Using the Frontal Branch of the Superficial Temporal Artery as a Landmark for Locating the Course of the Temporal Branch of the Facial Nerve during Rhytidectomy: An Anatomical Study

BACKGROUND: Previous studies have proposed that the frontal branch of the superficial temporal artery could be used to determine the course of the temporal branch of the facial nerve; however, these studies have not documented this relationship. The objective of this study was to thoroughly examine the courses of the frontal branch and temporal branch in the temporal region and to describe their relationship in detail. The operating technique used to avoid damaging the temporal branch in the rhytidectomy also is discussed. METHODS: An anatomical study was performed on 30 temporoparietal regions from 10 fixed adult cadavers and five fresh cadavers. Twenty halves of head-vascular-cast specimens also were observed. RESULTS: Depending on whether the bifurcation point of the superficial temporal artery is superior or inferior to the horizontal line of the superior orbital rim, the frontal branch can be classified as having a high-location or low-location type. The temporal branch and its terminal twigs run deeper into the superficial temporal fascia and are inferior to the frontal branch in the high-location type. In the low-location type, one or more terminal twigs of the temporal branch interweave with the frontal branch above the horizontal plane of the upper orbital rim and terminate below the frontal eminence. The temporal branch locates within a triangular area formed by the lower aspect of the zygomatic arch, the frontal branch, and the vertical line where it crosses the highest point of the frontal eminence CONCLUSION: The frontal branch can be the anatomical landmark used to locate and protect the temporal branch during rhytidectomy.