Anatomy of the superficial temporal artery and its branches: its importance for surgery

The temporoparietal, parieto-occipital flaps or the forehead flaps that are used in reconstructive surgery are prepared on the superficial temporal artery (STA) and its branches. For a successful surgery and a suitable flap design, adequate anatomical knowledge is needed. In our study, the red colored latex solution was injected into the external carotid artery; the STA and its branches were dissected in 27 specimens. The mean diameter of the STA at the zygomatic arch was determined as 2.73+/-0.51 mm. The diameters of the frontal branch were bigger than those of the parietal branch in 15 samples out of 27. The diameters of both the frontal and parietal branches were equal in four samples. The diameter of the parietal branch was bigger than that of the frontal branch in eight samples. In 20 samples out of 27 (74.07%), the bifurcation point of the STA was above the arch. In six samples (22.22%), the STA bifurcated directly over the arch. In only one sample (3.70%), bifurcation was not observed and the STA continued only as a frontal branch (absence of the parietal branch). The absence of the frontal branch was not encountered. In one sample (3.70%), double parietal branches were observed. In six samples out of 27 (22.22%), zygomatico-orbital artery was not encountered. In 21 samples (77.77%), zygomatico-orbital arteries ran towards the face, parallel to zygomatic arch and distributed in the orbicularis oculi muscle. The transverse facial artery existed in all samples. The auricular branches running to the helix and tragus were observed in all samples. The STA was 16.68+/-0.35 mm at the front of the tragus. Some landmarks were chosen on the head and then the STA was observed where it crossed all of these landmarks. This paper confirms the well-known variability of the superficial temporal arterial branches and their relation to the pericranial region. Knowledge concerning the arterial features of the lateral forehead region is important for the aesthetic surgeon. STA and its branches have been found to be suitable for use in microvascular anastomoses. A better understanding of the midline forehead vascularity should allow modification of reconstructive techniques and reduce postoperative complications.