Allotransplantation de face : étude anatomique, techniques de prélèvement partiel ou total de face, indications potentielles en clinique humaine

The authors evaluated the technical aspects of harvesting facial tissues in order to perform a facial allotransplantation by conducting dissections in 15 fresh cadavers. They developped anatomical models of harvesting the inferior two thirds and the totality of the face. The approach consisted in harvesting the totality of the facial soft tissues including the muscles and their innervation, in that way harvesting is fast and associated to minimal tissular trauma. The vessels were dissected at their origin at the level of the external carotid artery and the internal jugular vein. The vascular anatomy within the facial flaps was evaluated by transillumination and radiographic (Rx) studies and the authors concluded that the vascular network is rich and sufficient in both partial and full size face transplants. Another important aspect of that study was the restauration of the donor's face. This was achieved in a fast and aesthetically satisfying way with the use of a resin mask. After switching the facial soft tissues on the bony structures of the different subjects, the facial appearence that they observed was rather mixed. In conclusion, that study showed that a face allotransplantation is sound from a technical point of view and could achieve good results in selected cases which are discussed.