Innervation of the temporalis muscle for selective electrical denervation

Abstract

Bilateral hypertrophy of the temporal muscle can give the impression of an aggressive and violent facial appearance. The authors performed closed selective denervation of the deep temporal nerve using electrocauterization. Before the procedure, precise anatomical knowledge of the deep temporal nerve is mandatory. Sixteen hemifaces of Korean cadavers were dissected. To standardize the position of the anterior division of the deep temporal nerve, we recorded the distance from six anatomical landmarks to the nerve. In 19% (3 of 16) of cadavers, one deep temporal nerve was observed, and in the remainder, two deep temporal nerves were identified. In all our specimens, a mean of three (range: 1-4) temporal branches also arose from the buccal nerve. One temporal branch arising in common with the masseteric nerve was observed in 2 of 15 of our specimens. On the infratemporal crest, the distances from the anterior division of the deep temporal nerve to the posterior division of the deep temporal nerve and to the masseter nerve were 4.7 +/- 0.9 mm (range: 3-6 mm) and 8.3 +/- 1.1 mm (range: 6-10 mm), respectively. On the superior surface of the zygomatic arch, the distance from the most concave point of the zygomatic bone (point A) to the anterior division of the deep temporal nerve was 19.4 +/- 1.2 mm (range: 18-21 mm). On the inferior surface of the zygomatic arch, the distance from the prominent point of the condylar process of the mandible to the anterior division of the deep temporal nerve was 22.3 +/- 1.6 mm (range: 22-25 mm). Great consistency in the position of the anterior division of the deep temporal nerve was shown. The results of this study could provide a basis for closed selective denervation of the anterior division of the deep temporal nerve using electrocauterization. Clinical application is needed.