Clinical Implications of the Middle Temporal Vein With Regard to Temporal Fossa Augmentation Wonsug Jung, MD, PhD,* Kwan-Hyun Youn, PhD,† Sung-Yoon Won, PhD,‡ Jong-Tae Park, PhD,x Kyung-Seok Hu, DDS, PhD,† and Hee-Jin Kim, DDS, PhD†
BACKGROUND The middle temporal vein (MTV) traverses the temporal fossa between the superficial and deep layers of the deep temporal fascia. During filler injection into a deficient temporal fossa, filling agents may be inadvertently injected into the MTV, which results in vascular complications. OBJECTIVE
To investigate the course of the MTV to enable safe filler injection in the temple area.
MATERIALS AND MATERIALS 9 Korean cadavers.
The course and diameter of the MTV were measured in 18 hemifaces from
RESULTS The MTV was located 23.5 and 18.5 mm above the zygomatic arch at the jugale and the zygion, respectively. The diameter of the MTV at its thickest point was 5.1 mm. A splitting and reuniting pattern, such that the MTV occupied more space than a single trunk, was observed in 28% of cases. CONCLUSION We propose that the safest area for filler injection in temporal fossa augmentation is one finger width above the zygomatic arch. The authors have indicated no significant interest with commercial supporters.
T
he middle temporal vein (MTV) is a relatively unknown blood vessel that receives several veins, including the sentinel vein, and traverses the temporal fossa deep to the superficial layer of the deep temporal fascia. It then joins the superficial temporal vein just above the level of the zygomatic arch.1 The temporal region undergoes several changes with age: the temporalis muscle becomes thinner, the temporal fat pad becomes smaller, and the temporal bone becomes slightly more concave. Through these changes, the temple loses its youthful convex volume and the bony margins of the zygomatic arch become more prominent, lending a gaunt wasted appearance.2 The most popular corrective technique for augmenting the aging-related deficient temporal fossa is injection with various filling agents such as hyaluronic acid or
poly-L-lactic acid,3 whereas temporal hollowing after craniofacial surgery is usually corrected with surgical alloplasts, calcium hydroxyapatite, or autologous fat.4 However, a hypertrophied temporalis muscle can be a cause of migraine, headache secondary to temporomandibular disorders, and bruxism. Botulinum toxin has often been injected into the temporalis muscle to treat these conditions.5–7 The MTV is prone to injury when the temporal fossa is being injected with filling agents or botulinum toxin; furthermore, these substances may be inadvertently injected into the vessel, resulting in various vascular complications such as hematoma, embolism, and obstruction. Given the relative dearth of information regarding the MTV as it pertains to those procedures,
*Department of Anatomy, School of Medicine, Gachon University, Inchon, Korea; †Division in Anatomy and Developmental Biology, Department of Oral Biology, BK21 PLUS Project, Human Identification Center, Yonsei University College of Dentistry, Seoul, Korea; ‡Department of Occupational Therapy, College of Health and Welfare, Woosong University, Daejeon, Korea; xDepartment of Anatomy, Department of Oral Anatomy, Dankook University College of Dentistry, Cheonan, Korea
·
© 2014 by the American Society for Dermatologic Surgery, Inc. Published by Lippincott Williams & Wilkins ISSN: 1076-0512 Dermatol Surg 2014;40:618–623 DOI: 10.1111/dsu.0000000000000004
·
·
·
618
Copyright © American Society for Dermatologic Surgery. Unauthorized reproduction of this article is prohibited.
