Facial-cavernous anastomoses
Citation, DOI, disclosures and article data
At the time the article was created Owen Kang had no recorded disclosures.
View Owen Kang's current disclosuresAt the time the article was last revised Jeevan K Karuppannan had no financial relationships to ineligible companies to disclose.
View Jeevan K Karuppannan's current disclosuresThe facial-cavernous anastomoses are the communications of the facial and deep facial veins with the cavernous sinus.
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Gross anatomy
At the medial canthus of the eye there is a communication with the ophthalmic veins, which drain into the cavernous sinus. Blood from the frontal scalp normally flows via the facial vein, however if flow via this passageway is occluded (e.g. due to thrombosis or pressure) blood above the obstruction will flow through the orbit and into the cavernous sinus.
The second communication is via the pterygoid plexus. The deep facial vein passes between the facial vein and drains into the pterygoid plexus anterior to the masseter muscle. The pterygoid plexus in the infratemporal fossa receives an emissary vein from the cavernous sinus in the middle cranial fossa through the foramen ovale.
Variant anatomy
If present, the pterygoid plexus receives a vein from the venous foramen of Vesalius, a small hole medial to the foramen ovale.
Related pathology
The danger area of the face lies between the deep facial and angular veins.
Infection of the upper lip, vestibule of the nose and eyelids spread by way of the angular, supraorbital and supratrochlear veins to the ophthalmic veins which drain directly into the cavernous sinus.
Peritonsillar abscesses, osteomyelitis of the maxilla and deep cervical abscesses may spread by the pterygoid plexus or by direct extension to the internal jugular vein.
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