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PubMed1998

Regional peripheral vascular supply based on the superficial temporal artery in dogs and cats.

Cutaneous arterial blood supply to the temporal region was evaluated in 8 dogs and 8 cats. Subtraction radiography and angiography of the carotid and superficial temporal arteries were used in 4 dogs and 4 cats to determine arterial blood supply to the temporal region and frontalis muscle. A myocutaneous axial pattern flap based on the superficial temporal artery and frontalis muscle may be indicated for cosmetic reconstruction in dogs and cats following surgical resection of neoplastic lesions or traumatic wounds in the maxillofacial region. The frontalis muscle was identified as the thin subcutaneous continuation of the platysma muscle extending cranially and rostrally. Dissection of the temporal region in 4 dogs and 4 cats revealed the subcutaneous location of the superficial temporal artery as it continues rostrally from the caudal aspect of the zygomatic arch.

Angiography↗

PubMed1991

Temporal artery biopsy technique: a clinico-anatomical approach.

A positive temporal artery biopsy is required to conclusively establish the diagnosis of temporal arteritis. The temporal artery biopsy technique we describe is based on the anatomical branching patterns of the superficial temporal artery, the various fascial layers, and the location of the temporal branches of the facial nerve. Special emphasis is placed on avoiding facial nerve trauma during a biopsy of the frontal branch of the superficial temporal artery. Proper surgical technique combined with a working knowledge of the anatomy of the temporalis region enhances the safety of a temporal artery biopsy procedure.

Biopsy↗

PubMed1988

An interposed superficial temporal artery graft bypass for anterior cerebral artery ischemia.

A new microsurgical revascularization technique for anterior cerebral artery ischemia is reported. An arterial graft bypass interposed between the superficial temporal artery and the distal anterior cerebral artery was successfully completed in a 43-year-old male with transient ischemic attacks in the anterior cerebral artery territory. The contralateral superficial temporal artery was harvested and used as an arterial graft. Both procedures were carried out with one single transcoronal scalp incision. The patient's postoperative cerebral angiogram revealed good filling of the area distal to the stenotic lesion of the anterior cerebral artery through the bypass graft. The patient was discharged with no neurological deficit and has been free of ischemic events for more than 2 years since the surgery. If the bilateral superficial temporal arteries are fairly well developed, the ipsilateral superficial temporal artery can be used as an arterial graft for revascularization of the anterior cerebral artery territory.

Adult↗

PubMed1978

Immunological and histological study of temporal arteries.

Sixty-four temporal arteries were studied. 36 were from patients with clinically active temporal arteritis or polymyalgia rheumatica; 22 showed histological changes of temporal arteritis, 12 of which were in an active stage. 28 arteries, none of which showed histological changes, were taken at necropsy or from patients with unrelated disease. Extracellular immunoglobulin and complement deposition was seen in the artery biopsies showing active arteries and in 1 of the 10 biopsies with inactive arteritis. There was no immunoglobulin or complement deposition in the 14 patients with clinically active temporal arteritis and/or polymyalgia rheumatica, but with a normal artery biopsy. Patients with clinically active temporal arteritis were more likely to have a positive biopsy. Our results support the suggestion that the immune deposition is concurrent with an active histologically proven arteritis. Immunofluorescent examination does not appear to be a better diagnostic test than histological examination.

Aged↗

PubMed2002

Medin and medin-amyloid in ageing inflamed and non-inflamed temporal arteries.

Small amyloid deposits commonly occur along the internal elastic lamina of the temporal artery. In temporal artery biopsies from 22 patients with histological signs of giant cell arteritis and 25 without, amyloid deposits were found in 14 and 21 biopsies, respectively. Two specific peptide antisera show that this amyloid is identical to the recently identified medin-amyloid in the ageing aorta. On immunoelectron microscopy, the amyloid appeared topographically closely related to the elastic material. Furthermore, fragmented elastic material was often immunolabelled for medin and found to be engulfed by giant cells. Medin is an internal fragment of the larger precursor lactadherin and is presumably formed by specific enzymatic cleavage events. In situ hybridization showed that lactadherin is expressed locally by smooth muscle cells of the temporal artery. Given the potential role of lactadherin as a mediator for the adhesion of cells, including macrophages, to other cells or surfaces, lactadherin or its fragment medin may be important in the inflammatory process in giant cell arteritis.

Aged↗

PubMed1989

[Why perform Doppler sonography before every biopsy of the temporal artery?].