JUNG ET AL
the aim of this study was to determine the morphology and course of the MTV. Materials and Methods Eighteen hemifaces from 9 embalmed Korean adult cadavers (5 males, 4 females; mean age, 76 years; age range, 52–94 years) were used in this study. After skin removal through a coronal incision, the medial zygomaticotemporal vein (sentinel vein) was identified and followed until where it pierced the temporoparietal fascia and drained into the MTV. The temporoparietal fascia was carefully reflected, and the blood-filled MTV was often seen through the superficial layer of the deep temporal fascia. The superficial layer of the deep temporal fascia was removed, and the MTV buried in the temporal fat pad was exposed. The distances between the MTV and the zygomatic arch were measured at 2 points: the jugale (where the temporal and frontal processes of the zygomatic bone meet) and the zygion (the most lateral point on the zygomatic arch). The diameter of the MTV was measured at the point where it exhibits the largest caliber. Results Buried in the fat pad of the temporal fascia, the MTV passed between the superficial and deep layers of the deep temporal fascia. The MTV was located 23.5 mm (15.7–33.6 mm) and 18.5 mm (12.5–23.5 mm) above the zygomatic arch at the jugale and the zygion, respectively (Figure 1). It then took a downward course and entered the opening in the deep layer of the deep temporal fascia and ran between the temporalis muscle and the deep temporal fascia. When the MTV bent downward, the angle of the descending course varied from a smooth curve to a right angle (Figure 2). The diameter of the MTV at its thickest point was 5.1 mm (range, 2.0–9.1 mm; Figure 3). A splitting and reuniting pattern of the course of the MTV was observed in 28% of cases. Discussion The MTV has not received much attention, and anatomical and surgical textbooks do not provide a detailed description of its course, simply mentioning
Figure 1. Distance between the MTV and the zygomatic arch.
its existence in passing, if at all. An article published in the early 1980s reported the risk of damaging the MTV during Gillies’ operation,8 and only recently its usability as a recipient vessel in head and neck reconstructions has been suggested.9,10 Temporal fossa augmentation using dermal fillers is a widely performed procedure, but there is only limited information describing the injection technique in this region. Sykes2 suggested that hyaluronic acid should be placed in either the subcutaneous plane or in the plane between the superficial and deep layers of the deep temporal fascia. The latter space is where the MTV lies buried in the fat pad of the temporal fascia. Moradi and coworkers3 recommended multiple filler injections with only 0.05 to 0.1 mL of hyaluronic acid at each insertion rather than a single large bolus injection to avoid lumps. They illustrated multiple injection sites in the temple, several of which appear to put the MTV in danger of perforation. Previous studies have measured the diameter of the MTV just before it flows into the superficial temporal vein, because the main concern of the researchers was
40:6:JUNE 2014
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Copyright © American Society for Dermatologic Surgery. Unauthorized reproduction of this article is prohibited.
MIDDLE TEMPORAL VEIN
Figure 2. Variations in the course of the MTV. The MTV took a curved course (A, arrowheads) or bent sharply, almost at a right angle (B, arrowheads), to join the superficial temporal vein.
its utility as an alternative recipient vessel in skull base reconstruction.10,11 We measured its diameter at the point where the vein was the thickest in the temporal fossa. The diameter of the MTV in the temporal fossa was much larger than that has been reported previously at the draining point to the superficial temporal vein (Table 1). Considering its rather large size, along with its splitting variation (28%), which occupies more space in the temporal fossa than the
single main trunk, the MTV is thought to be highly vulnerable to injury during filler or botulinum toxin injection. Hyaluronic acid fillers generally have a wide safety profile, but related vascular complications are not uncommon, ranging from mild, such as telangiectasia, to severe, such as tissue necrosis and blindness.12–14 Vascular complications are mostly due to arterial
Figure 3. Variations in the diameter of the MTV. The MTV was generally thick (A), but in some cases it was very thin (B, arrows).
620
DERMATOLOGIC SURGERY
Copyright © American Society for Dermatologic Surgery. Unauthorized reproduction of this article is prohibited.
JUNG ET AL
TABLE 1. Comparison of MTV Diameters Measured in This Study and Other Studies
This study* 10,
Yano and coworkers † Abul-Hassan and coworkers11,†
n
Mean Diameter, mm
Minimum Diameter, mm
Maximum Diameter, mm
18
5.1
2.0
9.1
8
2.0
1.2
2.5
30
1.9
1.0
3.5
*Measured in the temporal fossa where the MTV was thickest. †Measured just before the MTV flowed into the superficial temporal vein.
occlusion, but venous occlusion can also lead to skin damage.15 In addition to dozens of cases of blindness after cosmetic filler injection of the face, there is a case of blindness after silicone injection into the temple area.16 The cause of the blindness after facial filler injection is thought to be central retinal artery embolization. This is related to the retrograde
displacement of the injected products from peripheral arteries into the ophthalmic arterial system.13 The MTV is connected to the cavernous sinus through the periorbital veins, and it would thus be much easier for the filler to be inadvertently injected into the MTV— which is much larger than other related arteries—and create cavernous sinus embolization (Figure 4).
