C. D. Liao1, S. Svoboda1, M. Applebaum1,2, J. Thompson1,2 1Virginia Tech Carilion School of Medicine,Roanoke, VA, USA 2Carilion Clinic,Department Of Plastic And Reconstructive Surgery,Roanoke, VA, USA
Introduction:
In head and neck reconstruction, the superficial temporal artery (STA) and vein are often the first-choice recipient vessels for tissue flaps. Thorough understanding of STA anatomy and variability is crucial for avoiding surgical complications.
To date, no study has determined the influence of patient characteristics such as ethnicity, age, and sex on anatomical variations in the STA, underscoring a need to record these data in future studies. Additionally, study designs of reports documenting STA anatomy vary considerably. Therefore, more robust and comprehensive studies are necessary to accurately capture STA anatomy, enable more skillful dissections, and minimize complications.
A comprehensive review of the current literature offers an appropriate starting point. This study aims to provide surgeons with accurate and reliable measurements of STA architecture to promote safe dissection.
Methods:
We screened 1,105 studies by title/abstract. We consolidated data from 16 primary reports, all of which were examined for study design, patient characteristics, and relevant anatomical data.
Results:
The 16 studies represent patient populations in 11 different countries and yielded a total of 961 STAs for analysis. About half of the studies were cadaveric; the other half were angiographic. The male-to-female ratio is 57:43 among the studies that specified these details (N = 343 subjects). On average, only about 6 out of 16 of the studies documented important patient descriptors such as health status, sex, ethnicity, and age.
About 98% of STAs were reported to have two branches. About 74% of STAs bifurcated above the zygomatic arch; furthermore, we discovered considerable variation in the level of bifurcation among the 16 studies. Forest plots demonstrated that the average diameters of the STA, frontal branch, and parietal branch differ significantly from the pooled average in all categories, indicating cross-study inconsistencies. The pooled average diameters of the STA, frontal branch, and parietal branch were 2.03 ± 0.09 mm, 1.53 ± 0.06 mm, and 1.48 ± 0.06 mm, respectively. Distance of the STA anterior to the pinna was also inconsistent among the 3 studies that reported this information; the pooled average was 1.46 ± 0.12 cm. Comparing radiologic and cadaveric studies demonstrated significant differences in reported parietal and frontal artery diameters, but no differences in STA diameter, level of bifurcation, and number of branches.
Conclusion:
This meta-analysis provides a necessary first step in revisiting anatomical architecture and variability of the STA, which can promote positive outcomes for patients requiring flaps for head and neck reconstruction. Future work will entail collection of anatomical data with consistent documentation of patient characteristics.