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Anteromesial Temporal Lobectomy for Medically Intractable Temporal Lobe Epilepsy: An Operative Study

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Superficial Temporal Artery Biopsy Incision Optimization: An Anatomical Study.

Alexander R Engelmann¹, Nicole P Rebollo, Suraj Bala

¹Cleveland Clinic Foundation, Cole Eye Institute, Cleveland, Ohio, U.S.A.

Ophthalmic Plastic and Reconstructive Surgery

|September 11, 2025

Summary

This summary is machine-generated.

This study maps the superficial temporal artery (STA) course in cadavers to guide biopsies. The STA is reliably found near the helix root, aiding surgeons in nonpalpable cases.

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Area of Science:

Anatomy
Surgical Anatomy
Vascular Anatomy

Background:

Temporal artery biopsy is crucial for diagnosing giant cell arteritis.
Palpating the superficial temporal artery (STA) can be difficult, complicating biopsy.
Accurate anatomical knowledge is vital for safe and effective temporal artery biopsy.

Purpose of the Study:

To delineate the anatomical course of the superficial temporal artery (STA).
To determine the optimal incision site for temporal artery biopsy when the pulse is not palpable.
To minimize iatrogenic injury to surrounding structures, particularly the facial nerve.

Main Methods:

Anatomical dissection of 12 fresh adult cadaver heads.
Injection of red neoprene latex to visualize the STA.
Standardized coronal incisions and analysis of STA location on a grid system.

Main Results:

The STA consistently crossed the coronal incision line within 45 mm of the helix root.
The STA was located within a specific 5x5 mm area (10-15 mm cranial, 5-10 mm anterior to the incision) in 68.4% of specimens.
In all cases, the STA was found within 7 mm of this optimal location.

Conclusions:

The STA can be reliably located for biopsy with a specific incision strategy.
An incision starting 5 mm anterior and 5 mm cranial to the helix root is recommended.
This approach, angled posteriorly and cranially, aids in safely encountering the STA and avoiding facial nerve injury.