Figure 4. Venous connection between the MTV and the cavernous sinus. The MTV was connected to the supratrochlear vein (STV), which drained toward the cavernous sinus (CS). Photographs of the anterior (A) and lateral aspect (B) of the dissected head. Upper margin of the orbicularis oculi muscle was trimmed to reveal the periorbital vein lying underneath. Superficial layer of the deep temporal fascia was cut and reflected downward to reveal the middle temporal vein and temporal fat pad. (C) Drawing depicting the vertical anatomy of the temple and its venous connection. CS, cavernous sinus; DL, deep layer; DTF, deep temporal fascia; POV, periorbital vein; SL, superficial layer; SOV, supraorbital vein; STV, supratrochlear vein; SV, sentinel vein; TFP, temporal fat pad; TPF, temporoparietal fascia.
40:6:JUNE 2014
621
Copyright © American Society for Dermatologic Surgery. Unauthorized reproduction of this article is prohibited.
MIDDLE TEMPORAL VEIN
Figure 5. The suggested area for safe filler injection. No main trunk of the MTV was found in the area one finger width above the zygomatic arch in any of the specimens. Photographs of the MTV without (A) and with (B) a finger on the temple area.
The MTV is a relatively unknown vessel among both clinicians and anatomists. However, awareness of the existence of the MTV is essential to avoid unnecessary vascular complications during cosmetic procedures in the temporal region. Based on our measurement of the course of the MTV, we propose that the safest area for filler injection for temporal fossa augmentation is one finger width above the zygomatic arch, because we found no main trunk of the MTV in this area (Figure 5). We also provide another rationale to prefer supraperiosteal injection over subcutaneous injection, because the MTV is located rather superficially and there is the possibility of inadvertent intravenous injection of fillers with subcutaneous injection. The use of a microcannula instead of a needle would further reduce the possibility of MTV perforation and venous occlusion caused by accidental intravenous dermal filler injection.17 Acknowledgment This work was supported by the Gachon University Research Fund of 2013 (GCU2013-M056). We thank Sophie Soyeon Kim at the Madeira School for assisting in revision of the manuscript and in the anatomical procedure. References 1. Standring S, editor-in-chief. Gray’s Anatomy (39th ed). Elsevier: Edinburgh, 2005; pp. 511
622
2. Sykes JM. Applied anatomy of the temporal region and forehead for injectable fillers. J Drugs Dermatol 2009;8:s24–7. 3. Moradi A, Shirazi A, Perez V. A guide to temporal fossa augmentation with small gel particle hyaluronic acid dermal filler. J Drugs Dermatol 2011;10:673–6. 4. McNichols CH, Hatef DA, Cole P, Hollier LH, et al. Contemporary techniques for the correction of temporal hollowing: augmentation temporoplasty with the classic dermal fat graft. J Craniofac Surg 2012; 23:e234–8. 5. Lee SJ, McCall WD Jr, Kim YK, Chung SC, et al. Effect of botulinum toxin injection on nocturnal bruxism: a randomized controlled trial. Am J Phys Med Rehabil 2010;89:16–23. 6. Farinelli I, Coloprisco G, De Filippis S, Martelletti P. Long-term benefits of botulinum toxin type A (BOTOX) in chronic daily headache: a fiveyear long experience. J Headache Pain 2006;7:407–12. 7. von Lindern JJ, Niederhagen B, Appel T, Bergé S, et al. Type A botulinum toxin for the treatment of hypertrophy of the masseter and temporal muscles: an alternative treatment. Plast Reconstr Surg 2001; 107:327–32. 8. Longmore RB, McRae DA. Middle temporal veins - a potential hazard in the Gillies’ Operation. Br J Oral Surg 1981;19:129–31. 9. Davison SP, Kaplan KA. The deep temporal vein: an alternative recipient vessel in microsurgical head and neck reconstruction. Plast Reconstr Surg 2005;116:1181–2. 10. Yano T, Tanaka K, Iida H, Kishimoto S, et al. Usability of the middle temporal vein as a recipient vessel for free tissue transfer in skull-base reconstruction. Ann Plast Surg 2012;68:286–9. 11. Abul-Hassan HS, von Drasek Ascher G, Acland RD. Surgical anatomy and blood supply of the fascial layers of the temporal region. Plast Reconstr Surg 1986;77:17–28. 12. Weinberg MJ, Solish N. Complications of hyaluronic acid fillers. Facial Plast Surg 2009;25:324–8. 13. Lazzeri D, Agostini T, Figus M, Nardi M, et al. Blindness following cosmetic injections of the face. Plast Reconstr Surg 2012;129: 995–1012.