The authors present three cases of AION with suspected temporal arteritis to show why a Doppler sonographic examination should be performed prior to a biopsy of the temporal artery. In Case 1, with stenosis of the internal carotid artery, the cerebral perfusion depended, entirely on collateral circulation, the nutritive vessel of which was the temporal artery. Cases 2 and 3 illustrate a proximal stenosis of the ophthalmic artery. In these two cases the temporal artery maintained the blood supply to the eye. All these findings were obtained by Doppler sonographic examinations. Biopsy of the temporal artery, which could otherwise have caused sudden death in Case 1, or blindness in Cases 2 or 3, was therefore dispensed with.

Aged↗

PubMed1983

The therapeutic impact of temporal artery biopsy.

To evaluate the clinical usefulness of temporal artery biopsy in the diagnosis of giant-cell arteritis we followed up all 134 residents of Olmsted County, Minnesota, who had temporal artery biopsies between 1965 and 1980. Initial biopsies were positive for giant-cell arteritis in 46 cases and negative in 88. A history of jaw pain or claudication and the findings of a palpably abnormal temporal artery were significantly more common in the patients whose biopsy specimens showed giant-cell arteritis. Over a median follow-up period of 70 months (range 1-192) only 8 of the 88 biopsy-negative patients had clinical courses requiring long-term, high-dose corticosteroid therapy for giant-cell arteritis. In this population-based study temporal artery biopsy correctly predicted the subsequent need for corticosteroid therapy in 94% of cases: these findings indicate that biopsy should be done before patients are committed to long-term corticosteroid therapy.

Adrenal Cortex Hormones↗

PubMed2004

[The superficial temporal artery: anatomical type and clinical application to the flap of the fascia temporal superficialis].

The goal of our study is to assess the anatomical type of the superficial temporal artery (STA) in the black population using the classification of Ricbourg et al.. Forty-seven fresh cadavers and three extracted and frozen heads were included in this study. The external carotid artery was isolated in the neck and injected by Rhodopas stained with Congo Red. The superficial temporal artery was dissected using a Y-shaped skin incision. The last step of the procedure was to remove the flap of the fascia superficialis temporis. The third segment of the superficial temporal artery and its terminal branches were studied. This segment courses cephalad and wraps the zygomatic arcade. It splits into two terminal branches: the temporo-frontal and the temporo-parietal ones. The most important of its collaterals, the zygomato-maleus artery, plays a crucial role for distinguishing the subtypes of STA according to the classification of Ricbourg et al.. Indeed, this branch can be subdivided into two types: --type I: the zygomato-malar artery arises from the trunk of the STA; it courses perpendicular and with a slightly ascending direction; this type accounts for 93% of the cases. --type II: the zygomato-malar artery originates from the branch of the temporo-frontal artery. Its course is either horizontal or caudad. This type accounts for 3% of the cases. Our results confirm those of Ricbourg et al.. Thus, we could not CONFIRM the notion of a racial predominance of typology of the STA in our context. We did not study the dimensions of STA and also the level of its bifurcation. Indeed, it has been largely reported in the literature. These elements constitute the anatomic basis of the surgical use of temporal flaps. The vessel-containing tissue in which travels the STA forms the so-called fascia temporalis superficialis whose plasticity and polyvalency are critical during the procedures of plastic and reconstructive surgeries.

Black People↗

PubMed2005

Comparison of temporal artery thermometer to standard temperature measurements in pediatric intensive care unit patients.

