Applied Anatomy Study On The Branches Of Superficial Temporal Artery In Preauricular Area

Objective:This study were to investigate branches of superficial temporal artery(STA) in preauricular area to improve the survival rate and aspect ratio of local flaps and guide the clinical applicationMethods:①Observation Range:The post boundary was vertical line through the tragus point, while the anterior border was vertical line 3cm off the tragus point. The upper boundary was the horizon line 3cm above the tragus point, and the lower bound was the horizontal line 7cm below the tragus point.②dissect 10 adult cadavers(10% formaldehyde solution perfused and latex fixed), to observe the distribution and direction of branches of superficial temporal artery (STA) in preauricular area;③2 fresh (died within 6 hours) cadaver heads:transparent 2 of them (the whole layer of facial soft tissue), to measure he distribution area of Superficial temporal artery branches in the preauricular region.Results:Skin and subcutaneous tissue in prequricular area were mainly supplied by the superficial temporal artery and its branches Zygomatic orbital artery, anterior tragal cutaneous branch (ATCB) and transverse facial artery. The region above the zygomatic arch was mainly supplied by zygomatic orbital artery. The area under the zygomatic arch was devided into two regions by the line connected mandibular angle and outer canthal point:the upward area was supplied by ATCB and the lower branches of the zygomatic orbital artery, and the downward area was supplied by the small branches of the transverse facial artery. Anastomosis between the arteries and its branches were rich.Most of the zygomatic orbital artery originated from the superficial temporal artery trunk, and the original point was about 7mm away from tragus points.It gone along the upper edge of the zygomatic arch lateral to the orbital forward, and divided into two brenches. They supplied orbicularis muscle of upper eyelid and lower eyelid. Zygomatic orbital artery arised to the top and bottom small branches, supply the adjacent skin and subcutaneous tissue.There was constant artery issued from the superficial temporal artery before the tragus, and it was present in all cadaver(100%). The original point was 38.17±3.26 (mm) down away from the tragus point, and the diameter was 0.61 ±0.27 (mm). The artery was gone after the parotid gland, and perforated the SMAS before the tragus The point was 13.15±1.56 (mm) away from the tragus point, and the average diameter was 0.53±0.12 (mm). After piercing the artery divided into 2～3 branches and gone parallel to the skin.The distribution area was 18.64±2.32 (cm2), and the transverse facial artery, zygomatic orbital artery, a branch of facial artery and other arteries had a rich agreement.The Anterior Tragal Cutaneous Branch had not been reported in detail ever before. The arteries were branches of superficial temporal artery, the starting point average diameter of 0.6mm, so they were small arteries. The type of the artery was cutaneous artery, for it directly run from the aorta to distribute skin and subcutaneous tissue. Because the arteries distributed skin and subcutaneous tissue before tragus, and they had constant point perforating the SMSA layar before tragus, we named it the Anterior Tragal Cutaneous Branch.Transverse facial artery gone under SMAS in preauricular area, and perforeted the SMAS level directly in the downward region. Then it issued several branches to suppliy the skin and subcutaneous tissue. These terminal branches supplied a smaller range.Conclusions:Skin and subcutaneous tissue in prequricular area were mainly supplied by the superficial temporal artery and its branches Zygomatic orbital artery, anterior tragal cutaneous branch (ATCB) and transverse facial artery. Anastomosis between the arteries and its branches were rich. The Anterior Tragal Cutaneous Branch had not been reported in detail ever before. The arteries were branches of superficial temporal artery, and it was present in all cadaver(100%), and perforated the SMAS before the tragus. The distribution area was big. Therefore, it was of great importance to local flap transplantion. The preauricular area can be divided into 3 districts, districtⅠand districtⅢare not suitable as a pedicle flap donor site. DistrictⅡis suitable as a site to donor pedicle of flap. The clinical application was satisfactory of local flap designed on ATCB.