Background : Migraine headache is one of the most common neurovascular disordersthat is often inadequately treated by currently available medical therapies.Clinical evidences have shown that the decompression of peripheral nervetrigger points is successful in migraine relief. The nerve responding tothe temporal trigger site is the zygomaticotemporal branch of the trigeminalnerve.Objectives : This cadaveric study of the anatomy of the zygomaticotemporal nerve wasundertaken to delineate where this nerve exits the deep temporal fascia inrelation to the plane through the superior border of tragus and thezygomaticofrontal suture.Methods : The temporal region of twenty-two fresh cadaveric hemiheads weredissected through bicoronal incision. Points of measurement wherethe zygomaticotemporal nerve exits the deep temporal fascia in relation tothe plane through the superior border of tragus and the zygomaticofrontalsuture were recorded.Results : The piercing point of the zygomaticotemporal nerve was located27.0 ± 3.7 mm from the zygomaticofrontal suture, 3.9 ± 4.7 mm superiorto the plane through the superior border of tragus and the zygomaticofrontalsuture (HL), and 25.6 ± 3.7 mm lateral to the plane through thezygomaticofrontal suture and perpendicular to HL. No significant differencebetween the right and left sides was detected.Conclusions : The nerve responding for the temporal trigger site in migraine headache isthe zygomaticotemporal branch of the trigeminal nerve. Surgicaldecompression or chemodenervation of the surrounding temporalis canhelp alleviate the symptoms of migraine headache. Advances inthe understanding of detailed anatomical information will enhance the safetyand effectiveness of migraine surgery and botulinum toxin A injectiontreatment.
Faculty of Medicine, Chulalongkorn University
Jirapinyo, Chutima and Iamphongsai, Seree
"Anatomical study of zygomaticotemporal nerve: Clinical implications for surgical treatment of migraine headache in Thai population,"
Chulalongkorn Medical Journal: Vol. 62:
4, Article 4.
Available at: https://digital.car.chula.ac.th/clmjournal/vol62/iss4/4