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Editorial
. 2017 Sep 1;37(8):969-973.
doi: 10.1093/asj/sjx089.

Periorbital and Temporal Anatomy, "Targeted Fat Grafting," and How a Novel Circulatory System in Human Peripheral Nerves and Brain May Help Avoid Nerve Injury and Blindness During Routine Facial Augmentation

Joel E Pessa  1 , Jeffrey M Kenkel  1 , Coy D Heldermon  1
Affiliations
Editorial

Periorbital and Temporal Anatomy, "Targeted Fat Grafting," and How a Novel Circulatory System in Human Peripheral Nerves and Brain May Help Avoid Nerve Injury and Blindness During Routine Facial Augmentation

Joel E Pessa et al. Aesthet Surg J. .
No abstract available

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Figures

Figure 1.
Figure 1.
(A) The entire meningeal surface of human dura is an interlaced network of neurochannels (black arrow). (B) The histology of dura shows vessels (V) with intervening channels (C). This circulatory system has molecular and structural characteristics similar to xylem/pholem (ie, vessels and tracheids) (100×). (C) Nerves are invested by a prolific network of neurochannels (black arrow). (D) Neurochannels exist in all layers including the perineurium seen here (white arrows) (1200×3D volume view).
Figure 2.
Figure 2.
Cerebrospinal fluid ultimately drains to a plexus of vessels in the temporal fossa (black arrows). We have cannulated the falx in the dissection. This is a flow system from sagittal sinus to thoracic duct.
Figure 3.
Figure 3.
Secondary drainage of CSF occurs from neurochannels through bony foramina directly to lymphatics. (A) Neurochannels exist the skull at the occipital protuberance (black arrow). (B) We injected these channels with fluorescent dye. (C) Dura is turned down. (D) The dura, as well as the arachnoid, fluoresces. This is iatrogenic retrograde flow from lymphatic vessels to brain.
Figure 4.
Figure 4.
Lymphatic injections can travel to nerves. (A) We injected a lymphatic (black arrow) traveling to this nerve with molecular gold. (B) Imaging shows gold particles not only in perineurium (white arrow), but in endoneural channels as well (400x).
See this image and copyright information in PMC

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