A Case of Abrupt Termination of the Facial Artery with Unusual Multiple Arterial Anastomoses: Clinical Implications in the Head and Neck

Address for Correspondence: Priti L. Mishall, MD, MBBS, Assistant Professor, Department of Anatomy and Structural Biology, 1300 Morris Park Ave, Forchheimer 620SA, Albert Einstein College of Medicine, Bronx, NY United States 10465. Telephone number: 718-430-3483 E-Mail: [email protected] Having up-to-date knowledge of the variability in facial artery topography is an essential starting point in performing certain surgical and radiological procedures on the head and neck (e.g. oromucosal reconstruction flaps, transarterial embolization). We report a unique case with: (1) the left facial artery truncating as an atypical inferior labial artery, (2) the left anterolateral face being perfused by unusual arterial collaterals derived from the right superior labial, left infraorbital and left dorsal nasal arteries, (3) the transverse facial artery not being one of the perfusing collaterals, and (4) the right submental artery piercing the mylohyoid muscle and entering the oral cavity. The embryologic basis of this atypical vascular pattern is discussed. Discovery of a highly atypical facial artery highlights the importance of performing a thorough pre-operative vascular evaluation to prevent iatrogenic injuries and complications before any surgical or therapeutic procedure.