title: Manson's point: A facial landmark to identify the facial artery.
abstract: BACKGROUND
  The anatomy of the facial artery, its tortuosity, and branch patterns are well documented. To date, a reliable method of identifying the facial artery, based on surface landmarks, has not been described. The purpose of this study is to characterize the relationship of the facial artery with several facial topographic landmarks, and to identify a location where the facial artery could predictably be identified.
  
  
  METHODS
  Following institutional review board approval, 20 hemifacial dissections on 10 cadaveric heads were performed. Distances from the facial artery to the oral commissure, mandibular angle, lateral canthus, and Manson's point were measured. Distances were measured and confirmed clinically using Doppler examination in 20 hemifaces of 10 healthy volunteers.
  
  
  RESULTS
  Manson's point identifies the facial artery with 100% accuracy and precision, within a 3 mm radius in both cadaveric specimens and living human subjects. Cadaveric measurements demonstrated that the facial artery is located 19 mm ± 5.5 from the oral commissure, 31 mm ± 6.8 from the mandibular angle, 92 mm ± 8.0 from the lateral canthus. Doppler examination on healthy volunteers (5 male, 5 female) demonstrated measurements of 18 mm ± 4.0, 50 mm ± 6.4, and 79 mm ± 8.2, respectively.
  
  
  CONCLUSIONS
  The identification of the facial artery is critical for the craniofacial surgeon in order to avoid inadvertent injury, plan for local flaps, and in preparation of a recipient vessel for free tissue microvascular reconstruction. Manson's point can aid the surgeon in consistently indentifying the facial artery.
authors.affiliation: Division of Plastic, Reconstructive and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA; Department of Plastic & Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Calva
authors.affiliation: Division of Plastic, Reconstructive and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA; Department of Plastic & Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Karan K
authors.initials: KK
authors.lastname: Chopra
authors.affiliation: Division of Plastic, Reconstructive and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Sosin
authors.affiliation: Division of Plastic, Reconstructive and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Carla
authors.initials: C
authors.lastname: De La Cruz
authors.affiliation: Division of Plastic, Reconstructive and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Branko
authors.initials: B
authors.lastname: Bojovic
authors.affiliation: Department of Plastic Surgery, New York University Langone Medical Center, New York, NY, USA.
authors.forename: Eduardo D
authors.initials: ED
authors.lastname: Rodriguez
authors.affiliation: Department of Plastic & Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Paul N
authors.initials: PN
authors.lastname: Manson
authors.affiliation: Division of Plastic, Reconstructive and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: mchristy@umm.edu.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Christy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059925:Anatomic Landmarks; D001158:Arteries / Q000033:anatomy & histology*; D002102:Cadaver; D004210:Dissection / Q000379:methods; D005145:Face / Q000098:blood supply* / Q000601:surgery; D005152:Facial Muscles / Q000098:blood supply*; D005260:Female; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods
keywords: Anatomy; Craniofacial; Craniomaxillofacial; Face; Facial artery; Flaps