Arterial anatomy of the lateral orbital and cheek region and arterial supply to the “peri-zygomatic perforator arteries” flap

Arterial anatomy of the lateral orbital and cheek region and subsequently of the “peri-zygomatic perforator arteries” flap is described, based upon the dissection of the 24 human cadaver head halves. Each specimen was dissected in subdermal, first fascial and deep level. The subdermal vascular network of lateral orbital and cheek region, its orientation and contributing arteries were studied. Origin, perforation sites and diameters of transverse facial, zygomaticoorbital, zygomaticofacial and zygomaticotemporal arteries were also described and measured. Our findings support the view that the cheek island flap used for lower eyelid is a reverse flow axial pattern flap. It includes arterioles of the transverse facial artery, which are part of the subdermal vascular plexus and are uniformly longitudinally oriented. The flap receives its blood supply via perforators of the zygomaticoorbital, zygomaticofacial and zygomaticotemporal arteries, which are connected via their terminal branches with transverse facial artery.