OBJECTIVETo study the anatomy of the facial artery using 16-slice spiral CT angiography (CTA).

METHODSForty-five patients without vascular pathologies or other anomalies underwent 16-slice spiral CT angiography after injection of 350 mg I/ml Omnipaque through the ulnar vein. MIP and volume rendering of the images were performed to analyze the left and right facial artery.

RESULTSThe left facial artery arose from the external carotid artery with the distances from the carotid artery bifurcation of 4.5-47.90 mm (mean 18.77-/+8.98 mm), and in 1 case (2.2%), the artery arose from the common carotid artery. The right facial artery arose from the external carotid artery in all the 45 cases (100%) with distances from the carotid artery bifurcation of 6.8-39.70 mm (mean 19.23-/+8.25 mm). The bilateral facial arteries more commonly arose from the external carotid artery independently, and the lingual artery and facial artery sharing the same trunk arising from the external carotid artery was less common. In 1 case, the left facial artery and the submental artery shared the same trunk, and in another case, the left facial artery, thyroid artery and lingual artery shared the same trunk. The diameter of the left facial artery ranged from 1.40 to 4.70 mm (mean 2.83-/+0.77 mm), and that of the right facial artery was 1.60-4.30 mm (mean 2.81-/+0.79 mm). The left facial artery ended below the angle of the mouth in 12 cases (26.67%), between the angle of the mouth and the nasal wing in 7 cases (15.56%), and above the nasal wing in 26 cases (57.77%). The right facial artery ended below the angle of the mouth in 7 cases (15.56%), between the angle of the mouth and the nasal wing in 12 cases (26.67%), and above the nasal wing in 26 cases (57.77%). The bilateral facial arteries frequently passed through the submandibular gland parenchyma (23 cases on the left and 24 cases on the right), and the facial arteries were found occasionally to run below the submandibular gland (11 cases on the left and 9 on the right).

CONCLUSION16-slice spiral CT angiography can help in preoperative facial artery evaluation noninvasively. This modality can clearly display the bilateral facial arteries, including their origin, course, distribution and ending to provide detailed information for flap designing before plastic surgery and for preoperative evaluation for microvascular surgery.