Case of a completely absent facial artery

Introduction The facial artery generally arises from the anterior portion of the external carotid artery at a point a little above the lingual artery, and then runs forward under cover of the body of the mandible, and then is lodged in a groove on the posterior surface of the submandibular gland. It then curves upward over the body of the mandible at the anterior-inferior angle of the masseter muscle. Furthermore, the facial artery passes forward and upward across the cheek to the angle of the mouth, then runs upward to the medial angle of the eye along the side of the nose. However, variations of the facial artery have been reported by Adachi [1], Araya [2], Hanai et al. [3] and Yamamoto [4]. Particularly, it is comparatively rare that the facial artery is completely absent and compensated by another artery such as the transverse facial artery [1–5]. On the other hand, the facial artery is often selected as the target artery for superselective intra-arterial chemotherapy of head and neck cancer by inserting a catheter from the superficial temporal artery [6], therefore, knowledge of the anatomical variations of the facial artery is very important in the clinical administration of superselective intra-artrial chemotherapy. During a student course on gross anatomy dissection at Showa University School of Dentistry in 2005, we found a rare case of a completely absent left facial artery and such an absence was compensated by the transverse facial artery, which was larger in diameter than usual, and the findings of this case are herein described.