DERMATOLOGIC SURGERY
Copyright © American Society for Dermatologic Surgery. Unauthorized reproduction of this article is prohibited.
JUNG ET AL
14. Roberts SA, Arthurs BP. Severe visual loss and orbital infarction following periorbital aesthetic poly-(L)-lactic acid (PLLA) injection. Ophthal Plast Reconstr Surg 2012;28:e68–70. 15. Kim SG, Kim YJ, Lee SI, Lee CJ. Salvage of nasal skin in a case of venous compromise after hyaluronic acid filler injection using prostaglandin E. Dermatol Surg 2011;37:1817–9. 16. Tangsirichaipong A. Blindness after facial contour augmentation with injectable silicone. J Med Assoc Thai 2009;92:S85–7. 17. Hexsel D, Soirefmann M, Porto MD, Siega C, et al. Double-blind, randomized, controlled clinical trial to compare safety and efficacy of
a metallic cannula with that of a standard needle for soft tissue augmentation of the nasolabial folds. Dermatol Surg 2012;38:207–14.
Address correspondence and reprint requests to: Hee-Jin Kim, DDS, PhD, Division in Anatomy and Developmental Biology, Department of Oral Biology, BK21 PLUS Project, Human Identification Center, Yonsei University College of Dentistry, 50 Yonsei-Ro, Seodaemun-Gu, Seoul 120-752, Korea, or e-mail: [email protected]
40:6:JUNE 2014
623
Copyright © American Society for Dermatologic Surgery. Unauthorized reproduction of this article is prohibited.
BACKGROUND The middle temporal vein (MTV) traverses the temporal fossa between the superficial and deep layers of the deep temporal fascia. During filler injection into a deficient temporal fossa, filling agents may be inadvertently injected into the MTV, which results in vascular complications. OBJECTIVE
To investigate the course of the MTV to enable safe filler injection in the temple area.
MATERIALS AND MATERIALS 9 Korean cadavers.
The course and diameter of the MTV were measured in 18 hemifaces from
RESULTS The MTV was located 23.5 and 18.5 mm above the zygomatic arch at the jugale and the zygion, respectively. The diameter of the MTV at its thickest point was 5.1 mm. A splitting and reuniting pattern, such that the MTV occupied more space than a single trunk, was observed in 28% of cases. CONCLUSION We propose that the safest area for filler injection in temporal fossa augmentation is one finger width above the zygomatic arch. The authors have indicated no significant interest with commercial supporters.
