The focus of our recent publication was branch facial nerve injury occurring as a result of superficial temporal artery biopsy. In the article, we stressed that the risk of this complication is reduced by obtaining a specimen from the parietal as opposed to the frontal branch of the superficial temporal artery. We mentioned that locating the path of the artery is aided with removal of hair overlying the surgical site. Dastgir and associates advise not removing hair as a slight modification. The neurosurgical literature suggests that shaving hair on the head has little impact on infection risk. In short, we are not opposed to their suggested technique of simply parting the hair along the line of the surgical incision and pasting the hair with antibiotic ointment. One can also use rubber bands to keep hair out of the surgical field, a technique commonly used in cosmetic brow lifting.

However, there are potential disadvantages to not removing the hair overlying the surgical site. Hair can make it more difficult to locate the artery. Hair dampens the artery pulse to palpation and may create background noise when performing Doppler ultrasonography. The consequences of hair removal are trivial, and certainly less serious than failure to obtain an adequate biopsy specimen. One should not hesitate to remove the hair if necessary, but we agree this step can be omitted in many cases.