The zygomaticotemporal nerve is a branch of the zygomatic nerve (from the maxillary division of the trigeminal, V2). It passes through the zygomaticotemporal foramen in the temporal surface of the zygomatic bone and pierces the temporalis fascia to supply sensation to the skin of the anterior temporal region. It also carries postganglionic parasympathetic secretomotor fibres from the pterygopalatine ganglion, which it passes to the lacrimal nerve to stimulate the lacrimal gland.
The zygomaticotemporal nerve is the relay point for parasympathetic secretomotor fibres from the pterygopalatine ganglion to the lacrimal gland, explaining the neurological pathway of lacrimation. It is anaesthetised as part of the zygomatic nerve block for temporal fossa and zygomatic arch procedures. In endoscopic brow lift surgery, the nerve is identified as it pierces the temporoparietal fascia and must be preserved to maintain temporal sensation and lacrimal function.
A coronal scalp incision extending into the temporal region can injure the zygomaticotemporal nerve as it pierces the temporalis fascia, producing numbness of the anterior temporal skin and potentially affecting lacrimal secretion through loss of its parasympathetic relay function.
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