“Three-Dimensional Computed Tomography Angiography for Safer Filler Injections in Lying Ear Corrections: Identifying Key Vascular Structures”

Background: Concerns exist regarding potential complications associated with injectable cosmetic treatments for lying ear correction. This study aimed to examine the blood vessel distribution patterns in the ear and face related to ear filler procedures and surgeries by using three-dimensional computed tomography angiography of cadaveric head specimens. Methods: In total, 50 high-resolution images of the lateral aspects of the specimens were captured. Three-dimensional images of blood vessels in the cephalo-auricular sulcus were created using Mimics. The coordinate system was established based on the highest points of the bilateral external auditory canals and the left suborbital border point, corresponding to the Frankfurt plane. The posterior cephalo-auricular region was divided into regions A, B, C, and D, with region C further subdivided into regions C1 and C2. Results: The primary blood supply to the cephalo-auricular sulcus comes from the medial temporal artery, posterior auricular artery (PAA), and superior auricular artery. Two hypovascular regions, referred to as regions B and C1, were observed between the cephalo-auricular sulcus and the PAA. The measured distances from the PAA to the cephalo-auricular sulcus at three evenly spaced points in region B and at the inferior point of region C1 were 5.6±1.5 mm, 8.8±2.1 mm, 10.7±1.9 mm, and 10.1±2.2 mm, respectively. Conclusions: Regions A, C2, and D pose a higher risk for filler injections, whereas regions B and C1 are relatively safer. This study provides valuable insights into the safe administration of filler injections for correction of lying ears.