Attachment of the deep temporal fascia to the zygomatic arch: an anatomic study.

It is generally acknowledged that the superficial layer of the deep temporal fascia attaches to the lateral surface and its deep layer along the medial surface of the zygomatic arch. However, Ramírez asserts that the superficial and the deep layer of the deep temporal fascia fuse consistently approximately 1 cm above the upper ridge of the arch and attach to the outer surface of the arch, blending with the superficial fascia of the masseter muscle. In this study the authors clarify the precise anatomic relations between the fascia and the zygomatic arch. Coronal sections crossing the midpoint between the zygomaticotemporal suture and the tubercle of zygoma were observed grossly and histologically in 32 hemifaces from 16 Korean adult cadavers. This study demonstrates that the superficial and the deep layers of the deep temporal fascial fuse and insert onto the superior margin of the arch in 18 dissections (56%) and insert onto the superolateral surface in 14 dissections (44%). The contacting surface of the fused deep temporal fascia to the periosteum of the zygomatic arch is less than 2 mm. The following route is safer and is recommended for reaching the zygomatic arch region: Just above the split of the deep temporal fascia, a dissection is carried through the deep temporal fasica, continuing downward to the superior margin of the arch along the undersurface of the fascia. At this spot the periosteum of the arch is dissected.