TEMPORAL ARTERY BIOPSY

 

A temporal artery biopsy is a medical procedure where a small section of the temporal artery, located just in front of the ear and continuing up into the scalp, is removed and examined under a microscope. This procedure is often used to diagnose temporal arteritis, also known as giant cell arteritis, an inflammation of the blood vessels that can cause headaches, jaw pain, and vision problems.

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During the procedure, the patient is typically given a local anesthetic to numb the area. The surgeon then makes a small incision in the skin over the artery and removes a small section of the artery. The incision is then closed with stitches. The removed artery segment is sent to a laboratory for histological examination to look for signs of inflammation or other abnormalities.

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Temporal artery biopsy is the primary modality to diagnose giant cell arteritis / temporal arteritis.

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Giant cell arteritis (temporal arteritis) affects the vessels supplying the head, eyes, and optic nerves.

                                                                                                 

                                                 Anesthetic Implications for Temporal Artery Biopsy

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Anesthesia type: General, TIVA, MAC

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Airway: LMA, ETT, spontaneous ventilation

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Preoperative:

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• Shared workspace with the surgeon

• A doppler is used to find the temporal artery

• Disease occurs most frequently in people older than 70

• Giant cell arteritis is frequently associated with polymyalgia rheumatica (inflammatory disorder that causes muscle pain and stiffness, mostly in the shoulders and hips)

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Intraoperative:

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• Duration: 15-45 minutes

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Postoperative:

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• Procedural pain

• Pain management

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Complications:

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• Temporary or permanent damage to the temporal branch of the facial nerve

• Bleeding

• Infection

• Hematoma

• Wound dehiscence

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Sources:

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Chase E, Patel BC, Ramsey ML. Temporal Artery Biopsy. [Updated 2023 May 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470397/

Elisha, S. (2010). Case Studies in Nurse Anesthesia.

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Elisha, S. (2010). Case Studies in Nurse Anesthesia.

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Macksey, L. F. (2011). Surgical procedures and anesthetic implications: A handbook for nurse anesthesia practice. 

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Jaffe, R. A. (2020). Anesthesiologist's Manual of Surgical Procedures (6th ed.). 

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Singh-Radcliff, N. (2013). 5-Minute Anesthesia Consult.

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