Superficial temporal artery as an external landmark for deeper-lying brain structures.

Area of Science:

• Neurosurgery
• Anatomy
• Surgical Navigation

Background:

• Accurate localization of intracranial structures is crucial for neurosurgical procedures.
• Identifying reliable superficial landmarks can aid in pre-operative planning and intra-operative guidance.

Purpose of the Study:

• To assess the utility of the superficial temporal artery (STA) as an external anatomical landmark for deeper brain structures.
• To quantify the spatial relationships between the STA and key intracranial targets.

Main Methods:

• Latex injection of the STA in 13 adult cadavers (26 sides).
• Dissection to skeletonize the STA and its frontal and parietal branches.
• Craniectomies and dural excision to expose underlying brain structures.
• Measurements between STA branches and intracranial landmarks (e.g., Sylvian fissure, central sulcus, foramen of Monro).

Main Results:

• The STA bifurcated approximately 3 cm superior to the tragus, often at the level of the middle cranial fossa floor or superior temporal gyrus.
• The Sylvian fissure was located ~2 cm superior to the STA bifurcation.
• The frontal branch's angle relative to the zygomatic arch was ~37 degrees; frontal and parietal branches formed an ~87-degree angle.
• Key intracranial structures like the frontal pole, temporal tip, foramen of Monro, and central sulcus were consistently located at measurable distances anterior or posterior to specific STA branches.

Conclusions:

• The superficial temporal artery and its branches provide consistent and measurable external landmarks for neurosurgical localization.
• Palpation or Doppler identification of the STA can be a valuable adjunct for mapping deeper brain structures, enhancing surgical precision.