The middle temporal artery is a branch of the superficial temporal artery arising just above the zygomatic arch, penetrating the temporal fascia to supply the temporalis muscle from its superficial surface. It is the most constant superficial branch to the temporalis and runs between the two layers of the temporalis fascia (the superficial layer and the deep layer) before entering the muscle.
The middle temporal artery runs between the two layers of the deep temporal fascia and is the landmark for the subfascial dissection plane used in coronal approach temporal procedures. In facial reanimation using the temporalis muscle, the middle temporal artery must be preserved as a component of the muscle pedicle to ensure superficial muscle viability. In zygoma and temporal region approaches, inadvertent injury to the middle temporal artery produces troublesome bleeding within the fascial layer. The plane between the two temporal fascia layers (the interfascial plane) is used to protect the frontal branch of the facial nerve during temporal approaches.
The middle temporal artery running between the two layers of the temporal fascia is divided when the temporal fascia is incised without proper plane identification, producing bleeding within the fascial compartment; staying in the subfascial plane between the temporal fascia layers and the temporalis muscle prevents this injury and protects the facial nerve temporal branch.
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