Re-evaluation of the Medial Temporal Artery: A Three-Dimensional Anatomical Study and Its Clinical Implications for Safe Auricular Filler Injections

Vollständiger Abstract

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Abstract Background The medial temporal artery (MTA) supplies the auricle and temporal region but remains understudied despite its relevance to filler injection safety. Objective To comprehensively evaluate the MTA using three-dimensional computed tomography angiography (3D-CTA) and grossdissection. Methods Fifty-three cadaverheads (106 sides)underwent lead oxide perfusion and CT scanning. The origin, course, branching patterns, and anastomosesof the MTA were analyzed, and a vasculardistribution heat map wasgenerated. Results The MTA waspresent in all specimens. Itoriginated from the superficial temporal artery at the zygomaticotemporal suture, coursed posteriorly (27.21°±7.21°) then posterosuperiorly (67.75°±7.27°). Branching patterns were single-trunk (56.6%), bifurcated (29.2%), and trifurcated (14.2%). The MTA ran between the temporalis muscle and periosteum, forming extensive anastomoses with the posterior auricular and deep temporal arteries. A high-probability zone was identified 1–2 cm posterior and 1–2 cm superior to the superior auricularpoint. Conclusion The MTA exhibits multiple branching patterns and extensive anastomoses, posing a theoretical risk for retrograde embolization leading to ophthalmic artery occlusion. Deep injections should be avoided in the identified high-risk zone to preventvascular complications.