arteries. The maxillary artery is located deep within the tissue and considered the main artery of the maxilla; however, the facial artery is easy to access. The objective of this study was to examine the territories of the maxillary and facial arteries within the maxilla.
  
  
  METHODS
  We excised and examined 22 maxillae. Of these, 18 were injected with latex and four with India ink.
  
  
  RESULTS
  We observed that the ascending palatine artery, which was collateral with the facial artery, vascularized the maxilla through its dorsal part. The facial artery vascularized the maxilla through its ventral part with the philtral and columellar branches of the superior labial artery. Therefore, the facial artery formed, through the nasal and palatine mucosa, an arterial circle with a dorsal and ventral pole. Angiosomes formed by both the facial and maxillary arteries were also observed. The India ink injected into the facial and maxillary arteries delineated specific territories for each artery.
  
  
  CONCLUSIONS
  This study allowed us to determine the anatomical structures that provide vascularization to the maxilla and describe their different forms. The whole of the maxilla was vascularized by the facial artery, despite the caution imposed by several studies on the removal of the facial artery alone. Indeed, the removal technique was found to be safer when it preserved the anastomoses between the facial and maxillary arteries. Therefore, previous clinical experience and our anatomical study definitively demonstrate that the facial artery vascularizes the maxilla.
authors.affiliation: Department of Maxillofacial Surgery, CHI, Villeneuve Saint Georges, France; Department of Anatomy, URDIA, Paris, France. Electronic address: gaoussou.toure@chiv.fr.
authors.forename: Gaoussou
authors.initials: G
authors.lastname: Touré
authors.affiliation: Department of Plastic Reconstructive and Esthetic Surgery, Université Paris 12, Faculty of Medicine, Assistance Publique-Hôpitaux de Paris, Groupe Henri Mondor-Albert Chenevier, Créteil, France.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Meningaud
mesh_terms: D001158:Arteries / Q000033:anatomy & histology; D001163:Arteriovenous Anastomosis / Q000033:anatomy & histology; D005145:Face / Q000098:blood supply; D005147:Facial Bones / Q000098:blood supply; D006801:Humans; D008437:Maxilla / Q000098:blood supply*; D009092:Mucous Membrane / Q000098:blood supply; D063986:Vascularized Composite Allotransplantation
keywords: Allotransplant; Angiosomes; Facial artery; Maxilla; Vascular territories; Vascularization