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Zig-Zag Incision for Temporal Artery Biopsy: Technique and Rationale
Grant Slagle1, Mont J Cartwright2
1Department of Ophthalmology, HCA Florida Bayonet Point Hospital, Hudson.
Ophthalmic Plastic and Reconstructive Surgery
|July 3, 2025
Summary
A novel zig-zag incision technique for temporal artery biopsy (TAB) improves diagnostic yield by increasing biopsy length while minimizing scalp scarring, particularly benefiting female patients with giant cell arteritis.
Area of Science:
- Vascular Surgery
- Rheumatology
- Dermatology
Background:
- Giant cell arteritis (GCA) diagnosis relies on temporal artery biopsy (TAB).
- Women with GCA often have shorter TAB lengths due to scarring concerns.
- Reduced biopsy length can impact diagnostic accuracy.
Purpose of the Study:
- To describe a zig-zag incision technique for TAB.
- To improve intraoperative exposure and increase TAB length.
- To minimize the risk of post-TAB scalp scarring.
Main Methods:
- A zig-zag incision was made posterior to the temporal hairline.
- Dissection extended to the superficial temporal fascia for artery identification.
- A retrospective analysis of 13 TABs from 11 patients was conducted.
Main Results:
- The zig-zag incision provided excellent exposure without increasing overall incision length.
- Mean TAB length was 4.8 ± 0.8 cm.
- No postoperative complications or significant scarring were reported, with excellent cosmetic outcomes.
Conclusions:
- The zig-zag incision technique for TAB is safe and effective.
- This method enhances cosmetic results and biopsy length.
- It addresses concerns about scarring, potentially improving diagnostic yield in GCA patients.
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