Topographical anatomy of the transverse facial artery.

The transverse facial artery (TFA) is found in the lateral face and supplies the parotid gland and duct, facial nerve, facial muscles, and skin. To better understand the cutaneous vascularization of the lateral face and to better characterize the topography and other anatomical features of the TFA, microsurgical dissection was performed in 44 cadavers. The number of TFAs present ranged from one to three, and a single TFA was most common (70.5%). The TFA originated from the superficial temporal artery at or above the level of crossing by the temporofacial trunk of the facial nerve in the parotid gland (57.6%). The TFA divided into superior and inferior trunks in the gland, and continued as emerging branch. The superior emerging branch emerged from the gland superior to the parotid duct and divided into many branches. It supplied the malar area, crossed the parotid duct, terminated as perforator, vasa nervorum, or artery to the parotid duct or muscle. The inferior trunk in 72.5% continued as emerging branch instead of terminating in the gland. TFAs were classified into four types; the most common type was Type A in which the superior and inferior emerging branches and the duct-crossing branch were present. The mean number of perforators to the superficial cutaneous layer was 1.9. Most perforators extended from the superior emerging branches (77.9%). The most common perforating site was below the duct on the anterior third of the masseter muscle. In two cases, the TFA formed an anastomosis with the facial artery.