Anat Cell Biol.  2016 Dec;49(4):273-280. 10.5115/acb.2016.49.4.273.

Anatomical variants of the superficial temporal artery in patients with microtia: a pilot descriptive study

• Imran FH
• Yong CK
• Das S
• Huei YL

• KMID: 2365557
• DOI: http://doi.org/10.5115/acb.2016.49.4.273

Abstract

Superficial temporal artery (STA) based pedicled fascial flap plays a pivotal role in ear reconstruction for microtia patients. There is paucity of literature on the anatomy of the STA in microtia patients. The present study aimed to describe any possible anatomical variations seen in the STA of patients afflicted with microtia. Pre-operative carotid computer tomographic angiography images of patients under the microtia database of Plastic and Reconstructive Surgery Unit at a tertiary medical centre were selected and 3-dimensionally reconstructed. Measurements were made on the 3D reconstructed computed tomographic angiography images of the STA on both the sides of the microtic ear and the non-microtic ear to assess its various anatomical parameters. We managed to obtain a total of 39 computed tomographic angiography images of STAs for analysis. There was a significant difference in the number of main branches of STA between the two groups (P=0.006). The proportion of ears with 2 main branches was higher in the non-microtia group (89.5%) compared to the microtia group (45.0%). A significant difference was found in the STA diameter between the two groups (P=0.012). The mean diameter of STA in the non-microtia group was larger by 0.4 mm. Furthermore, the median angle of STA was larger on the side of the non-microtic ears compared to that of microtic ears by 24.5°, with a P-value of 0.011. The results of the study may be of clinical importance while planning and performing ear reconstructive surgeries using STA based pedicled fascial flaps.

Keyword

Anatomy; Variations; Superficial temporal artery; Microtia; Temporoparietal; Fascial; Flaps

MeSH Terms

Angiography
Congenital Microtia*
Ear
Humans
Plastics
Temporal Arteries*
Plastics

Figure

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  Fig. 1 (A) 3D reconstruction of external carotid computed tomographic angiography. (B) Measurement of the diameter of superficial temporal artery (STA) and its main branches. (C) Measurement of the angle of STA and its main branches in relation to a plane drawn parallel to the upper border of the ipsilateral zygomatic arch. (D) Measurement of the distance and level of STA branching point in relation to the upper border of the ipsilateral zygomatic arch.

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  Fig. 2 Anatomical variations of the superficial temporal artery in microtia subjects.

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  Fig. 3 (A) Classification of superficial temporal artery (STA) by anatomic variations in normal population, according to Marano et al. [4]. Adapted from Marano et al. Neurosurgery 1985;16:786-90 [4], with permission from Wolters Kluwer. (B) Preponderance of different anatomical variants of STA in the microtia population compared to that described by Marano et al. [4] in the normal population. Note that the main variants found in this study is the type “E” variants, i.e., STA with frontal branch only. Also, it was noted that the mean diameters of the STA and its branches were smaller in the microtia population compared to the normal population described by Marano et al. [4].

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