> ## Content Index > Fetch the complete content index at: https://www.theplasticsfella.com/llms.txt > Use this file to discover other available public pages before exploring further. # Temporal/Frontal Branch of Facial Nerve - URL: https://www.theplasticsfella.com/temporal-or-frontal-branch-of-facial-nerve/ - Published: 2021-03-17T11:22:12.000Z - Updated: 2025-02-07T14:16:14.000Z - Description: Facial nerve's frontal or temporal branch has significant anatomical varation. This details its origin, course, innveration, clinical findings when injured. - Author: PlasticsFella - Tags: Anatomy, #benedetta ## Origin of Frontal/Temporal Branch The temporal/frontal branch of the facial nerve arises from the superomedial aspect of the parotid gland. More specifically, this branch arises from the temporofacial trunk – which forms part of the **pes anserinus* and is located superficial to the retromandibular vein in 90% of cases^​1​ --- ## Course of Frontal/Temporal Branch > The temporal/frontotemporal branches emerge from the superior surface of the parotid, cross the zygomatic arch and travel towards the pterion and the superolateral brow. ### Pitanguy’s Line A general guide for **location** of the temporal/frontal branches of facial nerve. Pitanguy’s Line in 0.5 cm inferior to the tragus to a point 1.5cm superior and lateral to the eyebrow​2​. ### Davies’ Area This is a general guide for the **distribution** of the frontal/temporal branch of the facial nerve. Whilst Pitanguy’s line uses variable soft tissue landmarks, Davies in 2013​3​ identified palpable surface features to predict the course. According to this study, the greatest distribution of frontal branch is within these following boundaries: 1. **Anterior:** Zygomatic suture line (ZSL) connecting zygomaticotemporal and frontozygomatic suture. 2. **Inferior:** Infraorbitomeatal line (IOML) connecting the infra-orbital margin and the external acoustic meatus. 3. **Superior:** Supra­orbitomeatal line SOML (SOML) – connecting the supra-orbital margin and the external acoustic meatus. 4. **Posterior:** Porion Line connecting the SOML and IOML 12mm in front of the porio (upper landmark of external acoustic meatus/superior aspect of tragus) ### Depth/Layers It is important to understand the facial nerve is not a 2-dimensional structure but rather a goes through different depths/layers in the face and skull. After leaving the superior surface of the parotid gland, the frontal/temporal branch of facial nerve​4​: 1. Pierces the parotidomassteric fascia (White Line) 2. Cross the zygomatic arch in the subcutaneous tissue (Blue Line) 3. Enter the subgaleal space (Yellow Line ### Anatomical Variations The facial nerve has significant communicating branches, anatomical variation and cross-innervation. Six different branching patterns have been published​3​. The temporal branch usually divides into anterior and posterior rami soon after piercing the parotidomasseteric fascia below the zygomatic arch; there is often a middle (frontal) ramus. --- ## Innervation of Frontal/Temporal Branch > Lower motor neuron lesions paralyse the ipsilateral frontalis muscle. > Upper motor neuron lesions preserve the frontalis, due to dual cortical representation of the forehead. ### Muscles The twigs of the frontal/temporal facial nerve branch innervates: 1. Frontalis Muscle – raises the eyebrows 2. Orbicularis Oculi Muscle – closes the eye 3. Corrugator Supercili Muscle – wrinkles forehead 4. Ear (intrinsics on lateral surface of auricle, Anterior and Superior auricular muscles) --- ### Communication **Clinical Pearl:** These anastomoses and branches patterns explain why a division of a small branch often fails to result in the expected facial nerve weakness. There is significant overlap and cross-innervation. There is also communication/anastomosis with: 1. Supraorbital and lacrimal branches of the ophthalmic nerve 2. Zygomaticotemporal branch of the maxillary nerve 3. Auriculotemporal branch of the mandibular nerve --- ## References 1. 1\. Westphal M. Cranial Neuroimaging and Clinical Neuroanatomy, Third Ed. **Neuro-Oncology*. July 2004:267-268\. doi:[10.1215/s1152851704200035](https://doi.org/10.1215/s1152851704200035?ref=theplasticsfella.com) 2. 2\. Pitanguy I, Ramos A. The frontal branch of the facial nerve: the importance of its variations in face lifting. **Plast Reconstr Surg*. 1966;38(4):352-356\. doi:[10.1097/00006534-196610000-00010](https://doi.org/10.1097/00006534-196610000-00010?ref=theplasticsfella.com) 3. 3\. Davies J, Fattah A, Ravichandiran M, Agur A. Clinically relevant landmarks of the frontotemporal branch of the facial nerve: a three-dimensional study. **Clin Anat*. 2012;25(7):858-865\. doi:[10.1002/ca.22162](https://doi.org/10.1002/ca.22162?ref=theplasticsfella.com) 4. 4\. D’Antoni AV. Gray’s Anatomy, the Anatomical Basis of Clinical Practice, Forty-First Edition, by Susan Standring, Editor-in-Chief, Elsevier Limited , 2016, 1,562 Pages, Hardcover, $228.99 ($171.74), ISBN: 978-0-7020-5230-9\. **Clin Anat*. January 2016:264-265\. doi:[10.1002/ca.22677](https://doi.org/10.1002/ca.22677?ref=theplasticsfella.com)