Case series of tongue necrosis from vascular complications after chin augmentation with hyaluronic acid: Potential pathophysiology and management.
chin augmentation
filler injection
hyaluronic acid
hyaluronidase
tongue necrosis
vascular complication
Journal
Journal of cosmetic dermatology
ISSN: 1473-2165
Titre abrégé: J Cosmet Dermatol
Pays: England
ID NLM: 101130964
Informations de publication
Date de publication:
Mar 2023
Mar 2023
Historique:
received:
14
09
2022
accepted:
14
10
2022
pubmed:
27
1
2023
medline:
3
3
2023
entrez:
26
1
2023
Statut:
ppublish
Résumé
Even though the chin is considered a safe injection area for facial filler augmentation, tongue necrosis is a rare complication in this area. Our aim was to present case series of rare complications from chin filler augmentation with possible pathophysiology and management. From our thorough literature search found only one case report of tongue necrosis from chin filler augmentation. We present case series of unilateral tongue necrosis from vascular occlusion following hyaluronic acid injection in the chin, which was successfully treated with a high-dose hyaluronidase injection resulting in complete recovery in all patients. Variation in vascular anastomosis leads to a possible cause of vascular occlusion. The lingual artery is the primary arterial supply for the tongue, which is an exclusive target for embolism. Two main responsible arteries and branches are the deep lingual and sublingual arteries. The submental artery variation was previously described as the cause of this event. We proposed potential pathophysiology of the occlusion, not only the variation of vasculature but bone. The midline lingual foramen, an anatomical bone variation on the surface of the midline inferior jaw, was found to be another possible cause. This foramen contains a branch of the submental and sublingual artery, which includes the perforating artery, median perforating artery, or both. Filler injection with a sharp needle on the bone can potentially increase the risk of this vascular incident. A high dose of hyaluronidase administered with multiplane injections was accomplished with complete recovery. Tongue necrosis from vascular complications after hyaluronic acid filler injection can occur. Not only vessels but bone variation pathology were possible causes.
Sections du résumé
BACKGROUND
BACKGROUND
Even though the chin is considered a safe injection area for facial filler augmentation, tongue necrosis is a rare complication in this area.
OBJECTIVE
OBJECTIVE
Our aim was to present case series of rare complications from chin filler augmentation with possible pathophysiology and management.
METHODS
METHODS
From our thorough literature search found only one case report of tongue necrosis from chin filler augmentation. We present case series of unilateral tongue necrosis from vascular occlusion following hyaluronic acid injection in the chin, which was successfully treated with a high-dose hyaluronidase injection resulting in complete recovery in all patients.
RESULTS
RESULTS
Variation in vascular anastomosis leads to a possible cause of vascular occlusion. The lingual artery is the primary arterial supply for the tongue, which is an exclusive target for embolism. Two main responsible arteries and branches are the deep lingual and sublingual arteries. The submental artery variation was previously described as the cause of this event. We proposed potential pathophysiology of the occlusion, not only the variation of vasculature but bone. The midline lingual foramen, an anatomical bone variation on the surface of the midline inferior jaw, was found to be another possible cause. This foramen contains a branch of the submental and sublingual artery, which includes the perforating artery, median perforating artery, or both. Filler injection with a sharp needle on the bone can potentially increase the risk of this vascular incident. A high dose of hyaluronidase administered with multiplane injections was accomplished with complete recovery.
CONCLUSIONS
CONCLUSIONS
Tongue necrosis from vascular complications after hyaluronic acid filler injection can occur. Not only vessels but bone variation pathology were possible causes.
Substances chimiques
Hyaluronic Acid
9004-61-9
Dermal Fillers
0
Hyaluronoglucosaminidase
EC 3.2.1.35
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
784-791Informations de copyright
© 2023 The Authors. Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.
Références
DeLorenzi C. Complications of injectable fillers, part 2: vascular complications. Aesthet Surg J. 2014;34(4):584-600.
Rzany B, DeLorenzi C. Understanding, avoiding, and managing severe filler complications. Plast Reconstr Surg. 2015;136(5 Suppl):196 S-203 S.
Ozturk CN, Li Y, Tung R, Parker L, Piliang MP, Zins JE. Complications following injection of soft-tissue fillers. Aesthet Surg J. 2013;33(6):862-877.
Goodman GJ, Roberts S, Callan P. Experience and management of intravascular injection with facial fillers: results of a multinational survey of experienced injectors. Aesthetic Plast Surg. 2016;40(4):549-555.
