Temple Surgery

  • Thomas Muehlberger


Many migraine patients complain about pain in the temple during an attack. Some patients with temple pain can actually point to a specific spot of maximum pain. Other patients, however, will, when asked where exactly the pain is during their attacks, point to several different spots or delineate varying anatomical areas (Fig. 12.1).


  1. 1.
    Hwang K, Suh MS, Lee SI, Chung IH. Zygomaticotemporal nerve passage in the orbit and temporal area. J Craniofac Surg. 2004;15:209–14.CrossRefPubMedGoogle Scholar
  2. 2.
    Tubbs RS, Mortazavi MM, Shoja MM, Loukas M, Cohen-Gadol AA. The zygomaticotemporal nerve and its relevance to neurosurgery. World Neurosurg. 2012;78:515–8.CrossRefPubMedGoogle Scholar
  3. 3.
    Jeong SM, Park KJ, Kang SH, Shin HW, Kim H, Lee HK, Chung YG. Anatomical consideration of the anterior and lateral cutaneous nerves in the scalp. J Korean Med Sci. 2010;25:517–22.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Kim S, Matic DB. The anatomy of temporal hollowing: the superficial temporal fat pad. Craniofac Surg. 2005;16:760–3.CrossRefGoogle Scholar
  5. 5.
    Totonchi A, Pashmini N, Guyuron B. The zygomaticotemporal branch of the trigeminal nerve: an anatomical study. Plast Reconstr Surg. 2005;115:273–7.PubMedGoogle Scholar
  6. 6.
    Akita K, Shimokawa T, Tsunoda A, Sato T. Nervous branch passing through an accessory canal in the sphenozygomatic suture: the temporal branch of the zygomatic nerve. Surg Radiol Anat. 2002;24:113–6.CrossRefPubMedGoogle Scholar
  7. 7.
    Janis JE, Hatef DA, Thakar H, Reece EM, McCluskey PD, Schaub TA, Theivagt C, Guyuron B. The zygomaticotemporal branch of the trigeminal nerve: Part II. Anatomical variations. Plast Reconstr Surg. 2010;126:435–42.CrossRefPubMedGoogle Scholar
  8. 8.
    Williams PL, Warwick R, Dyson M, et al. Gray’s anatomy. 37th ed. New York: Churchill Livingstone; 1989. p. 1098–103.Google Scholar
  9. 9.
    Odobescu A, Williams HB, Gilardino MS. Description of a communication between the facial and zygomaticotemporal nerves. J Plast Reconstr Aesthet Surg. 2012;65:1188–92.CrossRefPubMedGoogle Scholar
  10. 10.
    Kwak HH, Park HD, Youn KH, et al. Branching patterns of the facial nerve and its communication with the auriculotemporal nerve. Surg Radiol Anat. 2004;26:494–500.CrossRefPubMedGoogle Scholar
  11. 11.
    Namking M, Boonruangsri P, Woraputtaporn W, Guldner FH. Communication between the facial and auriculotemporal nerves. J Anat. 1994;185:421–6.PubMedPubMedCentralGoogle Scholar
  12. 12.
    Tohma A, Mine K, Tamatsu Y, et al. Communication between the buccal nerve (V) and facial nerve (VII) in the human face. Ann Anat. 2004;186:173–8.CrossRefPubMedGoogle Scholar
  13. 13.
    Hwang K, Han JY, Battuvshin D, et al. Communication of infraorbital nerve and facial nerve: anatomic and histologic study. J Craniofac Surg. 2004;15:88–91.CrossRefPubMedGoogle Scholar
  14. 14.
    Baumel JJ. Trigeminal-facial nerve communications. Their function in facial muscle innervations and reinnervation. Arch Otolaryngol. 1974;99:34–44.CrossRefPubMedGoogle Scholar
  15. 15.
    Guyuron B, Harvey D, Reed D. A prospective randomized outcomes comparison of two temple migraine trigger site deactivation techniques. Plast Reconstr Surg. 2015;136:159–65.CrossRefPubMedGoogle Scholar
  16. 16.
    Peled ZM. A novel surgical approach to chronic temporal headaches. Plast Reconstr Surg. 2016;137:1597–600.CrossRefPubMedGoogle Scholar
  17. 17.
    De La Plaza R, Valiente E, Arroyo JM. Supraperiosteal lifting of the upper two-thirds of the face. Br J Plast Surg. 1991;44:325–32.CrossRefGoogle Scholar
  18. 18.
    Trinei FA, Januszkiewicz J, Nahai F. The sentinel vein: an important reference point for surgery in the temporal region. Plast Reconstr Surg. 1998;101:27–32.CrossRefPubMedGoogle Scholar
  19. 19.
    Yang HM, Jung W, Won SY, Youn KH, Hu KS, Kim HJ. Anatomical study of medial zygomaticotemporal vein and its clinical implication regarding the injectable treatments. Surg Radiol Anat. 2015;37:175–80.CrossRefPubMedGoogle Scholar
