Evaluation of variation, distance to reference points and diameter at specific points of the facial artery with three dimensional CT angiography in Turkish population

Introduction: Facial artery is the main vessel responsible for the arterial nutrition of the jaw and face area. Knowing the variable course of this artery is great importance in preventing complications after clinical applications such as intra-arterial filler injection into the facial area. The aim of this study is to examine the anatomy of the facial artery in 3D CT images in the Turkish population and to provide guidance for clinicians in the light of the data obtained against complications that may occur in procedures to be performed on the facial area. Method: Individuals, 72 men and 38 women, between the ages of 18 and 65, were included in the study. Study cases were loaded Fuji PACS onto the Syngo.via (software version syngo.via VB30A_HF06, Siemens, Germany) workstation. Various parameters of the facial artery were evaluated through CT Angiography images. Results: Facial artery types 13 type 1, 92 type 3, 1 type 4 and 2 type 5 were seen on the right, while 5 type 1, 87 type 3 and 1 type 4 were seen on the left. A statistically significant difference was detected between the right and left sides in all types (p<0,001). In the distance measurement of the facial artery to the lower level of the ala of nose, the medial canthus, midpoint of the orbit and the distance between the artery's exit point from the mandible and the labial commissure. (p=0,042, p=0,010, p=0,005, p<0,001). Additionally, the course of facial artery to nasolabial fold was also examined. Accordingly, while 82 medial, 13 lateral, 7 medial to lateral, 7 lateral to medial transition types were seen on right, 77 medial, 6 lateral, 6 medial to lateral, 8 lateral to medial transition types were seen on the left. Significant differences were found between the right and left sides in all types and between the right- left symmetry of all types (p<0,001). In depth measurements, the difference between the skin-artery distance at groove of the facial artery and the bone-artery distance at the lower level of the ala of nose between the right and left sides was statistically significant (p=0,001, p=0,021). Conclusion: As a result of this study, it is thought that knowing the variations of facial artery and its depth in frequently applied areas will provide safety to clinicians during the procedure. In addition, the ability to make depth measurements using radiological methods is also valuable in minimizing the time required for cadaver studies.