Analyse des implications du tissu graisseux dans la morphologie faciale, à partir d'une revue de la littérature et de dissections de dix hémifaces

[The parapharyngeal adipose corpus: Surgical anatomy and imaging]

The aim of this study is to define the parapharyngeal adiposis corpus (PAC) and its anatomical relationships originally described by P. Sebileau in 1892 to assess the potential clinical implications.

MATERIALS AND METHODS

Seven frozen fresh cadavers were used, 3 of which after injection of latex neoprene colored in cervicocephalic arterial network. A MRI was performed in 10 patients without cervical pathology. The analysis was done on the frontal and transverse T1-weighted sections.

RESULTS

The PAC, which is a yellowish fat formation, fills the paratonsillar space. It measures an average of 4.8cm (4.5 to 5.2cm) in length and 1.2cm (1.1 to 1.5cm) for subjects of varying size and sex. Its arterial supply is mainly provided by the ascending palatine artery, an early branch of the facial artery. A left-right symmetry was found on MRI analyses regardless of sex or age. It is found in all the medial and ventral cases on the pharyngeal extension of the parotid gland in homogeneous hyperintense T1.

CONCLUSION

The PAC is a constant fat structure. Its vascularization depends mainly on the ascending palatine artery. Through its association with fatty peripharyngeal space, it could be a functionally sliding space. In imaging, it may be helpful in the interpretation of images of the pharyngeal extension of the parotid gland tumors.

[Cheek reconstruction]

We describe the different cheek reconstruction techniques with primary emphasis on the superficial layers. In addition to the clinical context, location and size of the lesion will be taken into account to choose the best method that will optimize the functional and aesthetic results while minimizing potential sequelae. Main evaluation criteria include absence of natural orifice deformation, scar location, skin cover quality and respect of volumes.