Superficial Temporal Artery Endoscopic Dissection - Technique Description and it’s use for Multiple Grafts

Gustavo AR Passos*, Ronan S Costa, Carolina G Benjamin
University of Miami - Neurological Surgery dept - CANES Lab, Miami, FL USA
*Corresponding Author: Gustavo AR Passos, University of Miami - Neurological Surgery dept - CANES Lab, Miami, FL USA.

Published: September 30, 2025

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Abstract  

Introduction: The superficial temporal artery (STA) is a critical vessel in neurosurgery, plastic surgery, otolaryngology, maxillofacial, and ocular surgery, serving as main blood supply for vascularized flaps, bypasses, and grafts. Traditional dissection methods are often invasive, with risk of trauma to adjacent tissues. This study describes a minimally invasive fully endoscopic technique for dissection of the STA with accuracy, proposed to reduce tissue trauma, and minimize scarring.

Methods: The study was conducted on six latex-injected cadaveric specimens using a 30° endoscope (Ecleris® and Storz®) and standard microsurgical instruments. The STA was identified above the zygomatic arch, followed to its frontal and parietal branches through a 1inch incision, and mobilized using endoscopic magnification.

Results: The fully endoscopic approach provided accurate identification and mobilization of the STA with minimal collateral damage, allowing dissection up to 3-4 inches from the incision site. Compared to open techniques, it can reduce scar area and accelerate recovery with less discomfort.

Discussion: This technique offers significant advantages for STA-based procedures, including STA revascularization to the middle cerebral artery (MCA) and possible posterior circulation bypass revascularization, ocular grafts, and expanded applications in plastic surgery for anterior/posterior skin grafts and cranial reconstruction. Challenges include equipment costs, a steep learning curve, and risks of intraoperative bleeding in a confined field.

Conclusion: The endoscopic STA dissection technique can increase surgical precision, reduce morbidity, and improve aesthetic outcomes in a variety of disciplines. Its implementation requires specialized training and careful patient selection, and further clinical validation is needed.

Keywords: Superficial temporal artery; Minimally invasive; Endoscopy; Vascular graft