| Background The lips play an important roll in the facial aesthetics.At the same time,it has the function of complementary feeding,daily communication and expression of features.The lips tissue is soft and flexible.Defect or malformation of the lips caused by any reason will make the patients suffer a lot.Microsurgery and plastic surgery have paid a lot of attention to the repair and reconstruction of the lip defects for a long time.To repair the defect of lips,we should not only concern with maintaining a moderate size of the mouth cleft,lip function,aesthetics,but also care about the adequate blood supply of the transferred flap.The local and free flap are the methods commonly used in lip reconstruction.The rapid development of microsurgery puts the repair and reconstruction of lips in a good condition.The scholars have done a lot of research about the relationship between facial artery and the blood supply of the lips before the 1990s.These studies provide the direction for the later research.But most of the studies focused on the facial artery.The studies of the blood supply of the lips are relatively rare.The microsurgery develops rapidly since the 1990s and the clinical work attaches more importance to the repair and reconstruction of the lips.Many new methods such as angiography,arterial mold,and tissue biopsies are used to observe the blood supply of lips.Although the domestic and foreign scholars have done a lot of research in the blood supply of lips.It is necessary to carry out more comprehensive and detailed study of the lip anatomy in order to obtain relevant information because of the deficiency in the respect of clinical use.Objectives To study the origin,course,distribution and anastomosis of lip arteries,measure the maximal diameters at different planes,and provide anatomical guides for clinical treatments.Methods Specimens were selected randomly and 5 heads were perfused with red latex to observe the the origin,course,distribution,anastomosis and diameters of lip arteries.All the diameters were measured by vernier caliper,the reading error is 0.02mm.Data was handled by spss 14.0 analysis system.ResultsThe blood supply of the upper lip1.The main arterial supply of the upper lip is from the superior labial artery (SLA);in addition,the subalar and septal branches contributed to its vascularization. The septal branches arised from the superior labial artery in the midline,anterior ethmoidal artery and posterior ethmoidal artery branched off ophthalmic artery, sphenopalatine artery and the descending palatine artery branched off maxillary artery,and branches from the facial artery take anastomosis in the nose septum to form a wide range of capillary plexus called the Little's area.These artries all contribute to the blood supple of the upper lip.The superior labial artery also connect with the external nasal artery rete by the columnar branch.2.The septal branches of the SLA can be derided into the superficial and deep branch.Three are(6±2) superficial septal branches,these branches run through the superficial section of the orbiculais oris muscle to the nose septum.The external diameter is(0.62±0.31)mm.There are 1～2 deep septal branches,these branches are located between the mucousa and the orbiculais oris muscle.They go up to the nose septum with a external diameter(0.82±0.21) mm.The superficial and deep septal branches all take part in the composition of Little's area.The appearance rate of the columnar branch of the SLA is 60%.It arises from the SLA in the lacuna amatorum,rans vertically to the inferior part of the nose septum. It connect the SLA with the posterior septal artery.The blood supply of the lower lip 1.The blood supply of the lower lip was derived from the facial artery and three dominant labial arteries:the inferior labial artery,the horizontal labiomental artery, and the vertical labiomental artery.The inferior labial artery was derived from the facial artery or superior labial artery,and ran through the submucous tissue horizontally.The horizontal labiomental artery arising from the facial artery was located between the depressor labii inferioris muscle and orbicularis oris muscle.The vertical labiomental artery arose from the submental artery.These three arteries provided small vessels that traversed vertically.These small vessels and the small branches of the facial artery,that run superficial and deep to the orbicularis oris muscle,formed a vascular network in subcutaneous and submucous tissues and minute vessels branched off to the skin,mucosa,and muscles.2.The inferior labial artery(ILA) origins from the facial artery in all cases except the one branched off the superior labial artery.The distance of the origin of the inferior labial artery from the labial commissura is(2.21±0.76) cm.The external diameter is(1.18±0.54) mm on the right and(1.26±0.43) mm on the left. Measurements of this artery were(4.67±1.79) cm on the right and(4.13±1.52) cm on the left for the length.Course:The inferior labial artery was derived from the facial artery or superior labial artery,and ran through the submucous tissue horizontally,located between the mucosa and orbicularis oris muscle.3.The horizontal labiomental artery arising from the facial artery was located between the depressor labii inferioris muscle and orbicularis oris muscle.The distance of the origin of the horizontal labiomental artery from the labial commissura is(3.16±0.72) cm.The external diameter is(1.47±0.57) mm on the right and(1. 17±0.35) mm on the left.Measurements of this artery were(4.76±1.35) cm on the right and(3.59±1.58) cm on the left for the length.4.The vertical labiomental artery arose from the submental artery.The external diameter at the original part is(1.67±0.59)mm.Measurements of this artery were (3.76±1.36) cm for length.The lip artery circle The arteries supply the upper and lower lip,the bilateral facial artery located near the lip form a artery circle which can be called the lip artery circle.This circle is composed of bilateral or single SLA,bilateral facial artery,bilateral or single ILA,horizontal labiomental artery,vertical labiomental artery.Each artery has many branches to supply the tissue they have ran through and these branches form a vascular network.Conclusions1.The main arterial supply of the upper lip is from the superior labial artery (SLA),in addition,the subalar and septal branches contributed to its vascularization. The septal branches branched off SLA in the midline took part in the composition of Little's area.The superior labial artery also connect with the external nasal artery rete by the columnar branch.2.The superficial septal branches run through the superficial section of the orbiculais oris muscle to the nose septum.The external diameter is(0.62±0.31) mm.The deep septal branches are located between the mucousa and the orbiculais oris muscle.They go up to the nose septum with a external diameter(0.82±0.21) mm.In the clinic,the mucosal arterial flap and cutaneous arterial flap of the upper lip can be designed to repair the defect of the tissue.3.The blood supply of the lower lip was derived from the facial artery and three dominant labial arteries:the inferior labial artery,the horizontal labiomental artery, and the vertical labiomental artery.The inferior labial artery was derived from the facial artery or superior labial artery,and ran through the submucous tissue horizontally.The horizontal labiomental artery arising from the facial artery was located between the depressor labii inferioris muscle and orbicularis oris muscle.The vertical labiomental artery arose from the submental artery.These three arteries provided small vessels that traversed vertically.These small vessels and the small branches of the facial artery,that run superficial and deep to the orbicularis oris muscle,formed a vascular network in subcutaneous and submucous tissues and minute vessels branched off to the skin,mucosa,and muscles.4.The vertical labiomental artery arose from the submental artery.Vertical labiomental arterial flap can be designed5.The source and the distribution of lip artery are commenly asymmetry. Individual variation is significant.This feature request detail data about the lip arteries when using the lip flaps.6.The arteries supply the upper and lower lip,the bilateral facial artery located near the lip form a artery circle which can be called the lip artery circle.This circle is composed of bilateral or single SLA,bilateral facial artery,bilateral or single ILA,horizontal labiomental artery,vertical labiomental artery.Each artery has many branches to supply the tissue they have ran through and these branches form a vascular network.The flaps based on the lip artery circle enlarge the rotating range and the longth of pedicle.
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