The frontal-temporal nerve triangle: a new concept of locating the motor and sensory nerves in upper third of the face rhytidectomy.

Abstract

How to avoid damage to the temporal branch of the facial nerve has long been a central topic of discussion. Recently, damage to the supraorbital nerve, the auriculotemporal nerve, and other branches of the trigeminal nerve divisions has attracted much attention. Focusing on frontal and temporal rhytidectomy, the authors have investigated the course and distribution of the facial nerve branches, the supraorbital nerve, the auriculotemporal nerve, and other branches of trigeminal division. In this article, they present the concept of the frontal-temporal nerve triangle; its contents, vicinity, and clinical significances are discussed. An anatomical study was performed using 30 temporal-parietal regions of 10 fixed adult cadavers and five fresh cadavers. A step-by-step dissection from the superficial layer to the deep layer was involved; all the measurement data were analyzed, and the mean and standard deviation were calculated and expressed in centimeters. The frontal-temporal nerve triangle is an approximately triangular area formed by the temporal branch of the facial nerve, the supraorbital nerve, and the auriculotemporal nerve. Together with its contents and vicinal structures, it forms a complicated three-dimensional rather than two-dimensional structure. Anatomical structures closely associated with rhytidectomy are located in or near this area. Acting as the anatomical body surface landmark for preoperatively locating the temporal branch, the supraorbital nerve, the auriculotemporal nerve, and its related structures, the concept of the frontal-temporal nerve triangle has practical significance in designing incisions and selecting planes of dissection in upper third of the face rhytidectomy.