T
he middle temporal vein (MTV) is a relatively unknown blood vessel that receives several veins, including the sentinel vein, and traverses the temporal fossa deep to the superficial layer of the deep temporal fascia. It then joins the superficial temporal vein just above the level of the zygomatic arch.1 The temporal region undergoes several changes with age: the temporalis muscle becomes thinner, the temporal fat pad becomes smaller, and the temporal bone becomes slightly more concave. Through these changes, the temple loses its youthful convex volume and the bony margins of the zygomatic arch become more prominent, lending a gaunt wasted appearance.2 The most popular corrective technique for augmenting the aging-related deficient temporal fossa is injection with various filling agents such as hyaluronic acid or
poly-L-lactic acid,3 whereas temporal hollowing after craniofacial surgery is usually corrected with surgical alloplasts, calcium hydroxyapatite, or autologous fat.4 However, a hypertrophied temporalis muscle can be a cause of migraine, headache secondary to temporomandibular disorders, and bruxism. Botulinum toxin has often been injected into the temporalis muscle to treat these conditions.5–7 The MTV is prone to injury when the temporal fossa is being injected with filling agents or botulinum toxin; furthermore, these substances may be inadvertently injected into the vessel, resulting in various vascular complications such as hematoma, embolism, and obstruction. Given the relative dearth of information regarding the MTV as it pertains to those procedures,
*Department of Anatomy, School of Medicine, Gachon University, Inchon, Korea; †Division in Anatomy and Developmental Biology, Department of Oral Biology, BK21 PLUS Project, Human Identification Center, Yonsei University College of Dentistry, Seoul, Korea; ‡Department of Occupational Therapy, College of Health and Welfare, Woosong University, Daejeon, Korea; xDepartment of Anatomy, Department of Oral Anatomy, Dankook University College of Dentistry, Cheonan, Korea
·
© 2014 by the American Society for Dermatologic Surgery, Inc. Published by Lippincott Williams & Wilkins ISSN: 1076-0512 Dermatol Surg 2014;40:618–623 DOI: 10.1111/dsu.0000000000000004
·
·
·
618
Copyright © American Society for Dermatologic Surgery. Unauthorized reproduction of this article is prohibited.
JUNG ET AL
the aim of this study was to determine the morphology and course of the MTV. Materials and Methods Eighteen hemifaces from 9 embalmed Korean adult cadavers (5 males, 4 females; mean age, 76 years; age range, 52–94 years) were used in this study. After skin removal through a coronal incision, the medial zygomaticotemporal vein (sentinel vein) was identified and followed until where it pierced the temporoparietal fascia and drained into the MTV. The temporoparietal fascia was carefully reflected, and the blood-filled MTV was often seen through the superficial layer of the deep temporal fascia. The superficial layer of the deep temporal fascia was removed, and the MTV buried in the temporal fat pad was exposed. The distances between the MTV and the zygomatic arch were measured at 2 points: the jugale (where the temporal and frontal processes of the zygomatic bone meet) and the zygion (the most lateral point on the zygomatic arch). The diameter of the MTV was measured at the point where it exhibits the largest caliber. Results Buried in the fat pad of the temporal fascia, the MTV passed between the superficial and deep layers of the deep temporal fascia. The MTV was located 23.5 mm (15.7–33.6 mm) and 18.5 mm (12.5–23.5 mm) above the zygomatic arch at the jugale and the zygion, respectively (Figure 1). It then took a downward course and entered the opening in the deep layer of the deep temporal fascia and ran between the temporalis muscle and the deep temporal fascia. When the MTV bent downward, the angle of the descending course varied from a smooth curve to a right angle (Figure 2). The diameter of the MTV at its thickest point was 5.1 mm (range, 2.0–9.1 mm; Figure 3). A splitting and reuniting pattern of the course of the MTV was observed in 28% of cases. Discussion The MTV has not received much attention, and anatomical and surgical textbooks do not provide a detailed description of its course, simply mentioning
Figure 1. Distance between the MTV and the zygomatic arch.
its existence in passing, if at all. An article published in the early 1980s reported the risk of damaging the MTV during Gillies’ operation,8 and only recently its usability as a recipient vessel in head and neck reconstructions has been suggested.9,10 Temporal fossa augmentation using dermal fillers is a widely performed procedure, but there is only limited information describing the injection technique in this region. Sykes2 suggested that hyaluronic acid should be placed in either the subcutaneous plane or in the plane between the superficial and deep layers of the deep temporal fascia. The latter space is where the MTV lies buried in the fat pad of the temporal fascia. Moradi and coworkers3 recommended multiple filler injections with only 0.05 to 0.1 mL of hyaluronic acid at each insertion rather than a single large bolus injection to avoid lumps. They illustrated multiple injection sites in the temple, several of which appear to put the MTV in danger of perforation. Previous studies have measured the diameter of the MTV just before it flows into the superficial temporal vein, because the main concern of the researchers was
40:6:JUNE 2014
619
Copyright © American Society for Dermatologic Surgery. Unauthorized reproduction of this article is prohibited.
