What is the anatomy of the superficial temporal artery relevant to temporal artery biopsy?

Updated: Sep 04, 2018
  • Author: Andrew A Winkler, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Answer

The superficial temporal artery is the smaller of 2 terminal branches of the external carotid. It begins behind the mandibular ramus in the substance of the parotid gland and courses superiorly over the posterior aspect of the zygoma. It can be consistently palpated in this region just anterior to the tragus. Approximately 5 cm above the zygoma, it divides into a frontal and parietal branch.

As it crosses the zygomatic process, it is covered by the auricularis anterior muscle, which can aid in identifying the vessel. The superficial temporal artery runs within the superficial temporal fascia, also known as the temporoparietal fascia. This is also the fascia within which the temporal branch of the facial nerve traverses. As the vessel travels superiorly, it is crossed at the level of the lobule by the temporal and zygomatic branches of the facial nerve, which are traveling medially. Safe dissection within the substance of the temporoparietal fascia is permitted because of the divergent course of the vessel from the facial nerve.

While the superficial temporal artery crosses the posterior zygoma and continues posteriorly, the temporal branch of the facial nerve crosses the zygoma in the middle third and courses anteriorly to innervate the frontalis muscle.

Throughout its course, the artery is accompanied by the auriculotemporal nerve, which lies immediately posterior to it, as well as the superficial temporal vein, which lies anterior to the artery. The superficial temporal artery may be safely ligated because of anastomoses with the supraorbital artery of the internal carotid artery, among others. The video below demonstrates relevant anatomy.

Anatomy of the superficial temporal artery.

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