Brief Clinical StudiesZygomatico-Orbital Artery as a Recipient Vessel for Microsurgical Head and Neck ReconstructionHigashino, Takuya MD; Sawamoto, Naoya MD; Hirai, Rintaro MD; Arikawa, Masaki MDAuthor Information From the Department of Plastic Surgery, Asahi General Hospital, Chiba, Japan. Received February 9, 2013. Accepted for publication March 3, 2013. Address correspondence and reprint requests to Takuya Higashino, MD, Department of Plastic Surgery, Asahi General Hospital, I-1326, Asahi-City, Chiba, Japan 289-2511, Japan; E-mail: [email protected] The authors report no conflicts of interest. Journal of Craniofacial Surgery: July 2013 - Volume 24 - Issue 4 - p e385-e387 doi: 10.1097/SCS.0b013e31829042c2 Buy Metrics Abstract The selection of recipient vessels in head and neck reconstruction is one of the key factors influencing its difficulty and outcome. We report a case of a microsurgical scalp reconstruction using the zygomatico-orbital artery as a recipient vessel. A 71-year-old woman had intractable skin ulcers on her head after neurosurgeries. Computed tomography angiography findings showed that the superficial temporal artery was obstructed and that the zygomatico-orbital artery ran forward and upward. She underwent scalp reconstruction using a free anterior lateral thigh flap. The zygomatico-orbital artery was dissected distally, cut, and turned over cranially. The diameter of the zygomatico-orbital artery was 1.2 mm. The blood flow through the zygomatico-orbital artery was sufficient. The thinned scalp area was excised, and some of the titanium devices and infectious tissues were removed. An anterior lateral thigh flap measuring 20 × 9 cm was harvested and transferred to the defect in the head. The discrepancy in calibers was within double, and the zygomatico-orbital artery fit the descending branch of the lateral circumflex femoral artery. The flap was transferred successfully. The zygomatico-orbital artery is one of the branches from the external carotid artery and supports the suprazygomatic territory. The zygomatico-orbital artery is present in 78% to 92% of people and originates from the superficial temporal artery and sometimes from the frontal branch of superficial temporal artery. The mean diameter of the zygomatico-orbital artery at origin is reported to be 1.20 mm. The zygomatico-orbital artery is another option as a recipient vessel in head and neck reconstruction. © 2013 by Mutaz B. Habal, MD.