Anatomy-based image processing analysis of the running pattern of the perioral artery for minimally invasive surgery.

We aimed to elucidate the tortuous course of the perioral artery with the aid of image processing, and to suggest accurate reference points for minimally invasive surgery. We used 59 hemifaces from 19 Korean and 20 Thai cadavers. A perioral line was defined to connect the point at which the facial artery emerged on the mandibular margin, and the ramification point of the lateral nasal artery and the inferior alar branch. The course of the perioral artery was reproduced as a graph based on the perioral line and analysed by adding the image of the artery using MATLAB. The course of the artery could be classified into 2 according to the course of the alar branch - oblique and vertical. Two distinct inflection points appeared in the course of the artery along the perioral line at the ramification points of the alar branch and the inferior labial artery, respectively, and the course of the artery across the face can be predicted based on the following references: the perioral line, the ramification point of the alar branch (5∼10 mm medial to the perioral line at the level of the lower third of the upper lip) and the inferior labial artery (5∼10 mm medial to the perioral line at the level of the middle of the lower lip).