Influence of using a single facial vein as outflow in full-face transplantation

A three-dimensional computed tomographic study

Andres Rodriguez-Lorenzo, Thorir Audolfsson, Corrine Wong, Angela Cheng, Gary Arbique, Daniel Nowinski, Shai Rozen

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

SummaryBackground The aim of this study was to evaluate the contribution of a single unilateral facial vein in the venous outflow of total-face allograft using three-dimensional computed tomographic imaging techniques to further elucidate the mechanisms of venous complications following total-face transplant. Methods Full-face soft-tissue flaps were harvested from fresh adult human cadavers. A single facial vein was identified and injected distally to the submandibular gland with a radiopaque contrast (barium sulfate/gelatin mixture) in every specimen. Following vascular injections, three-dimensional computed tomographic venographies of the faces were performed. Images were viewed using TeraRecon Software (Teracon, Inc., San Mateo, CA, USA) allowing analysis of the venous anatomy and perfusion in different facial subunits by observing radiopaque filling venous patterns. Results Three-dimensional computed tomographic venographies demonstrated a venous network with different degrees of perfusion in subunits of the face in relation to the facial vein injection side: 100% of ipsilateral and contralateral forehead units, 100% of ipsilateral and 75% of contralateral periorbital units, 100% of ipsilateral and 25% of contralateral cheek units, 100% of ipsilateral and 75% of contralateral nose units, 100% of ipsilateral and 75% of contralateral upper lip units, 100% of ipsilateral and 25% of contralateral lower lip units, and 50% of ipsilateral and 25% of contralateral chin units. Conclusion Venographies of the full-face grafts revealed better perfusion in the ipsilateral hemifaces from the facial vein in comparison with the contralateral hemifaces. Reduced perfusion was observed mostly in the contralateral cheek unit and contralateral lower face including the lower lip and chin units.

Original languageEnglish (US)
Pages (from-to)1358-1363
Number of pages6
JournalJournal of Plastic, Reconstructive and Aesthetic Surgery
Volume68
Issue number10
DOIs
StatePublished - Oct 1 2015

Fingerprint

Facial Transplantation
Veins
Phlebography
Lip
Perfusion
Chin
Cheek
Barium Sulfate
Injections
Forehead
Submandibular Gland
Gelatin
Nose
Cadaver
Allografts
Blood Vessels
Anatomy
Software
Transplants

Keywords

  • Allotransplantation
  • Face transplantation
  • Vascular complications
  • Vascular tissue
  • Venous ouflow

ASJC Scopus subject areas

  • Surgery

Cite this

Influence of using a single facial vein as outflow in full-face transplantation : A three-dimensional computed tomographic study. / Rodriguez-Lorenzo, Andres; Audolfsson, Thorir; Wong, Corrine; Cheng, Angela; Arbique, Gary; Nowinski, Daniel; Rozen, Shai.

In: Journal of Plastic, Reconstructive and Aesthetic Surgery, Vol. 68, No. 10, 01.10.2015, p. 1358-1363.

Research output: Contribution to journalArticle

Rodriguez-Lorenzo, Andres ; Audolfsson, Thorir ; Wong, Corrine ; Cheng, Angela ; Arbique, Gary ; Nowinski, Daniel ; Rozen, Shai. / Influence of using a single facial vein as outflow in full-face transplantation : A three-dimensional computed tomographic study. In: Journal of Plastic, Reconstructive and Aesthetic Surgery. 2015 ; Vol. 68, No. 10. pp. 1358-1363.
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abstract = "SummaryBackground The aim of this study was to evaluate the contribution of a single unilateral facial vein in the venous outflow of total-face allograft using three-dimensional computed tomographic imaging techniques to further elucidate the mechanisms of venous complications following total-face transplant. Methods Full-face soft-tissue flaps were harvested from fresh adult human cadavers. A single facial vein was identified and injected distally to the submandibular gland with a radiopaque contrast (barium sulfate/gelatin mixture) in every specimen. Following vascular injections, three-dimensional computed tomographic venographies of the faces were performed. Images were viewed using TeraRecon Software (Teracon, Inc., San Mateo, CA, USA) allowing analysis of the venous anatomy and perfusion in different facial subunits by observing radiopaque filling venous patterns. Results Three-dimensional computed tomographic venographies demonstrated a venous network with different degrees of perfusion in subunits of the face in relation to the facial vein injection side: 100{\%} of ipsilateral and contralateral forehead units, 100{\%} of ipsilateral and 75{\%} of contralateral periorbital units, 100{\%} of ipsilateral and 25{\%} of contralateral cheek units, 100{\%} of ipsilateral and 75{\%} of contralateral nose units, 100{\%} of ipsilateral and 75{\%} of contralateral upper lip units, 100{\%} of ipsilateral and 25{\%} of contralateral lower lip units, and 50{\%} of ipsilateral and 25{\%} of contralateral chin units. Conclusion Venographies of the full-face grafts revealed better perfusion in the ipsilateral hemifaces from the facial vein in comparison with the contralateral hemifaces. Reduced perfusion was observed mostly in the contralateral cheek unit and contralateral lower face including the lower lip and chin units.",
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AU - Cheng, Angela

AU - Arbique, Gary

AU - Nowinski, Daniel

AU - Rozen, Shai

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AB - SummaryBackground The aim of this study was to evaluate the contribution of a single unilateral facial vein in the venous outflow of total-face allograft using three-dimensional computed tomographic imaging techniques to further elucidate the mechanisms of venous complications following total-face transplant. Methods Full-face soft-tissue flaps were harvested from fresh adult human cadavers. A single facial vein was identified and injected distally to the submandibular gland with a radiopaque contrast (barium sulfate/gelatin mixture) in every specimen. Following vascular injections, three-dimensional computed tomographic venographies of the faces were performed. Images were viewed using TeraRecon Software (Teracon, Inc., San Mateo, CA, USA) allowing analysis of the venous anatomy and perfusion in different facial subunits by observing radiopaque filling venous patterns. Results Three-dimensional computed tomographic venographies demonstrated a venous network with different degrees of perfusion in subunits of the face in relation to the facial vein injection side: 100% of ipsilateral and contralateral forehead units, 100% of ipsilateral and 75% of contralateral periorbital units, 100% of ipsilateral and 25% of contralateral cheek units, 100% of ipsilateral and 75% of contralateral nose units, 100% of ipsilateral and 75% of contralateral upper lip units, 100% of ipsilateral and 25% of contralateral lower lip units, and 50% of ipsilateral and 25% of contralateral chin units. Conclusion Venographies of the full-face grafts revealed better perfusion in the ipsilateral hemifaces from the facial vein in comparison with the contralateral hemifaces. Reduced perfusion was observed mostly in the contralateral cheek unit and contralateral lower face including the lower lip and chin units.

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