Superficial Temporal Artery Ligation

Q: Dr. Eppley, Several years ago, I developed bulging temple veins and I had the superficial temporal artery ligation in my right temple with a single point ligation.I’ve had some potential complications and I’m looking for a second opinion.

For the most part, the surgery was a success. The bulging vessel is gone and any scarring was very minimal. A couple years after the surgery, I developed a very rare condition called Partial Third Nerve Palsy, most likely caused by lack of blood flow to my ocular motor nerve. As with most partial ocular nerve palsies, my condition improved within weeks. 

Fast forward a couple years and it happened again. And just like the first time, I recovered completely. I had the top ophthalmologic docs stumped. I told them about my superficial temporal artery ligation and they brushed it off as insignificant. I’m relatively young and healthy and have no other conditions that typically would cause an ocular nerve palsy. 

I was recently reading Men’s Health and there was an article about giant cell temporal arteritis and how it can cause double vision or blindness. So that tells me that there IS a possible connection between the superficial temporal artery ligation and vision, right?

But everything I read online said the procedure is safe and perhaps my recurring ocular nerve palsy is just a totally unrelated coincidence. As you seem like an expert in this field, I thought I would reach out to you and hope you can put my mind at ease.

Q: In short, I know of no connection between superficial temporal artery ligation and oculomotor nerve palsy. The superficial temporal artery is a terminal branch of the external carotid artery that supplies the forehead and anterior scalp. Conversely the oculomotor nerve receives its blood supply from the internal carotid artery through an intracranial course. Thus there is no apparent anatomic connection on the basis of arterial blood supply.

Dr. Barry Eppley

Indianapolis, Indiana