Anatomy and external landmarks of the superficial temporal artery using 3-dimensional computed tomography

The Superficial Temporal Artery

“…Specifically, Stock et al found a bifurcation above the zygomatic arch in 60% of cases, over the arch in 32% and below it in 8% of cases ( 3 ). Similar results were published by Kuruoglu et al (58%, 40%, 2%), Tayfur et al (62%, 38%) and Pinar et al (74.1%, 22.2%, 3.7%), Hardy et al (61.5%, 26.9%, 11.54%) ( 2 , 7 , 14 , 15 ). According to Imanishi et al the terminating points of the STA are mainly located in the posterior fourth of the area between the external canthus and the root of the helix, or near this region ( 39 ).…”

“…The superficial temporal artery (STA) courses inside the superficial temporal fascia, which is an extension of the galea and the muscular aponeurotic system of the face, and usually bifurcates into two branches: an anterior frontal branch and a posterior parietal branch ( 7 , 33 , 34 ). Apart from the main branches, the STA gives rise to the transverse facial, zygomatico-orbital, auricular and middle temporal arteries ( 8 ).…”

“…The distance measured between the STA and the tragus was 16.68+-0.35 mm in a study by Pinar et al ( 2 ). On the eye-tragus-line, the location of the artery was measured at 15.55+-4.5 mm in front of the tragus ( 7 ). Furthermore, the STA was found to be located 12.31+-12.83 mm away from the zygomatic arch in a study published by Hardy et al Regarding the level of its course, the STA was found to run within a depth of approximately 2.31 mm, while the bifurcation point was identified within a depth of 3.25 mm ( 7 , 44 ).…”

“…Morphological differences in the anatomic distribution of the STA with regard to the zygomatic arch were ascertained in a cadaver study of the Chinese population in comparison to corresponding studies in Caucasian adults. Chen et al observed a classical bifurcation pattern above the zygomatic arch in 86.5% of cases, while 3.8% of the STAs issued their terminal branches on the zygomatic arch and 9.6% below that level (12) (2,7,14,15). According to Imanishi et al the terminating points of the STA are mainly located in the posterior fourth of the area between the external canthus and the root of the helix, or near this region (39).…”

Safety of the inferolateral orbital access for filling the temporal region with the fanning technique

“…Throughout the experimentation, the mean angle between artery and cannula for the conventional access was of 35 degrees. According to Hardy‐Jean Philippe, in a 2020 paper in which they evaluate via topographical means the anatomy and trajectory of the superficial temporal artery, the mean distance between the artery and tragus is of 15.55 mm with a variation of 4.5 mm, 20 which corroborates the unsafe aspects of this access, primarily when employed at a distance to the tragus close to 1 cm. The inferolateral orbital access, however, has been shown to be safer, once that no plotting coincided with subjacent vessel trajectories and the mean angle was higher (73 degrees), reinforcing that with the aforementioned technique, in most cases, the cannula is practically perpendicular to the superficial temporal artery.…”