Surgical anatomy of the superficial temporal artery to prevent facial nerve injury during arterial biopsy

Shin, Kang‐Jae; Shin, Hyun Jin; Lee, Shin‐Hyo; Koh, Ki‐Seok

doi:10.1002/ca.23033

Cited by 28 publications

(25 citation statements)

References 22 publications

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“…Focus has been primarily on the relationship between the temporal STVs and the auriculotemporal nerve, as well as on the infrazygomatic STVs and their relationship to the temporal branch of the facial nerve (TBFN). [32][33][34] Importantly, we found no incidence of facial nerve palsy in the clinical cohort undergoing free flap reconstruction with microanastomosis to the intraparotid STVs, demonstrating that the vessels can be safely dissected in this region without nerve damage. On cadaver dissection, the facial nerve entered the parotid on average 11.7 mm inferior to the confluence point (target for microanastomosis).…”

Section: Discussionmentioning

confidence: 64%

Utilization of Intraparotid Segments of Superficial Temporal Vessels for Head and Scalp Free Flap Microanastomosis: A Clinical, Histological, and Cadaveric Study

Venkatesh

Fracol

Turin

et al. 2019

J Reconstr Microsurg

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Background The superficial temporal vessels (STV) are an underutilized target for head and neck microvascular reconstruction. Most surgeons regard the dissection as difficult, unreliable, and the anastomosis prone to vasospasm. The intraparotid course of the STV may provide more reliable flow without accompanying morbidity. Methods A retrospective review of patients who underwent head and scalp free flap reconstruction utilizing STV intraparotid segment was performed. Demographic factors such as intraoperative and postoperative complications are reported. Five bilateral cadaver heads were dissected to describe the relationship to the facial nerve. STV histology was performed on four of the cadavers, noting intraluminal diameter and vessel wall thickness. Results Thirty-nine patients underwent free flap reconstruction with anastomosis to intraparotid STVs. Defect etiology included tumor resection (71.8%), traumatic brain injury (10.3%), intracranial bleed (12.8%), and acute trauma (5.1%). Flaps transferred included anterolateral thigh (51.3%), latissimus (33.3%), thoracodorsal artery perforator (7.7%), radial forearm (2.8%), and vastus lateralis (5.1%). Two flaps (5.1%) required takeback for arterial thrombosis, with one incidence of total flap loss (2.8%). There were no instances of transient or permanent facial nerve damage nor sialocele. On cadaver dissection, three distinct vessel segments were identified. Segments 1 and 2 represented the STVs superior to the upper tragal border. Segment 3 (intraparotid segment) began at the upper tragal border and STVs enlarged with a targeted anastomosis point at an average of 16.3 mm medial and 4.5 mm inferior to the upper border of the tragus. The frontal branch coursed 11.7 mm inferior and 11.5 mm anterior to this point. On histology, the intraluminal diameter of segment 3 was significantly larger than segment 2 (1.2 vs. 0.9 mm, p = 0.007). Conclusion Head and neck free flap reconstruction with microanastomosis to the intraparotid segment of STVs can be safely and reliably performed.

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Section: Discussionmentioning

confidence: 64%

Utilization of Intraparotid Segments of Superficial Temporal Vessels for Head and Scalp Free Flap Microanastomosis: A Clinical, Histological, and Cadaveric Study

Venkatesh

Fracol

Turin

et al. 2019

J Reconstr Microsurg

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“…The superficial temporal fascia is thin in patients with temporal hollowing and confers a great risk to all the neurovascular structures it encompasses. 37,50,51 Several studies in our review reported transient paresthesias secondary to facial nerve damage, but the risk of permanent damage remains unknown.…”

Section: Discussionmentioning

confidence: 97%

Temporal Augmentation: A Systematic Review

et al. 2019

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Clinicians employ various modalities in order to achieve temporal augmentation; however, no literature comprehensively describes these methods or provides perspective on available options. Understanding the available methodologies for cosmetic temporal augmentation allows for improved patient satisfaction with limited risk of complications. To synthesize the available literature on cosmetic temporal augmentation, including all available methodologies, patient satisfaction data, and complication rates, as well as to identify gaps in the available literature to encourage further research. A literature search was performed using the databases PubMed, Ovid Medline, Cochrane Library, and Web of Science. Using the key terms “temporal” or “temple” and “augmentation” or “rejuvenation,” all article formats presenting primary literature data involving cosmetic temporal augmentation were included. Articles not presenting patient data or not discussing cosmetic indications were eliminated. A total of 12 articles were deemed appropriate for analysis. Of the 12 articles included, 6 (50%) evaluated filler techniques, 3 discussed fat grafting (25%), and 3 reviewed solid implant (25%) techniques. Eight (67%) of these were retrospective reviews, with the remaining being prospective trials (33%). All studies found high patient satisfaction rates and a small number of complications with their respective methodology. Several methods are employed for cosmetic temporal augmentation, including various types of injectable fillers, solid implants, and fat grafting, with all reporting successful satisfaction and complication outcomes. Further research is necessary to properly compare these modalities. Clinician discretion should guide procedural choice until future well-controlled studies are able to provide standardized outcomes.

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“…The superficial temporal artery (STA) is an important continuation of the external carotid artery. It is divided into the frontal branch and the parietal branch at or above the zygomatic arch (1). In neurosurgical practice, the STA is an excellent donor vessel for extracranial-intracranial bypass (2).…”

Section: Introductionmentioning

confidence: 99%

Anatomical features of the superficial temporal artery in hemorrhagic moyamoya disease based on CT angiography

Hou

et al. 2020

Exp Ther Med

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The superficial temporal artery (STA) is an important continuation of the external carotid artery. It is divided into the frontal branch and the parietal branch at or above the zygomatic arch. In the present study, a comparative analysis of the STA in patients with and without moyamoya disease (MMD) was performed using CT angiography. Patients admitted to our institution for spontaneous intracranial hemorrhage were potential candidates. In general, 25 cases (50 sides) in the MMD group and 25 cases (50 sides) in the non-MMD group were selected for evaluation. The morphology of the STA when crossing the zygomatic arch, the association between the STA bifurcation and the zygomatic arch, the branching characteristics of the STA, the parameters of the STA bifurcation point, the diameter of the STA and the distance from the origin of the STA to the bifurcation point were selected for analysis. There were no significant differences between the two groups with regard to the association between the STA bifurcation and the zygomatic arch, the diameter of the STA or the distance from the origin of the STA to the bifurcation point. However, the bifurcation point of the STA was closer to the posterior edge of the mandibular condyle in the patients with MMD.Workstation and indexes measured. Raw-image CTA data were reconstructed in the Volume Rendering program of the GE Workstation (version 4.6; GE Healthcare) to observe the anatomical characteristics of the STA.Morphology of the STA when crossing the zygomatic arch. According to their morphology when crossing the zygomatic

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Surgical anatomy of the superficial temporal artery to prevent facial nerve injury during arterial biopsy

Cited by 28 publications

References 22 publications

Utilization of Intraparotid Segments of Superficial Temporal Vessels for Head and Scalp Free Flap Microanastomosis: A Clinical, Histological, and Cadaveric Study

Utilization of Intraparotid Segments of Superficial Temporal Vessels for Head and Scalp Free Flap Microanastomosis: A Clinical, Histological, and Cadaveric Study

Temporal Augmentation: A Systematic Review

Anatomical features of the superficial temporal artery in hemorrhagic moyamoya disease based on CT angiography

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