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The Course of the Main Trunk and Parietal Branch of the Superficial Temporal Artery for a Pterional Scalp Flap with Superficial Temporal Artery Preservation: Cadaveric and Clinical Study

  • 0Division of Neurosurgery, Department of Surgery, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.
Asian Journal of Neurosurgery +

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August 25, 2025

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August 25, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

A modified pterional incision effectively preserves superficial temporal artery (STA) branches during surgery. This technique, starting anterior to the ear, minimizes risks associated with standard pterional approaches.

Area Of Science

  • Neurosurgery
  • Anatomy

Background

  • The pterional incision, commonly used in neurosurgery, risks injury to the superficial temporal artery (STA).
  • Understanding the precise anatomical course of the main trunk (mSTA) and parietal branch (pSTA) is crucial for surgical safety.

Purpose Of The Study

  • To assess the anatomical course of the mSTA and pSTA relative to surgical landmarks.
  • To evaluate the effectiveness of a modified pterional scalp incision in preserving all STA branches.

Main Methods

  • Cadaveric dissection of 16 heads to map mSTA and pSTA paths near the ear cartilage and oculomeatal (OM) line.
  • Clinical evaluation of 31 patients undergoing pterional craniotomy with a modified incision, assessing postoperative STA preservation.

Main Results

  • The mSTA runs very close to the ear cartilage (mean distance 0.5-0.6 mm).
  • The pSTA axis is nearly perpendicular to the OM line (mean angle 88.8°).
  • The modified incision preserved mSTA, pSTA, and frontal branch (fSTA) in 93.5%, 96.7%, and 88.9% of patients, respectively.

Conclusions

  • The anatomical findings highlight the proximity of STA branches to the standard pterional approach.
  • A modified pterional incision, initiated anterior to the ear and curving posteriorly, enhances the preservation of superficial temporal artery branches.

Keywords:

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