J Korean Med Sci.  2010 Apr;25(4):517-522. 10.3346/jkms.2010.25.4.517.

Anatomical Consideration of the Anterior and Lateral Cutaneous Nerves in the Scalp

• Jeong SM
• Park KJ
• Kang SH
• Shin HW
• Kim H
• Lee HK
• Chung YG

• KMID: 1792917
• DOI: http://doi.org/10.3346/jkms.2010.25.4.517

Abstract

To better understand the anatomic location of scalp nerves involved in various neurosurgical procedures, including awake surgery and neuropathic pain control, a total of 30 anterolateral scalp cutaneous nerves were examined in Korean adult cadavers. The dissection was performed from the distal to the proximal aspects of the nerve. Considering the external bony landmarks, each reference point was defined for all measurements. The supraorbital nerve arose from the supraorbital notch or supraorbital foramen 29 mm lateral to the midline (range, 25-33 mm) and 5 mm below the supraorbital upper margin (range, 4-6 mm). The supratrochlear nerve exited from the orbital rim 16 mm lateral to the midline (range, 12-21 mm) and 7 mm below the supraorbital upper margin (range, 6-9 mm). The zygomaticotemporal nerve pierced the deep temporalis fascia 10 mm posterior to the frontozygomatic suture (range, 7-13 mm) and 22 mm above the upper margin of the zygomatic arch (range, 15-27 mm). In addition, three types of zygomaticotemporal nerve branches were found. Considering the superficial temporal artery, the auriculotemporal nerve was mostly located superficial or posterior to the artery (80%). There were no significant differences between the right and left sides or based on gender (P>0.05). These data can be applied to many neurosurgical diagnostic or therapeutic procedures related to anterolateral scalp cutaneous nerve.

Keyword

Anatomy; Auriculotemporal Nerve; Supraorbital Nerve; Supratrochlear Nerve; Zygomaticotemporal Nerve

MeSH Terms

Adult
Aged
Aged, 80 and over
*Cadaver
Female
Frontal Bone/anatomy & histology
Humans
Male
Middle Aged
Neurosurgical Procedures
Orbit/anatomy & histology
Peripheral Nerves/*anatomy & histology
Scalp/*innervation
Zygoma/anatomy & histology

Figure

• 

  Fig. 1 Schematic drawings of the reference points and bony landmarks. (A) Reference points of the supraorbital and supratrochlear nerves. a, midline; b, supraorbital upper margin. (B) Reference points of the zygomaticotemporal and auriculotemporal nerves. a, frontozygomatic suture; b, upper margin of the zygomatic arch; c, lamina trigi; d, the point from which the zygomaticotemporal nerve exits from the deep temporalis fascia; e, the auriculotemporal nerve at its exit point; line a-d, the distance from the zygomaticofrontal suture to the zygomaticotemporal nerve; line b-d, the distance from the zygomaticotemporal nerve to the zygomatic arch upper margin; line b-e, the distance from the upper margin of the zygomatic arch to the auriculotemporal nerve at its exit point; line c-e, the distance from the auriculotemporal nerve at its exit point lamina trigi. (C) Schematic drawings of the relationship between the skin area innervated by each nerve and the subcutaneous nerve location.

• 

  Fig. 2 Photographs of the supraorbital and supratrochlear nerve (A, B). Cadaveric photographs showing the supraorbital nerve (1) and supratrochlear nerve (2). Supraorbital rim upper margin was drawn as a dotted line. M, midline; SOF, supraorbital foramen.

• 

  Fig. 3 Photograph of zygomaticotemporal nerve and schematic drawings of the zygomaticotemporal nerve branches. (A) Cadaveric photographs showing the zygomaticotemporal nerve (1) and the frontozygomatic suture (2), (B) The nerve is classified into three types depending on the branch pattern. T, temporalis muscle.

• 

  Fig. 4 Photograph of auriculotemporal nerve and schematic drawings of the relationship between the auriculotemporal nerve and the superficial temporal artery. (A) Cadaveric photographs showing the auriculotemporal nerve (1) and superficial temporal artery (2), (B) Schematic drawing of the relationship between the auriculotemporal nerve and the superficial temporal artery. Type I, The nerve runs posterior to the artery; Type II, The nerve runs anterior to artery; Type III, The nerve runs superficially parallel to the artery. A, artery; N, nerve, Ant, anterior, Post, posterior.

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