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DOI 10.1007/s00276-006-0094-z
O R I GI N A L A R T IC L E
Received: 5 May 2005 / Accepted: 12 January 2006 / Published online: 28 March 2006
Springer-Verlag 2006
Introduction
The supercial temporal artery (STA) is one of the
terminal branches of the external carotid artery. It
begins in the parotid gland behind the mandible and
crosses the posterior root of the zygomatic process of the
temporal bone [1, 4, 9, 12, 16]. Then, above the zygomatic process, it divides into an anterior frontal and a
posterior parietal branch [5, 15, 18, 19].
The STA supplies the face and scalp together with
some branches of the external carotid artery. As the face
is an aesthetic region, its deformation should be repaired
with the most suitable tissue. The scalp is popular
because it is suitable and near the face [1, 3, 8, 10]. For
this reason, knowing that the STA and its branches
supply the scalp and anastomose with the other arteries
is important.
The temporoparietal, parieto-occipital or the forehead aps that are used in reconstructive surgery are
prepared on the STA and its branches. It has been
reported that these aps are used for the treatment of
baldness and for the recovery of the defect of face and
scalp [3, 7, 14, 21]. In addition, the distance between the
STA and tragus is important for designing the preauricular aps [13]. The STA or its branches are also used
as an interposed artery graft for extracranial to intracranial vascular anastomoses [2, 6, 17, 20].
249
Fig. 1 The course of the STA and its branches. We used some
landmarks on the head (A, B, C, D, F points). Straight lines joined
these points (AB, AC and AD). Line DF, according to Juris
original ap, begins at the point 2 cm above the ear, and is directed
anterosuperiorly 45 above line AD to the anterior hairline. The F
point was over the anterior hairline. The course of the STA and its
branches were dened according to these lines and points.
Bifurcation of the STA above the zygomatic arch
Mean (extremes)
Right side
Left side
2.730.51 mm (1.823.70)
2.140.54 mm (1.203.70)
1.810.45 mm (1.12.75)
80.075.14 mm (6587)
81.765.29 mm (66.288)
20.010.54 mm
83.624.66 mm (7290)
11.047.75 mm (233.3)
2.660.58
2.130.57 mm
1.760.52 mm
80.384.09 mm
81.955.44 mm
2.700.44 mm
2.140.54 mm
1.840.40 mm
79.746.23 mm
81.565.35 mm
85.173.47 mm
11.658.31 mm
82.035.33 mm
10.437.43 mm
250
Results
The diameters of the STA at the level of the zygomatic
arch and the diameters of the terminal branches at the
point 1 cm from bifurcation were measured. The mean
diameter of the STA at the zygomatic arch was
determined as 2.730.51 mm. It was determined
as 2.140.54 mm for the frontal branch, and as
1.810.45 mm for the parietal branch. The measurements of STA and its branches have been given in
Table 1. There were no signicant dierences between
the vessel diameters of the right and left sides in any
subject (P>0.05).
The diameters of the frontal branch were bigger than
those of the parietal branch in 15 samples out of 27
(Fig. 2). The diameters of both the frontal and parietal
branches were equal in 4 samples out of 27 (Fig. 3). The
diameters of the parietal branch were bigger than those
of the frontal branch in eight samples. In 6 out of 27
(22.22%), the diameters of the parietal branch were
thinner than 1.5 mm. The samples with a diameter of
less 1.5 mm were dened as thin parietal branches.
Three of these six samples were observed on the left side,
251
the STA was over the arch (22.22%). The artery going to
the lobule of the auricle was seen in only 10 samples
(37.03%). The helical artery anastomosed with the posterior auricular artery by its subbranches (Figs. 1, 2, 3).
AB line
252
Discussion
Microsurgical procedures in the treatment of lateral
forehead region disorders demand detailed description
of all pericranial structures [1, 4, 7, 14, 17, 21]. Many
authors have published anatomical studies of the STA
and its distribution area [1, 4, 9, 12, 15, 19]. For a successful surgery and a suitable ap design, adequate
anatomical knowledge is necessary. When the ap is
raised at the temporoparietal area, the aesthetic defect is
minimized because the hair covers the donor site.
Table 2 Bifurcation point of the STA in literature
Position of the
bifurcation point
of the STA
according to authors
Above the
zygomatic
arch (%)
Over the
zygomatic
arch (%)
Below the
zygomatic
arch (%)
Stock [19]
Marano [12]
Abul-Hassan [1]
Czerwinski [5]
Chen [4]
Magden [11]
Sahinoglu [16]
Strauch [18]
Atamaz Pinar
60
88
80
62.5
86.5
80
61
80
74.07
32
4
26
3.8
10
14
22.22
8
4
11.5
9.6
8
7
253
Table 3 Diameters of the STA,
frontal branch and parietal
branch (mm)
Authors
STA
Frontal branch
Parietal branch
1.890.68
2.030.33
2.2 (15)
1.82.7
2.140.45
2.9 (24.1)
1.82.7
2.730.51 (1.823.7)
1.380.4
1.740.51
1.610.19
2.1 (0.83.1)
2.140.54 (1.23.7)
1.290.5
1.830.34
1.680.21
2.1 (0.93.1)
1.810.45 (1.12.75)
References
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anatomy and blood supply of the fascial layers of the temporal
region. Plast Reconstr Surg 77(1):728
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(2004) Proximal supercial temporal artery to proximal middle
cerebral artery bypass using a radial artery graft: an anatomic
approach. Neurosurg Rev 27:185188
3. Chang KP, Lai CS, Tsai CC, Lin TM, Lin SD (2003) Total
upper lip reconstruction with a free temporal scalp ap: longterm follow-up. Head Neck 25(7):602605
4. Chen TH, Chen CH, Shyu JF, Wu CW, Lui WY, Liu JC (1999)
Distribution of the supercial temporal artery in the Chinese
adults. Plast Reconstr Surg 104(5):12761279