Anatomical Insight Into the Zygomatico-orbital Artery Using 3-Dimensional Computed Tomography Angiography: Providing a Safe Area in the Temporal Region

Background The zygomatico-orbital artery (ZOA) poses a potential risk during aesthetic and surgical procedures due to its anastomoses with the ophthalmic artery. Accurate knowledge of its anatomical course is crucial to define safe zones and reduce complications in the temporal region. Objectives The goal of this study is to define the course of the ZOA according to the reference points determined for guiding temporal procedures in a safer manner. Methods This retrospective cross-sectional study employed the analysis of head and neck computed tomography (CT) angiograms obtained from 197 subjects aged 22 to 83 years. Patients with head trauma or craniotomy affecting the artery were excluded to ensure the accuracy of the results. The parameters were evaluated using three-dimensional volume rendering (3D-VRT), thin-slab axial, and thickness enhanced sagittal maximum intensity projection (MIP) images. Results The results obtained from the 103 ZOAs that were analyzed demonstrated that 82 (79.61%) of the arteries originated from the superficial temporal artery (STA), displaying an average diameter of 0.91 mm, while 21 (20.39%) originated from the frontal branch, with an average diameter of 0.85 mm. ZOAs originating from the STA were observed to be situated at a deeper level at the starting point in comparison to ZOAs originating from the frontal branch (5.78 and 4.91 mm depth from the skin, respectively, and p=0.008). Conclusions The findings of this study emphasize the necessity of a comprehensive understanding of the anatomical variations, the course and location of the ZOA to ensure safe clinical interventions.