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CC BY-NC-ND 4.0 · Asian J Neurosurg
DOI: 10.1055/s-0045-1809324
Original Article

The Course of the Main Trunk and Parietal Branch of the Superficial Temporal Artery for a Pterional Scalp Flap with Superficial Temporal Artery Preservation: Cadaveric and Clinical Study

Nattamon Suanchan
1   Division of Neurosurgery, Department of Surgery, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
,
Kitiporn Sriamornrattanakul
1   Division of Neurosurgery, Department of Surgery, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
,
Thirawass Phumyoo 
2   Division of Anatomy, Department of Basic Medical Science, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
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Abstract

Background

The pterional incision is usually performed near the course of the superficial temporal artery (STA), which carries a risk of injury to a branch or even the main trunk of the STA (mSTA). In this study, we assessed the usual course of the mSTA and its parietal branch of the STA (pSTA) and evaluated the efficacy of a modified pterional scalp incision for the preservation of all STA branches.

Materials and Methods

Sixteen sides of cadaveric heads were dissected to study the location and paths of the mSTA and pSTA in the vicinity of the ear cartilage and the oculomeatal (OM) line. We also performed a clinical study of 31 patients who underwent pterional craniotomy using the modified pterional scalp incision. Postoperative STA preservation was retrospectively evaluated.

Results

The mean distances between the mSTA and the anterior edge of the ear cartilage were 0.5 and 0.6 mm. The mean angle of the pSTA axis was 88.3 degrees (range 75–95 degrees) from the OM line. Among the patients treated using the modified pterional scalp incision, the mSTA, the pSTA, and the frontal branch of the STA (fSTA) were preserved within the scalp flap in 93.5, 96.7, and 88.9%, respectively.

Conclusion

The mSTA was found to pass very close to the ear cartilage, while the axis of pSTA coursed approximately perpendicular to the OM line. To preserve all branches of the STA, the pterional skin incision should begin just anterior to the ear cartilage and then curve slightly to the posterior above the pinna.

Keywords

main trunk of STA - parietal branch of STA preservation - pterional craniotomy - pterional scalp flap - pterional scalp incision - superficial temporal artery preservation

Authors' Contributions

N.S., K.S., and T.P. were actively involved in the conception and design of the study, as well as in the acquisition, analysis, and interpretation of data. They collaboratively contributed to drafting the manuscript. Additionally, K.S. undertook the critical revision of the article, reviewed the submitted version, and provided overall supervision throughout the study.


Ethical Approval

The study was approved by the Institutional Review Board of the Faculty of Medicine Vajira Hospital. COA no. was 084/2567.




Publication History

Article published online:
20 May 2025

© 2025. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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