Sun ZS, Zhu GZ, Wang HB, et al. Clinical outcomes of impending nasal skin necrosis related to nose and nasolabial fold augmentation with hyaluronic acid fillers. Plast Reconstr Surg. 2015;136(4):434 e-41 e.
Lazzeri D, Agostini T, Figus M, Nardi M, Pantaloni M, Lazzeri S. Blindness following cosmetic injections of the face. Plast Reconstr Surg. 2012;129(4):995-1012.
Yang Q, Qiu L, Yi C, et al. Reversible alopecia with localized scalp necrosis after accidental embolization of the parietal artery with hyaluronic acid. Aesthetic Plast Surg. 2017;41(3):695-699.
Tansatit T, Apinuntrum P, Phetudom T. A dark side of the cannula injections: how arterial wall perforations and emboli occur. Aesthetic Plast Surg. 2017;41(1):221-227.
Fang M, Rahman E, Kapoor KM. Managing complications of submental artery involvement after hyaluronic acid filler injection in chin region. Plast Reconstr Surg Glob Open. 2018;6(5):e1789.
Wang Q, Zhao Y, Li H, Li P, Wang J. Vascular complications after Chin augmentation using hyaluronic acid. Aesthetic Plast Surg. 2018;42(2):553-559.
Thanasarnaksorn W, Cotofana S, Rudolph C, Kraisak P, Chanasumon N, Suwanchinda A. Severe vision loss caused by cosmetic filler augmentation: case series with review of cause and therapy. J Cosmet Dermatol. 2018;17(5):712-718.
O'Neill J, Shaw-Dunn J, Robertson S, Rea P. Arterial anastomosis in the tongue. J Oral Maxillofac Surg. 2016;74(5):1084-1090.
Lopez R, Lauwers F, Paoli JR, Boutault F, Guitard J. Vascular territories of the tongue: anatomical study and clinical applications. Surg Radiol Anat. 2007;29(3):239-244.
Tansatit T, Phumyoo T, Jitaree B, Sawatwong W, Sahraoui YME. Investigation of the presence and variation of the ascending mental artery: conventional dissections and ultrasonographic study. J Cosmet Dermatol. 2019;18:1821-1829.
Ozgur Z, Govsa F, Ozgur T. Assessment of origin characteristics of the front branches of the external carotid artery. J Craniofac Surg. 2008;19(4):1159-1166.
Fazan VP, da Silva JH, Borges CT, Ribeiro RA, Caetano AG, Filho OA. An anatomical study on the lingual-facial trunk. Surg Radiol Anat. 2009;31(4):267-270.
Nakajima K, Tagaya A, Otonari-Yamamoto M, et al. Composition of the blood supply in the sublingual and submandibular spaces and its relationship to the lateral lingual foramen of the mandible. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014;117(1):e32-e38.
Gakonyo J, Butt F, Mwachaka P, Wagaiyu E. Arterial blood supply variation in the anterior midline mandible: significance to dental implantology. Int J Implant Dent. 2015;1(1):24.
Martin D, Pascal JF, Baudet J, et al. The submental Island flap: a new donor site. Anatomy and clinical applications as a free or pedicled flap. Plast Reconstr Surg. 1993;92(5):867-873.
Rahpeyma A, Khajehahmadi S. Submental artery Island flap in intraoral reconstruction: a review. J Craniomaxillofac Surg. 2014;42(6):983-989.
Bernardi S, Bianchi S, Continenza MA, Macchiarelli G. Frequency and anatomical features of the mandibular lingual foramina: systematic review and meta-analysis. Surg Radiol Anat. 2017;39(12):1349-1357.
He P, Truong MK, Adeeb N, Tubbs RS, Iwanaga J. Clinical anatomy and surgical significance of the lingual foramina and their canals. Clin Anat. 2017;30(2):194-204.
Liang X, Jacobs R, Lambrichts I, Vandewalle G. Lingual foramina on the mandibular midline revisited: a macroanatomical study. Clin Anat. 2007;20(3):246-251.
Katakami K, Mishima A, Kuribayashi A, Shimoda S, Hamada Y, Kobayashi K. Anatomical characteristics of the mandibular lingual foramina observed on limited cone-beam CT images. Clin Oral Implants Res. 2009;20(4):386-390.
Iwanaga J, Watanabe K, Saga T, Tabira Y, Yamaki K. A rare case of an artery passing through the median Perforating Canal of the mandible. Case Rep Dent. 2016;2016:8183565-8183564.