Is angular artery trauma seen frequently in lateral osteotomy and responsible for peri-orbital ecchymosis?

Objective: This study was performed on fresh frozen cadavers to investigate the role of angular artery damage.

Methods: Lateral osteotomies ('high-low-high' method) were carried out bilaterally, with a 4 mm guarded lateral osteotome, after the creation of a subperiosteal tunnel. Following completion of the lateral osteotomy, a skin incision was made in the midline dorsum. The dermis and subcutaneous tissues were carefully dissected, taking care not to damage the angular artery. Overlying tissues were cut and retracted to show the course of the angular artery.

Results: The angular artery was not damaged in any of the cadavers. The angular artery was always lateral to the lateral osteotomy line.

Conclusion: The high-low-high lateral osteotomy does not damage or traumatise the angular artery. The ecchymosis and oedema are related to other factors.