  20. 20.
    Friedman T, Lurie D, Westreich M. Rembrandt’s sentinel vein. Aesthet Surg J. 2007;27:105–7.CrossRefGoogle Scholar
  21. 21.
    van Rijn R. Self-portrait with beret and turned-up collar. Edinburgh: National Gallery of Scotland.
  22. 22.
    Schmidt BL, Pogrel MA, Necoechea M, Kearns G. The distribution of the auriculotemporal nerve around the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;86:165–8.CrossRefPubMedGoogle Scholar
  23. 23.
    Johansson AS, Isberg A, Isacsson G. A radiographic and histologic study of the topographic relations in the temporomandibular joint region: implications for a nerve entrapment mechanism. J Oral Maxillofac Surg. 1990;48:953–61.CrossRefPubMedGoogle Scholar
  24. 24.
    Murayama RA, Stuginski-Barbosa J, Moraes NP, Speciali JG. Toothache referred from auriculotemporal neuralgia: case report. Int Endod J. 2009;42:845–51.CrossRefPubMedGoogle Scholar
  25. 25.
    Speciali JG, Goncalves DA. Auriculotemporal neuralgia. Curr Pain Headache Rep. 2005;9:277–80.CrossRefPubMedGoogle Scholar
  26. 26.
    Gulekon N, Anil A, Poyraz A, Peker T, Turgut HB, Karakose M. Variations in the anatomy of the auriculotemporal nerve. Clin Anat. 2005;18:15–9.CrossRefPubMedGoogle Scholar
  27. 27.
    Iwanaga J, Watanabe K, Saga T, Fisahn C, Oskouian RJ, Tubbs RS. Anatomical study of the superficial temporal branches of the auriculotemporal nerve: application to surgery and other invasive treatments to the temporal region. J Plast Reconstr Aesthet Surg. 2017;70:370–4.CrossRefPubMedGoogle Scholar
  28. 28.
    Andersen NB, Bovim G, Sjaastad O. The frontotemporal peripheral nerves: topographic variations of the supraorbital, supratrochlear and auriculotemporal nerves and their possible clinical significance. Surg Radiol Anat. 2001;23:97–104.CrossRefPubMedGoogle Scholar
  29. 29.
    Janis JE, Hatef DA, Ducic I, Ahmad J, Wong C, Hoxworth RE, Osborn T. Anatomy of the auriculotemporal nerve: variations in its relationship to the superficial temporal artery and implications for the treatment of migraine headaches. Plast Reconstr Surg. 2010;125:1422–8.CrossRefPubMedGoogle Scholar
  30. 30.
    Chim H, Okada HC, Brown MS, Alleyne B, Liu MT, Zwiebel S, Guyuron B. The auriculotemporal nerve in etiology of migraine headaches: compression points and anatomical variations. Plast Reconstr Surg. 2012;130:336–41.CrossRefPubMedGoogle Scholar
  31. 31.
    Torres TS, Lucena Neto B, Silva G. Surgical anatomy of the auriculotemporal nerve in the preauricular access (Article in Spanish). Int J Morph. 2004;22:327–30.Google Scholar
  32. 32.
    Gfrerer L, Maman DY, Tessler O, et al. Nonendoscopic deactivation of nerve triggers in migraine headache patients: surgical technique and outcomes. Plast Reconstr Surg. 2014;134:771–8.CrossRefPubMedGoogle Scholar
  33. 33.
    Sanniec K, Borsting E, Amirlak B. Decompression-avulsion of the auriculotemporal nerve for treatment of migraines and chronic headaches. Plast Reconstr Surg Glob Open. 2016;4:e678.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Guyuron B, Riazi H, Long T, Wirtz E. Use of a Doppler signal to confirm migraine headache trigger sites. Plast Reconstr Surg. 2015;135:1109–12.CrossRefPubMedGoogle Scholar
  35. 35.
    Chen JT, Sanchez R, Garg R, et al. Helpful hints for the superficial temporal artery and vein as recipient vessels. Plast Reconstr Surg. 2017;139:818e–20e.CrossRefPubMedGoogle Scholar
  36. 36.
    Lamey PJ, Burnett CA, Fartash L, Clifford TJ, McGovern JM. Migraine and masticatory muscle volume, bite force, and craniofacial morphology. Headache. 2001;41:49–56.CrossRefPubMedGoogle Scholar
  37. 37.
    Shevel E. Craniomandibular muscles, intraoral orthoses and migraine. Expert Rev Neurother. 2005;5:371–7.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Thomas Muehlberger
    • 1
  1. 1.Medsteps AGChamSwitzerland

Personalised recommendations