The Microsurgical Anatomy of the Orbitofrontal Arteries

The orbitofrontal (or frontobasal) arteries (OFAs) are the medial (MOFA) and lateral (LOFA) orbitofrontal artery, branches of the anterior and middle cerebral artery, respectively. They supply the orbitofrontal cortex. The purpose of this microscopic cadaveric study was the detailed and precise anatomic identification of the OFAs along their course.

Twenty formalin-fixed, colored latex-injected cadaveric heads were studied with the aid of an operating microscope and microsurgical instrumentation. The anatomy of the OFAs was examined after removing the cerebrum from the cranial vault. Anatomic features of the MOFA and LOFA were investigated and assessed in relation to demographic and anthropometric variables.

The MOFA supplies approximately 15 branches and LOFA almost 16 branches. The MOFA provides 1 branch to the olfactory bulb and 4 branches to the olfactory tract, and there are approximately 2 MOFA-LOFA anastomoses per hemisphere (novel finding). The MOFA origin is located approximately 7.9 mm anterior to the anterior communicating artery and 4.7 cm posterior to the anterior limit of the gyrus rectus. The LOFA origin is located approximately 11.1 mm from the middle cerebral artery bifurcation. Younger, shorter, and lighter individuals have more MOFA-LOFA anastomoses. Finally, the number of MOFA branches for the olfactory bulb is positively correlated with the number of MOFA branches for the olfactory tract, as well as with the number of MOFA-LOFA anastomoses.

The present study provides a detailed description of the OFAs' microsurgical anatomy and can help neurosurgeons to easily identify, manipulate, and preserve these vessels during surgery.