The supraorbital artery is a branch of the ophthalmic artery that exits the orbit through the supraorbital notch or foramen alongside the supraorbital nerve, then ascends across the forehead periosteum and scalp to supply the forehead skin, the pericranium, and the anterior scalp. It anastomoses with the supratrochlear artery medially and the superficial temporal artery laterally, forming the supraorbital arcade.
The supraorbital artery is at risk during eyebrow and forehead surgery, particularly in coronal and pretrichial incisions where the forehead flap is elevated. It contributes to the axial blood supply of the paramedian forehead flap alongside the supratrochlear artery. In brow lifting surgery, the supraorbital neurovascular bundle exiting the foramen must be identified and protected. Pulsatile supraorbital artery flow can be used to assess ophthalmic artery patency in carotid disease assessment.
The supraorbital neurovascular bundle exiting through the supraorbital notch must be identified and released from the notch (notch osteotomy) during coronal approach brow lifting and anterior cranial base surgery to allow complete galeal flap elevation and protect the artery and nerve from traction injury.
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