Sentinel vein: an anatomical landmark in the temple
- Vein
- Nerve
- Highlighted area
Quick facts
- Anatomical name
- Medial zygomaticotemporal vein.
- Location
- In the anterior temple, lateral to the lateral edge of the orbit and above the zygomatic arch.
- Course
- Pierces the deep temporal fascia and connects the superficial venous network to the deep venous system of the temple.
- Why sentinel
- The temporal branch of the facial nerve passes superficial to it, usually a little above.
- Relevance in HOF
- A point of caution in the anterior temple and a possible source of bruising.
The sentinel vein is the medial zygomaticotemporal vein, a vessel of the anterior temple that pierces the deep temporal fascia, lateral to the lateral edge of the orbit and above the zygomatic arch. It earned the name "sentinel" because it marks the proximity of the temporal branch of the facial nerve, which runs in a more superficial plane, usually a little above it. In orofacial harmonization (HOF), it is an anatomical landmark of the temple.
Where is it and what is its course?
The vein appears in the anterior, lower part of the temporal fossa, on each side, about a finger's width lateral to the outer corner of the eye, with variation between people. It rises from a deep plane and pierces the deep temporal fascia, connecting the superficial venous network of the temple to the deep venous system, which includes the middle temporal vein. It can be single or double, and its caliber varies considerably.
| Layer (from skin to bone) | Relationship to the sentinel vein |
|---|---|
| Skin and subcutaneous tissue | Above everything |
| Temporoparietal fascia (continuation of the SMAS) | Where the temporal branch of the facial nerve runs |
| Deep temporal fascia | The vein pierces this layer |
| Fat pads and temporal muscle | Plane from which the vein emerges |
| Bone of the temporal fossa | Deepest plane |
The detail of the layers of the area is in temporal fat pads and temporal fossa.
Why does the sentinel vein matter in HOF?
- Sign of nerve proximity: where it lies, the temporal branch of the facial nerve is usually close, in a more superficial layer. Injury to this branch can reduce brow elevation on the same side.
- Bruising: it is a vein of relevant caliber in the anterior temple, and bleeding there can result in a visible bruise.
- Map of the anterior temple: together with the temporal adhesion and the inferior temporal septum, it helps divide the temple into areas with and without critical structures.
How does it show up in the assessment?
- Visible veins in the temple: in thin people or those with a hollow temple, the venous network is apparent, which also changes the aesthetic expectation.
- Brow elevation: comparing both sides before any procedure helps document the function of the temporal branch.
- Previous procedures in the temple or brow surgery and lifting, which change the anatomy.
The procedure is covered in temple filler.
Also called: medial zygomaticotemporal vein, sentinel vein.
Frequently asked questions
Why is it called the sentinel vein?
The name comes from endoscopic forehead and temple surgery: on finding this vein, the surgeon knows the temporal branch of the facial nerve is close, running in a more superficial plane, usually a little above it. It works as a proximity warning.
Where is the sentinel vein?
In the anterior temple, on each side, lateral to the lateral edge of the orbit and above the zygomatic arch. The exact distance from the corner of the eye varies between people and between sides.