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Safe Zones for Temporal Muscle Hook Retraction: A Technical Note.

Matías Baldoncini¹, Amparo Saenz², Juan F Villalonga³

¹Laboratory of Microsurgical Neuroanatomy, Second Chair of Gross Anatomy, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

World Neurosurgery

|July 1, 2020

Summary

This summary is machine-generated.

This study identifies safe zones for temporal muscle (TM) hook retraction during cranial surgery. These zones help surgeons avoid damaging the posterior deep temporal artery (PDTA), preserving TM integrity.

Keywords:

Anatomical study Muscular vascularization Surgical technique Temporal retraction

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Area of Science:

Neurosurgery
Anatomy
Surgical Technique

Background:

The temporal muscle (TM) is critical in anterolateral cranial approaches.
Preserving TM integrity is vital for functional and cosmetic outcomes.
Limited guidance exists on safe hook retraction techniques for the TM.

Purpose of the Study:

To anatomically study the vascularization of the temporal muscle (TM).
To establish safe areas for muscular hook retraction during anterolateral cranial approaches.
To prevent direct vascular damage to the posterior deep temporal artery (PDTA) during TM retraction.

Main Methods:

Dissection of 16 temporal muscles (TMs) in 8 cadaveric heads.
Measurement of distances between the posterior deep temporal artery (PDTA) branches and anatomical landmarks (frontozygomatic suture, external auditory meatus).
Identification of safe zones for surgical hook placement.

Main Results:

The anterior branch of the PDTA was, on average, 19.5 mm from the frontozygomatic suture.
The posterior branch of the PDTA was, on average, 37.1 mm from the external auditory meatus.
Two safe zones for hook placement were defined: anteriorly 14 mm posterior to the frontozygomatic suture, and posteriorly 30 mm anterior to the external auditory meatus.

Conclusions:

Two safe zones for temporal muscle (TM) hook placement were established.
These zones aim to prevent direct vascular injury to the posterior deep temporal artery (PDTA).
This research aids in preserving TM integrity during anterolateral cranial approaches.