OBJECTIVES: To determine the accuracy of noninvasive infrared temporal artery thermometry compared with rectal, axillary, and pulmonary artery catheter measurements in pediatric intensive care patients, and to determine whether temporal artery temperatures are affected by circulatory shock or by vasopressor use. We hypothesized that temporal artery temperatures do not differ from axillary and rectal temperatures in critically ill children, but temporal artery accuracy is decreased by shock or vasopressor use. DESIGN: Observational study, unblinded. SETTING: Pediatric intensive care unit of a quarternary referral children's hospital. PATIENTS: Seventy-five temperature comparison pairs were obtained in 44 pediatric intensive care unit patients. INTERVENTIONS: Temperature measurements were made using a temporal artery thermometer with simultaneously obtained rectal, axillary, and, when available, pulmonary artery catheter measurements. MEASUREMENTS AND MAIN RESULTS: Mean bias was calculated between comparison pairs using each temperature method. Bland-Altman analysis demonstrated wide variability between methods. No significant differences in mean bias were seen between method pairs for all temperatures, but bias was significantly less in pulmonary artery catheter-rectal pairs compared with other method pairs. In febrile (> 38 degrees C) patients, bias in rectal-temporal artery and rectal-axillary was significantly greater than in temporal artery-axillary pairs (p < .001). Mean bias in pulmonary artery catheter-rectal pairs was also significantly smaller than in other pairs for all patients (p = .008) and febrile patients (p = .049). Presence of shock or vasopressor use did not significantly increase bias in any comparison pair. Sensitivity and specificity of both temporal artery and axillary for diagnosing fever were similar and improved with fever definition at temperatures > 38.5 degrees C. CONCLUSIONS: Temporal artery and axillary temperature measurements showed variability to rectal temperatures but had marked variability in febrile children. Neither was sufficiently accurate to recommend replacing rectal or other invasive methods. As temporal artery and axillary provide similar accuracy, temporal artery thermometers may serve as a suitable alternative for patients in whom invasive thermometry is contraindicated.

Axilla↗

PubMed2000

Superficial temporal artery dilatation in a patient with infectious temporal headache clinically mimicking temporal arteritis.

A 57-year-old woman noticed a pulsatile shooting headache in her right temporal region 3 days after extraction of a tooth from the right mandible. The following day, a localized headache over the right superficial temporal artery (STA), low grade fever, and jaw claudication appeared and progressed subacutely. Seven days after the onset, magnetic resonance imaging and angiography (MRI/MRA) disclosed inflammatory swelling of the right temporal muscle and dilatation of the right STA. All the symptoms disappeared following antibiotic treatment, and neuroimaging findings were improved. In conclusion, MRA is thought to be useful to non-invasively identify reversible inflammatory dilatation of extracranial vessels.

Bacterial Infections↗

PubMed2005

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.

Dissection↗

PubMed1984

[Horton's disease: a too often delayed diagnosis. Plea for an early biopsy of the temporal artery].

The diagnosis of temporal arteritis is made after a mean delay of four months. This delay is explained by the absence, in 50% of cases, of any clinical sign in the temporal area, the possible presence of alterations in liver function tests, and the frequency of anemia and loss of weight. These signs often suggest a mistaken diagnosis of hepatobiliary disease or cancer. The authors evaluate the cost of this delay in a personal series of 33 cases confirmed histologically. They recommend biopsy of the temporal artery in each patient aged more than 70 with a marked rise in erythrocyte sedimentation rate unexplained by an infectious disease or dysglobulinemia.

Aged↗

PubMed2000

Multiple arteriosclerotic fusiform aneurysms of the superficial temporal artery--case report.

Superficial temporal artery (STA) aneurysms are very rare, and usually occur in young adult men due to blunt trauma as pseudoaneurysms. An 85-year-old male presented with two non-traumatic STA aneurysms. The aneurysms were ligated and resected. Histological examination showed arteriosclerotic fusiform aneurysm. The pathogenesis of non-traumatic aneurysm of the STA appears to be arteriosclerotic change and/or hemodynamic stress.

Aged↗

PubMed1999

Interleukin-1beta potentiates endothelin ET(B) receptor-mediated contraction in cultured segments of human temporal artery.

Segments of human temporal artery were placed in organ culture for up to 4 days and examined for endothelin ET(B) receptor activity in the presence and absence of the pro-inflammatory cytokine interleukin-1beta (IL-1beta) by in vitro pharmacology and reverse transcriptase-polymerase chain reaction (RT-PCR). The contractile effect of prostaglandin F2alpha (used as a reference), was not significantly altered by culture or IL-1beta. However, the selective ET(B) agonist sarafotoxin S6c induced no contraction in fresh arteries, but marked contraction after culture. Both maximal contraction and potency to sarafotoxin S6c were increased in segments incubated with IL-1beta . The contraction was sensitive to BQ 788 (ET(B) antagonist), but not FR 139317 (ET(A) antagonist). Actinomycin D abolished the contraction, whereas only the cytokine-induced increase in contraction was inhibited by cycloheximide. ET(A) and ET(B) receptor mRNAs were detected in all arteries; predominantly for the ET(A) receptor in fresh arteries, and for the ET(B) receptor after culture. However, there was no change in the ET(A)/ET(B) receptor mRNA ratio after treatment with IL-1beta. This suggests de novo synthesis of contractile ET(B) receptors after organ culture and that IL- 1beta may further stimulate translation of the mRNA to active receptors. The results raise the possibility that contractile ET(B) receptors may be implicated in disease states with inflammatory processes.

