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

Zhou, Yu-Hao; Yuan, Guo-Hao; Xu, Jia-Ying; Lu, Hui-Qin; Li, Fang-Wei; Wang, Xing; Wu, Yan-Qun; Wang, Hai-Bin · Aesthet Surg J · 2026

basic_science · Level V

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Abstract

The medial temporal artery (MTA) supplies the auricle and temporal region but remains understudied despite its relevance to filler injection safety. To comprehensively evaluate the MTA using three-dimensional computed tomography angiography (3D-CTA) and grossdissection. 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. 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. 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.