Anatomical Study Of The Superior Orbital Arcade And Its Clinical Significance In Peri-orbital Injection

Background:Objective:In recent years,the demand for facial rejuvenation is increasing day by day.Due to the small trauma,short operation time,rapid recovery,the minimally invasive non-operative cosmetology developed rapidly.Soft tissue filler injection is an important way to rejuvenate the face,and the complication of vascular injury caused by injection is the most worrying problem.Among them,the peri-orbital region is not only the common site of injection,but also the high site of complications caused by injection.The eyelid is one of the most exquisite structures of the human body,which plays an important role in facial aesthetics and function.The upper eyelids are full and the eyelid folds are sharp and clear,which are important features of young and beautiful faces.Sunken upper eyelids can makes a person look older,tired,and gaunt.At present,soft tissue injection is a common method for the treatment of upper eyelid depression.The detailed study of the blood vessels of the superior orbital rim is of great significance for clinical injection.Methods:Fifty-one voluntarily donated fresh frozen adult cadavers without underlying intracranial lesions were injected with lead oxide contrast agent through bilateral external carotid artery,internal carotid artery,facial artery and superficial temporal artery.Based on the angiography of facial vessels,a three-dimensional model of superior orbital rim vessels was established by computed tomography and three-dimensional reconstruction,and the vessels along the superior orbital rim were described in detail,so as to provide anatomical basis for hyaluronic acid injection of peri-orbital region.The specimen was dissected after the scan was completed.Results:Eighty-six qualified hemifaces clearly showed the origin,depth,and anastomoses of the superior orbital vessels,which consistently deployed 2 distinctive layers:deep and superficial.Of all hemifaces,59.3%had deep superior orbital vessels near the orbital rim,including 44.2%with deep superior orbital arcades and 15.1%with deep superior orbital arteries,which originated from the ophthalmic artery.Additionally,97.7%of the hemifaces had superficial superior orbital arcades,for which 4 origins were identified:ophthalmic artery,superior medial palpebral artery,angular artery,and anastomosis between the angular and ophthalmic arteries.Conclusion:1.The superior orbital vessels consistently deployed 2 distinctive layers:the deep layer and the superficial layer.The former is close to the periosteum,and the latter lies beneath the dermis of the skin in the adipose tissue.2.The study found that 44.2%(38/86)of the hemifaces had deep superior orbital arcades and that 97.7%(84/86)of the hemifaces had superficial superior orbital arcades,both running laterally along the superior orbital rim to the temporal region and anastomosing with the temporal arteries.3.The probability of occurrence of superficial vessels on the superior orbital rim is 97.7%.There are four sources:ophthalmic artery,superior medial palpebral artery,angular artery,and anastomosis between the angular and ophthalmic arteries.4.Hyaluronic acid injection of the upper eyelid and geisoma along the superior orbital rim should pay attention to avoid damaging the superior orbital artery so as not to cause serious complications.