✅ Step #2: Image the T3 zone on your own with your ultrasond, and using the checklist provided on this page, check off all key structures to be identified in this location.
TRANSDUCER POSITION AT T3
STANDARD T3 ORIENTATION: LONGITUDINAL
1-2 cm medal pre-auricularly and 1-2 cm above the superior margin of the zygomatic arch is the location for T3
The views between T2 (longitudinal) and T3 are very similar, but scanning the posterior aspect of the temple facilitates a comprehensive vascular mapping of the area.
If you have a smaller footplate probe, scanning superiorly and inferiorly is useful until you identify the zygomatic arch. This way you can appreciate the entire anterior temporal fossa in the longitudinal view.
The temporal fossa deepens as we move inferiorly; you will need to increase the depth of your penetration at T2; usually, 2-3cm is sufficient; make sure you visualize the temporal bone to determine the optimal depth.
EXAMPLE OF IMAGE ACQUIRED AT T3
Standard image acquired at T3. Left T3 Position (Longitudinal | Top of image is patient superior, right of image is superfical). See key below for lables.*
ANATOMICAL LEGEND FOR T3 LOCATION
*Standard image acquired at T3 labeled with key anatomical structures.
DOPPLER IMAGES ACQUIRED AT T3 OF KEY VESSELS
In most patients, the superficial temporal vessels are easy to spot. It is generally large and will be superficial.
But it is easily occluded! So Use lots of gel and a light touch!
In the temple, the vessels you see in the deeper layers will not be the superficial temporal artery. If you notice vessels in the deep fascial layer or below the temporalis muscle, you are looking at the middle temporal artery or deep temporal artery, respectively.
Considering many standard approaches for injecting fillers in the temple are to stay deep to avoid the superficial temporal artery, looking with ultrasound to visualize the anatomy of the site of injection in the temple prior to placing any filler is strongly recommended!
To identify the deeper temporal vessels, such as the deep temporal artery or middle temporal artery, turning the sensitivity of your Doppler to 2cm/s can be helpful, but beware, this can increase motion artifacts.
DO IT YOURSELF CHECKLIST
Structures to Identify on Ultrasound for T3
Once you have completed this checklist, mark this part of the lesson as complete.