Abstract
The superficial temporal artery (STA) is a terminal branch of the external carotid artery. It is commonly described as coursing posterior to the mandibular condyle and over the posterior zygomatic root (PZR) and then dividing terminally into parietal and frontal branches. However, possible variations of the main trunk of the STA have seemingly been overlooked. This study retrospectively examined the archived head tomography angiograms of 43 patients to determine the morphology and topography of the STA prior to its terminal bifurcation. In 79% of patients, the STA topography related to the mandibular condyle was bilaterally symmetrical, either retrocondylar (65.1%) or laterocondylar (13.6%). The parietal branch was sometimes absent unilaterally (16.3%) or bilaterally (9.3%). In 2/43 cases, the frontal branch of the STA was unilaterally absent. When both terminal branches were present, the bifurcation was retrocondylar or immediately above the PZR when on the PZR, or the terminal division of the STA was high above the PZR. In 88.4% of the STAs, different patterns of kinking and coiling were documented, including retrocondylar kinks (27.9%), laterocondylar kinks (20.9%), kinks placed on the PZR (81.4%) and variably oriented suprazygomatic kinks (32.6%). Five of the 86 STAs were coiled, one retrocondylar, one laterocondylar, and three other placed on the PZR. Two cases showed unilateral pseudoaneurysms of the STA, one above the PZR and the other on the temporomandibular joint. The STA is surgically important; therefore, the number of anatomical studies of the STA should increase.
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References
Bergman RA, Tubbs RS, Shoja MM, Loukas M (2016) Bergman’s comprehensive encyclopedia of human anatomic variation. Wiley, Hoboken
Fujimoto K, Kubo Y, Koji T, Yoshida J, Yoshida K, Ishigaki D, Sasou M, Yoshida Y, Ogasawara K (2019) A case of ipsilateral superficial temporal artery-interposed graft using contralateral superficial temporal artery-ipsilateral middle cerebral artery bypass and trapping for a traumatic middle cerebral artery aneurysm formed after repeated craniotomies. No Shinkei Geka 47:683–687. https://doi.org/10.11477/mf.1436204004
Galkin P, Gushcha A, Chechetkin A, Krotenkova I (2017) Superficial temporal artery to middle cerebral artery bypass with interposed saphenous vein graft in patients with atherosclerotic internal carotid artery occlusive disease and impaired cerebral hemodynamics. J Neurosurg Sci 61:22–32. https://doi.org/10.23736/S0390-5616.16.03234-3
Gray H, Standring S, Anand N, Birch R, Collins P, Crossman A, Gleeson M, Jawaheer G, Smith AL, Spratt JD, Stringer MD, Tubbs SR, Tunstall R, Wein AJ, Wigley CB (2016) Gray’s anatomy: the anatomical basis of clinical practice, 41st edn. Elsevier, London
Horvath M, Pasztor E, Vajda J, Nyary I (1982) Posterior fossa revascularization by superficial temporal artery (STA)–superior cerebellar artery (SCA) anastomosis. Acta Neurochir (Wien) 66:43–53. https://doi.org/10.1007/BF01809302
Ishii R, Koike T, Takeuchi S, Ohsugi S, Tanaka R, Konno K (1983) Anastomosis of the superficial temporal artery to the distal anterior cerebral artery with interposed cephalic vein graft. Case report. J Neurosurg 58:425–429. https://doi.org/10.3171/jns.1983.58.3.0425
Iwata Y, Mizuta T, Takemoto O, Shimizu K, Nakatani S (1988) An interposed superficial temporal artery graft bypass for anterior cerebral artery ischemia. Microsurgery 9:14–17. https://doi.org/10.1002/micr.1920090105
Marano SR, Fischer DW, Gaines C, Sonntag VK (1985) Anatomical study of the superficial temporal artery. Neurosurgery 16:786–790. https://doi.org/10.1227/00006123-198506000-00008
Osborn AG (1999) Diagnostic cerebral angiography, 2nd edn. Lippincott Williams & Wilkins, Philadelphia
Paulsen F, Tillmann B, Christofides C, Richter W, Koebke J (2000) Curving and looping of the internal carotid artery in relation to the pharynx: frequency, embryology and clinical implications. J Anat 197(Pt 3):373–381. https://doi.org/10.1046/j.1469-7580.2000.19730373.x
Pinar YA, Govsa F (2006) Anatomy of the superficial temporal artery and its branches: its importance for surgery. Surg Radiol Anat 28:248–253. https://doi.org/10.1007/s00276-006-0094-z
Rusu MC, Maru N, Radoi PM, Dinca D (2019) Trifurcated external carotid artery and complete gamma-loop of its maxillary branch. Surg Radiol Anat 41:231–234. https://doi.org/10.1007/s00276-018-2142-x
Sharma A, Tyagi G, Sahai A, Baijal SS (1991) Traumatic aneurysm of superficial temporal artery. CT demonstration. Neuroradiology 33:510–512. https://doi.org/10.1007/BF00588042
Shin KJ, Shin HJ, Lee SH, Koh KS, Song WC (2018) Surgical anatomy of the superficial temporal artery to prevent facial nerve injury during arterial biopsy. Clin Anat 31:608–613. https://doi.org/10.1002/ca.23033
Stock AL, Collins HP, Davidson TM (1980) Anatomy of the superficial temporal artery. Head Neck Surg 2:466–469. https://doi.org/10.1002/hed.2890020604
Takeuchi S, Koike T, Tanaka R (1997) Anastomosis of the superficial temporal artery to the middle cerebral artery with the interposed occipital artery graft in moyamoya disease: case report. Surg Neurol 48:615–619. https://doi.org/10.1016/s0090-3019(97)00015-3
Tayfur V, Edizer M, Magden O (2010) Anatomic bases of superficial temporal artery and temporal branch of facial nerve. J Craniofac Surg 21:1945–1947. https://doi.org/10.1097/SCS.0b013e3181f4ee6a
Tubbs RS, O’Neil JT Jr, Key CD, Zarzour JG, Fulghum SB, Kim EJ, Lyerly M, Shoja MM, Salter EG, Oakes WJ (2007) Superficial temporal artery as an external landmark for deeper-lying brain structures. Clin Anat 20:498–501. https://doi.org/10.1002/ca.20363
Zenteno M, Vinuela F, Moscote-Salazar LM-SR, Alvis-Miranda H, Zavaleta R, Flores A, Rojas A, Lee A (2014) Clinical implications of internal carotid artery tortuosity, kinking and coiling: a systematic review. Romanian Neurosurg 21:50–59
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MCR: protocol/project development, data analysis, documented specific literature, approved the final version of the manuscript. AMJ: documented specific literature, reviewed the manuscript. PMR: data collection and management, manuscript writing.
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Rusu, M.C., Jianu, A.M. & Rădoi, P.M. Anatomic variations of the superficial temporal artery. Surg Radiol Anat 43, 445–450 (2021). https://doi.org/10.1007/s00276-020-02629-x
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DOI: https://doi.org/10.1007/s00276-020-02629-x