MIDDLE TEMPORAL VEIN
Figure 2. Variations in the course of the MTV. The MTV took a curved course (A, arrowheads) or bent sharply, almost at a right angle (B, arrowheads), to join the superficial temporal vein.
its utility as an alternative recipient vessel in skull base reconstruction.10,11 We measured its diameter at the point where the vein was the thickest in the temporal fossa. The diameter of the MTV in the temporal fossa was much larger than that has been reported previously at the draining point to the superficial temporal vein (Table 1). Considering its rather large size, along with its splitting variation (28%), which occupies more space in the temporal fossa than the
single main trunk, the MTV is thought to be highly vulnerable to injury during filler or botulinum toxin injection. Hyaluronic acid fillers generally have a wide safety profile, but related vascular complications are not uncommon, ranging from mild, such as telangiectasia, to severe, such as tissue necrosis and blindness.12–14 Vascular complications are mostly due to arterial
Figure 3. Variations in the diameter of the MTV. The MTV was generally thick (A), but in some cases it was very thin (B, arrows).
620
DERMATOLOGIC SURGERY
Copyright © American Society for Dermatologic Surgery. Unauthorized reproduction of this article is prohibited.
JUNG ET AL
TABLE 1. Comparison of MTV Diameters Measured in This Study and Other Studies
This study* 10,
Yano and coworkers † Abul-Hassan and coworkers11,†
n
Mean Diameter, mm
Minimum Diameter, mm
Maximum Diameter, mm
18
5.1
2.0
9.1
8
2.0
1.2
2.5
30
1.9
1.0
3.5
*Measured in the temporal fossa where the MTV was thickest. †Measured just before the MTV flowed into the superficial temporal vein.
occlusion, but venous occlusion can also lead to skin damage.15 In addition to dozens of cases of blindness after cosmetic filler injection of the face, there is a case of blindness after silicone injection into the temple area.16 The cause of the blindness after facial filler injection is thought to be central retinal artery embolization. This is related to the retrograde
displacement of the injected products from peripheral arteries into the ophthalmic arterial system.13 The MTV is connected to the cavernous sinus through the periorbital veins, and it would thus be much easier for the filler to be inadvertently injected into the MTV— which is much larger than other related arteries—and create cavernous sinus embolization (Figure 4).
Figure 4. Venous connection between the MTV and the cavernous sinus. The MTV was connected to the supratrochlear vein (STV), which drained toward the cavernous sinus (CS). Photographs of the anterior (A) and lateral aspect (B) of the dissected head. Upper margin of the orbicularis oculi muscle was trimmed to reveal the periorbital vein lying underneath. Superficial layer of the deep temporal fascia was cut and reflected downward to reveal the middle temporal vein and temporal fat pad. (C) Drawing depicting the vertical anatomy of the temple and its venous connection. CS, cavernous sinus; DL, deep layer; DTF, deep temporal fascia; POV, periorbital vein; SL, superficial layer; SOV, supraorbital vein; STV, supratrochlear vein; SV, sentinel vein; TFP, temporal fat pad; TPF, temporoparietal fascia.
40:6:JUNE 2014
621
Copyright © American Society for Dermatologic Surgery. Unauthorized reproduction of this article is prohibited.
MIDDLE TEMPORAL VEIN
Figure 5. The suggested area for safe filler injection. No main trunk of the MTV was found in the area one finger width above the zygomatic arch in any of the specimens. Photographs of the MTV without (A) and with (B) a finger on the temple area.
