Choi You-Jin, Kim Hee-Jin
Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea.
Department of Materials Science and Engineering, College of Engineering, Yonsei University, Seoul, South Korea.
Clin Anat. 2023 Apr;36(3):406-413. doi: 10.1002/ca.23962. Epub 2022 Oct 17.
The zygomaticotemporal nerve is known to contribute to temporal migraines; however, its precise anatomy remains unknown. The potential accessory branches of the zygomaticotemporal nerve may be considered a cause of continued temporal migraines after surgical procedures. In this study, we defined the novel superficial branch of the zygomaticotemporal nerve (sZTN) and investigated its anatomical course, distribution, and clinical implications. Twenty-two hemifaces from 11 fixed Korean cadavers (six males, five females; mean age, 78.3 years) were used in this study. The piercing points of the sZTN through the deep and superficial layers of the deep temporal fascia, and the superficial temporal fascia were defined as P1, P2, and P3, respectively. The distance of each point from the zygomatic tubercle was measured using an image analysis software. The sZTN ascended between the bone and the temporalis after emerging from the zygomaticotemporal foramen. It then pierced the deep temporal fascia without penetrating the temporalis. After then, it pierced the superficial layer of the deep temporal fascia and turned superiorly toward the upper posterior temple. When the sZTN passed through the superficial temporal fascia, it intersected with the superficial temporal artery in every case. The novel findings of the sZTN may help in the treatment of intractable temporal migraines refractory to injection or surgical procedure. Based on our findings, targeting the sZTN may be applied as an alternative treatment strategy for patients who do not show significant improvement with treatment targeted to trigger sites.
已知颧颞神经与颞部偏头痛有关；然而，其确切解剖结构仍不清楚。颧颞神经的潜在副支可能被认为是手术治疗后颞部偏头痛持续发作的一个原因。在本研究中，我们定义了颧颞神经新的浅表支（sZTN），并研究了其解剖走行、分布及临床意义。本研究使用了11具固定的韩国尸体（6例男性，5例女性；平均年龄78.3岁）的22个半侧面部。sZTN穿过颞深筋膜深层和浅层以及颞浅筋膜的穿刺点分别定义为P1、P2和P3。使用图像分析软件测量每个点与颧结节的距离。sZTN从颧颞孔穿出后，在骨与颞肌之间上行。然后它穿过颞深筋膜而不穿透颞肌。之后，它穿过颞深筋膜浅层并向上转向颞部后上方。当sZTN穿过颞浅筋膜时，它在每种情况下都与颞浅动脉相交。sZTN的新发现可能有助于治疗对注射或手术治疗无效的顽固性颞部偏头痛。基于我们的发现，对于针对触发点的治疗未显示出明显改善的患者，靶向sZTN可作为一种替代治疗策略。
