title: [Horn shaped perforator flap pedicled with the angular artery: anatomy basis and clinical application].
abstract: OBJECTIVE
  To explore the anatomic basis and clinical application of the horn shaped perforator flap pedicled with the angular artery for the reconstruction of midface defect.
  
  
  METHODS
  (1) 10 fresh cadavers were perfused with a modified guiding oxide gelatin mixture for three-dimensional visualization reconstruction using a 16-slice spiral computed tomography scanner and specialized software (Materiaise' s interactive medical image control system, MIMICS). The origin and distribution of the angular artery perforator were observed. (2) Between July 2012 and July 2014, twenty-one patients underwent operations for the reconstruction of midface defect. Ten patients had squamous cell carcinoma, nine patients had basal cell carcinoma and two patients had nevus. The flaps' size ranged from 1.5 cm x 3.5 cm to 2.5 cm x 5.0 cm.
  
  
  RESULTS
  The facial artery branches the lateral nasal artery 1 cm from the outside corner of the mouth, subsequently strenches to inner canthus continuing as the angular artery. The angular artery anastomoses extensively with the dorsal nasal artery and the infraorbital artery. All the flaps survived. The patients were satisfied with the final aesthetic and functional results.
  
  
  CONCLUSIONS
  The flap can be designed flexibly and simply with reliable blood supply. The donor sites could be closed directly without skin graft, it is a simple and fast method for the reconstruction of midface defect.
authors.forename: Ma
authors.initials: M
authors.lastname: Dameng
authors.forename: Li
authors.initials: L
authors.lastname: Xiaojing
authors.forename: Ning
authors.initials: N
authors.lastname: Jinlong
authors.forename: Ding
authors.initials: D
authors.lastname: Maochao
authors.forename: Li
authors.initials: L
authors.lastname: Xinyi
authors.forename: Yao
authors.initials: Y
authors.lastname: Wende
authors.forename: Chen
authors.initials: C
authors.lastname: Zhao
authors.forename: Ge
authors.initials: G
authors.lastname: Lizheng
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D001158:Arteries / Q000033:anatomy & histology; D002102:Cadaver; D002280:Basal Cell Carcinoma / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005145:Face / Q000098:blood supply; D005153:Facial Neoplasms / Q000601:surgery*; D006801:Humans; D009506:Nevus / Q000601:surgery*; D009666:Nose / Q000098:blood supply; D061525:Perforator Flap / Q000098:blood supply* / Q000637:transplantation; D012878:Skin Neoplasms / Q000601:surgery*; D016038:Skin Transplantation; D012984:Software; D036542:Tomography, Spiral Computed