The superficial temporal artery is the smaller of two terminal branches that bifurcate superiorly from the external carotid. Based on its direction, the superficial temporal artery appears to be a continuation of the external carotid.
It begins in the substance of the parotid gland, behind the neck of the mandible, and passes superficially over the posterior root of the zygomatic process of the temporal bone; about 5 cm. above this process it divides into two branches, a frontal and a parietal.
As it crosses the zygomatic process, it is covered by the Auricularis anterior muscle, and by a dense fascia; it is crossed by the temporal and zygomatic branches of the facial nerve and one or two veins, and is accompanied by the auriculotemporal nerve, which lies immediately behind it.
The STA coursed over the zygomatic arch or over the condylar process of the mandible in all cases (25/25 pts, 100 %). The STA courses over the posterior zygomatic arch in 23/25 pts (92 %), creating a characteristic “C” shape half-buttonhole configuration as it embraces the arch. When the STA travels posterior to the zygomatic arch, there is no C shape configuration (2/25 pts, 8 %). The STA bifurcates distal to the zygomatic arch in 24/25 pts (96 %).
The “C” shape half-buttonhole configuration is a useful identifying characteristic of the most common course of the STA-over the posterior zygomatic arch before it bifurcates 1).
Superficial temporal artery (STA) is the mainstay of donor vessels for extra-intracranial bypass (EC-IC bypass) in cerebral revascularization. However, the typically used STA frontal or parietal branch is not always adequate in its flow-carrying capacity.
The superficial temporal artery is often affected in giant cell arteritis and biopsied if the diagnosis is suspected.
Migraine attacks can occur when the temporal artery enlarges.
The superficial temporal artery anastomoses with (among others) the supraorbital artery of the internal carotid artery.