Cycloheximide↗

PubMed2002

The predictive value of the halo sign in color Doppler ultrasonography of the temporal arteries for diagnosing giant cell arteritis.

OBJECTIVE: The diagnosis of giant cell arteritis (GCA) usually requires a temporal artery biopsy. Recently it has been reported that a periluminal dark halo, detected by color Doppler ultrasonography (US) of the temporal arteries, is a characteristic sign of GCA. We evaluated the predictive value of this dark halo sign in diagnosing GCA. METHODS: During a period of 2 years 69 patients suspected of having GCA were examined by US of both temporal arteries. Temporal artery biopsy was performed in 32 of these patients. The diagnosis of GCA was made if a patient had a biopsy showing arteritis, or met all the following criteria: (1) American College of Rheumatology GCA classification criteria were fulfilled; (2) there was a prompt clinical response to treatment with 40-60 mg/day of prednisone; and (3) no other diagnosis related to the patient's symptoms was made during 6 month followup. RESULTS: Periluminal dark halo was observed in 24 of 69 patients. GCA was diagnosed in 12 of them, giving a positive predictive value (PPV) of only 50%. No halo was detected in 45 cases of which only 2 had GCA, resulting in a high negative predictive value (NPV) of 96%. The sensitivity and specificity of the halo sign for diagnosing GCA were 86% and 78%, respectively. CONCLUSION: The PPV of the halo sign in US of the temporal arteries is unsatisfactory for diagnosing GCA. However, the NPV is very high. Thus the lack of a halo can practically serve to rule out a diagnosis of GCA, and precludes the need for a biopsy in most instances.

Biopsy, Needle↗

PubMed1988

Giant cell inflammation compared with amyloidosis of the internal elastic lamina in temporal arteries.

Close examination of a series of temporal artery biopsy specimens provided histologic and statistical evidence that any association between the occurrence of giant cell arteritis and senile amyloidosis of the temporal artery internal elastic lamina is not direct, but is associated incidentally with old age. Substantial demographic differences between the 2 conditions were found; the prevalence of giant cell arteritis first waxed and then waned with increasing age, while rates for senile amyloidosis of the temporal artery progressed steadily toward 100% in the ninth decade of life.

Adult↗

PubMed2006

[Microvascular nasal repair using a reversed superficial temporal artery auricular flap.].

OBJECTIVE: A reversed superficial temporal artery auricular flap was presented to explore a new method for reconstructing the defects of the distal nose by microsurgical techniques. METHODS: A reversed superficial temporal artery auricular flap had been used on fifteen patients with nasal defects, including thirteen patients with alar defects and two patients with nasal tip defects. The reversed superficial temporal vessels of the flap were anastomosed with the recipient facial vessels. The size of the flap was 2.5 cm x 2. 0 cm - 4.0 cm x 2.5 cm, the length of the vascular pedicle was 5 - 8 cm, average 6.5 cm RESULTS: The flap survived uneventfully in all fifteen patients. RESULTS: demonstrated satisfactory symmetry between the reconstructed ala and the contralateral side as well as an excellent tip projection. The donor-site defect was minimal. CONCLUSIONS: The reversed superficial temporal artery auricular flap offers an adequate length of vascular pedicle of the flap, it delivers a good solution to the problem of the vascular pedicle shortage of the proximal superficial artery auricular flap. This technique may become the top choice in the microvascular auricular transfer.

Adult↗

PubMedDate not supplied

Arterial occlusion following anastomosis of the superficial temporal artery to middle cerebral artery.

Symptoms of cerebral ischemia following superficial temporal artery (STA) to middle cerebral artery (MCA) anastomosis are uncommon and are usually related to impaired flow through the anastomosis or occlusion of the cortical receptor artery. In this report, 3 patients are described who developed symptoms of cerebral ischemia after surgery despite a widely patent anastomosis. In each patient, postoperative angiography revealed occlusion of a previously demonstrated high-grade stenosis of the intracranial internal carotid artery (ICA) or MCA. Occlusion of the stenotic artery was probably related to decreased velocity of blood flow through the narrowed vessel resulting from alterations in flow patterns following anastomosis.

Brain Ischemia↗