The MTV is a relatively unknown vessel among both clinicians and anatomists. However, awareness of the existence of the MTV is essential to avoid unnecessary vascular complications during cosmetic procedures in the temporal region. Based on our measurement of the course of the MTV, we propose that the safest area for filler injection for temporal fossa augmentation is one finger width above the zygomatic arch, because we found no main trunk of the MTV in this area (Figure 5). We also provide another rationale to prefer supraperiosteal injection over subcutaneous injection, because the MTV is located rather superficially and there is the possibility of inadvertent intravenous injection of fillers with subcutaneous injection. The use of a microcannula instead of a needle would further reduce the possibility of MTV perforation and venous occlusion caused by accidental intravenous dermal filler injection.17 Acknowledgment This work was supported by the Gachon University Research Fund of 2013 (GCU2013-M056). We thank Sophie Soyeon Kim at the Madeira School for assisting in revision of the manuscript and in the anatomical procedure. References 1. Standring S, editor-in-chief. Gray’s Anatomy (39th ed). Elsevier: Edinburgh, 2005; pp. 511
622
2. Sykes JM. Applied anatomy of the temporal region and forehead for injectable fillers. J Drugs Dermatol 2009;8:s24–7. 3. Moradi A, Shirazi A, Perez V. A guide to temporal fossa augmentation with small gel particle hyaluronic acid dermal filler. J Drugs Dermatol 2011;10:673–6. 4. McNichols CH, Hatef DA, Cole P, Hollier LH, et al. Contemporary techniques for the correction of temporal hollowing: augmentation temporoplasty with the classic dermal fat graft. J Craniofac Surg 2012; 23:e234–8. 5. Lee SJ, McCall WD Jr, Kim YK, Chung SC, et al. Effect of botulinum toxin injection on nocturnal bruxism: a randomized controlled trial. Am J Phys Med Rehabil 2010;89:16–23. 6. Farinelli I, Coloprisco G, De Filippis S, Martelletti P. Long-term benefits of botulinum toxin type A (BOTOX) in chronic daily headache: a fiveyear long experience. J Headache Pain 2006;7:407–12. 7. von Lindern JJ, Niederhagen B, Appel T, Bergé S, et al. Type A botulinum toxin for the treatment of hypertrophy of the masseter and temporal muscles: an alternative treatment. Plast Reconstr Surg 2001; 107:327–32. 8. Longmore RB, McRae DA. Middle temporal veins - a potential hazard in the Gillies’ Operation. Br J Oral Surg 1981;19:129–31. 9. Davison SP, Kaplan KA. The deep temporal vein: an alternative recipient vessel in microsurgical head and neck reconstruction. Plast Reconstr Surg 2005;116:1181–2. 10. Yano T, Tanaka K, Iida H, Kishimoto S, et al. Usability of the middle temporal vein as a recipient vessel for free tissue transfer in skull-base reconstruction. Ann Plast Surg 2012;68:286–9. 11. Abul-Hassan HS, von Drasek Ascher G, Acland RD. Surgical anatomy and blood supply of the fascial layers of the temporal region. Plast Reconstr Surg 1986;77:17–28. 12. Weinberg MJ, Solish N. Complications of hyaluronic acid fillers. Facial Plast Surg 2009;25:324–8. 13. Lazzeri D, Agostini T, Figus M, Nardi M, et al. Blindness following cosmetic injections of the face. Plast Reconstr Surg 2012;129: 995–1012.
DERMATOLOGIC SURGERY
Copyright © American Society for Dermatologic Surgery. Unauthorized reproduction of this article is prohibited.
JUNG ET AL
14. Roberts SA, Arthurs BP. Severe visual loss and orbital infarction following periorbital aesthetic poly-(L)-lactic acid (PLLA) injection. Ophthal Plast Reconstr Surg 2012;28:e68–70. 15. Kim SG, Kim YJ, Lee SI, Lee CJ. Salvage of nasal skin in a case of venous compromise after hyaluronic acid filler injection using prostaglandin E. Dermatol Surg 2011;37:1817–9. 16. Tangsirichaipong A. Blindness after facial contour augmentation with injectable silicone. J Med Assoc Thai 2009;92:S85–7. 17. Hexsel D, Soirefmann M, Porto MD, Siega C, et al. Double-blind, randomized, controlled clinical trial to compare safety and efficacy of
a metallic cannula with that of a standard needle for soft tissue augmentation of the nasolabial folds. Dermatol Surg 2012;38:207–14.
Address correspondence and reprint requests to: Hee-Jin Kim, DDS, PhD, Division in Anatomy and Developmental Biology, Department of Oral Biology, BK21 PLUS Project, Human Identification Center, Yonsei University College of Dentistry, 50 Yonsei-Ro, Seodaemun-Gu, Seoul 120-752, Korea, or e-mail: [email protected]
40:6:JUNE 2014
623
Copyright © American Society for Dermatologic Surgery. Unauthorized reproduction of this article is prohibited.
