Skull Base 2010; 20(6): 415-420
DOI: 10.1055/s-0030-1254405
ORIGINAL ARTICLE

© Thieme Medical Publishers

Distal Superficial Temporal Artery to Proximal Posterior Cerebral Artery Bypass by Posterior Oblique Transzygomatic Subtemporal Approach

Cagatay Han Ulku1 , Mehmet Erkan Ustun2 , Mustafa Buyukmumcu3
  • 1Department of Otolaryngology–Head and Neck Surgery, Selcuk University, School of Medicine, Konya, Turkey
  • 2Department of Neurosurgery, Selcuk University, School of Medicine, Konya, Turkey
  • 3Department of Anatomy, Selcuk University, School of Medicine, Konya, Turkey
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Publication History

Publication Date:
14 May 2010 (online)

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ABSTRACT

This article investigates the possibility for the distal superficial temporal artery (STA) to proximal posterior cerebral artery (PCA) direct bypass by subtemporal oblique posterior transzygomatic approach. Five adult cadaveric specimens were dissected. Cadeveric dissection protocol was approved by the Research Ethics Committee. A preauricular vertical skin incision was made, the trunk of STA was identified, and bifurcation, frontal, and parietal branches of the STA were followed distally. Posterior zygomatic arch osteotomy and microcraniotomy were then performed, and the dura was opened. The temporal lobe was retracted, interpeduncular and ambient cisterns were opened, and the P2 segment of the PCA was exposed. Parietal branch of STA and P2 segment of the PCA was anastomosed. The average length of the transected STA from the bifurcation and the zygomatic arch were 47.3 ± 2.1 mm and 71.4 ± 2.3 mm, respectively. The mean calibers of the parietal and frontal branch of the STA at this distance were 1.6 ± 0.1 and 1.4 ± 0.2, respectively. The mean diameter of the P2 was 2.1 ± 0.2 mm. Because of the calibers of the parietal branch of the STA and proximal PCA are over 1.5 mm and 2.0 mm, respectively, this direct end-to-side bypass technique may be a reasonable alternative in suitable cases.