Albertini J G, Ramsey M L, Marks V J
Department of Dermatology, Geisinger Medical Center, Danville, Pennsylvania, USA.
Dermatol Surg. 1999 Jun;25(6):501-8. doi: 10.1046/j.1524-4725.1999.08296.x.
A positive temporal artery biopsy (TAB) is essential to the diagnosis of temporal arteritis. Both this relatively common disease and its prolonged treatment with corticosteroids are associated with serious sequelae. Therefore, accurate and timely diagnosis is critical. The dermatologic surgery literature lacks a description of this straightforward surgical technique, as TABs are most often performed by ophthalmologists.
As a service to our rheumatology department we began performing TABs on a same-day on-call basis in July 1996.
We have performed 45 TABs in a 22-month period using a simple, safe, time-efficient technique. We review the surgical anatomy and danger zone of the temporal region and potential complications. We describe the biopsy technique which aims at safely obtaining a greater than 2 cm segment of a peripheral branch of the superficial temporal artery (STA), identified preoperatively by doppler ultrasonography.
The procedure was performed on the day requested in all cases. Intraoperative time ranged from 20 to 40 minutes. TAB established the diagnosis of temporal arteritis in 8 of 44 biopsies (18%) and in 7 of 35 patients (20%), including 1 of 9 patients in whom we performed bilateral TAB. One patient was diagnosed with small-vessel polyarteritis nodosa by TAB. The mean formalin-fixed length of the arterial specimen was 2.2 cm. The length did not vary between positive and negative specimens. There were no complications and the cosmetic results were excellent.
TAB is a quick, safe, straightforward, and gratifying office procedure which dermatologic surgeons are very qualified to perform.
颞动脉活检（TAB）阳性对颞动脉炎的诊断至关重要。这种相对常见的疾病及其长期使用皮质类固醇治疗均与严重的后遗症相关。因此，准确及时的诊断至关重要。皮肤科手术文献中缺乏对这种直接手术技术的描述，因为TAB大多由眼科医生进行。
为了服务于我们的风湿科，我们于1996年7月开始在当日随叫随到的基础上进行TAB。
我们在22个月的时间里使用一种简单、安全、高效的技术进行了45次TAB。我们回顾了颞部区域的手术解剖结构、危险区域及潜在并发症。我们描述了活检技术，该技术旨在安全获取一段大于2 cm的颞浅动脉（STA）外周分支，术前通过多普勒超声进行识别。
所有病例均在要求的当天进行了该手术。手术时间为20至40分钟。在44次活检中的8例（18%）以及35例患者中的7例（20%）中，TAB确诊为颞动脉炎，其中包括我们对9例患者进行双侧TAB中的1例。1例患者通过TAB被诊断为结节性小血管多动脉炎。动脉标本经福尔马林固定后的平均长度为2.2 cm。阳性和阴性标本的长度无差异。无并发症发生，美容效果极佳。
TAB是一种快速、安全、直接且令人满意的门诊手术，皮肤科医生非常有资格进行该手术。
