Auriculotemporal Nerve, Intraoperative Findings, and Potential Implications in Rhytidectomy

OBJECTIVE: To investigate the anatomic variations of the auriculotemporal nerve (ATN) during temporal rhytidectomy, its relationship with the superficial temporal artery (STA), and to analyze its potential clinical significance in postoperative pain and sensory abnormalities. METHODS: A retrospective analysis was conducted on 14 hemifaces receiving temporal rhytidectomy between September and December 2025. The ATN was actively identified intraoperatively, with documentation of branch count, dissection length, distance from the tragus, and proximity to the STA. RESULTS: The ATN was successfully identified in all 14 sides. The mean number of branches was 2.64±0.84, with a mean distance from the tragus line of 1.15±0.16 cm. In 5 hemifaces (35.7%), a close association between the ATN and STA was observed. CONCLUSIONS: The ATN exhibits significant anatomic variation in the temporal region. Proactive intraoperative identification and preservation of the ATN, along with understanding its complex vascular and neural connections, are crucial for preventing postoperative pain and enhancing patient satisfaction.