The temporal branches of the facial nerve (CN VII) exit the superior parotid, crossing the zygomatic arch in the temporoparietal (superficial temporal) fascia plane. They supply the frontalis (brow elevation), the corrugator supercilii (brow medial depression), and the superior orbicularis oculi (upper lid closure). The temporal branches have limited redundancy compared to other facial nerve branches — injury produces unilateral brow ptosis and inability to raise the brow that is difficult to reconstruct.
The temporal branch of the facial nerve is the most commonly injured facial nerve branch in surgery, particularly in coronal approach surgery, temporal craniotomy, and facelift (rhytidectomy). In the temporal region, the nerve crosses the zygomatic arch in the temporoparietal fascia plane 0.8-3.5 cm anterior to the tragus, within a zone defined by the three Pitanguy lines. Injury produces ipsilateral brow ptosis and inability to wrinkle the forehead. Nerve monitoring, fascial plane awareness, and limiting electrocautery near the nerve reduce injury risk. Static brow lifting (internal brow fixation) addresses the ptosis if recovery does not occur.
Coronal incision for frontocranial access risks the temporal branch of CN VII as it crosses the zygomatic arch in the temporoparietal fascia; dissection at the temporal crest must stay in the sub-superficial temporal fascia plane deep to the nerve to protect the branch, with injury producing ipsilateral brow ptosis and brow asymmetry.
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