Is angular artery trauma seen frequently in lateral osteotomy and responsible for peri-orbital ecchymosis?

Abstract

ObjectiveThis study was performed on fresh frozen cadavers to investigate the role of angular artery damage.MethodsLateral osteotomies (‘high-low-high’ method) were carried out bilaterally, with a 4 mm guarded lateral osteotome, after the creation of a subperiosteal tunnel. Following completion of the lateral osteotomy, a skin incision was made in the midline dorsum. The dermis and subcutaneous tissues were carefully dissected, taking care not to damage the angular artery. Overlying tissues were cut and retracted to show the course of the angular artery.ResultsThe angular artery was not damaged in any of the cadavers. The angular artery was always lateral to the lateral osteotomy line.ConclusionThe high-low-high lateral osteotomy does not damage or traumatise the angular artery. The ecchymosis and oedema are related to other factors.

Superimposition Study to Determine the Angular Arterial Distribution and its Clinical Application

“…1 The AA provides most of the blood supply to the nasal root and to the medial areas of the upper and lower eyelids. 2 The AA can be injured during various surgical procedures performed on the nasal root and medial canthal area, especially during paranasal sinus surgery, 3 lateral osteotomy as part of rhinoplasty, 4 and removal of the frontal maxilla process as part of a dacryocystorhinostomy performed to relieve excessive tearing. 5 Trauma to the AA during operations and inadequate local hemostasis may lead to excessive intraoperative bleeding, which can increase surgical time, morbidity risk, and postoperative recovery time.…”