Temporal Artery Ligations

Q: Dr. Eppley, I am interested in temporal artery ligations. I am talking to a couple of consultants here also and plan to make a decision once I have all the information I need.  It appears that you are the most experienced on this procedure – would you mind informing me how many you have done on the past? My main concerns are around potential scarring and hair loss.

I first noted the prominent temporal arteries appeared about six months ago – first on the left side and most recently on my right temple.  No idea what is causing them and have not been able to find out but I do get a throbbing/ shooting sensation in them most of the time.

Would the surgery eliminate the throbbing sensation I get as well as the appearance? I have attached pictures for your reference.

A: In answer to your temporal artery ligations questions:

1) I now perform about 1 to 2 temporal artery ligations per month from patients all over the world.

2) The incisions to do the procedure are very small (around 5 to 7mms) and usually heal imperceptibly.  Whether you  need just one proximal ligation (one point) or a combined proximal-distal ligation (two point) can not be determined until during the procedure. (The vast majority of patients receive a proximal and distal ligation) I have yet to have a patient have an issue with the scars. (at least a patient that has ever told me so)

3) Hair loss is not an issue with this procedure. It has not been seen or reported.

4) With a reduction in the temporal artery flow I would think that the throbbing sensation would decrease or be eliminated. That is what most patients who have these symptoms so state afterwards

5) Your pictures show a classic pattern of an enlarged anterior branch of the superficial temporal artery with its typical snakelike pattern coursing towards the forehead.

Dr. Barry Eppley
Indianapolis, Indiana