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

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.