Arterial anatomy of the auricle: its importance for reconstructive surgery

Because the auricle is an organ that is both used as a flap in reconstructive surgery and is often exposed to trauma, the arterial distribution of the auricle is of great importance. The aims of this study were to investigate the auricular branches of the posterior auricular artery (PAA) and superficial temporal artery (STA), to determine the vascular territory of various auricular flaps for flap design. Fifteen human male cadaver auricles were used for this study. A branch of the STA to the ear lobe (lower branch) was present in only five auricles (33%). Branches distributing the tragus were small and short arterioles (middle branch of the STA) which were present in 14 auricles (93%). The upper branch of the STA ascends the ascending helix, giving off sub-branches. Some of these sub-branches traverse to the posterior surfaces of the ear and communicate with branches of the PAA. The upper branch was present in all auricles. In 10 auricles (67%), the PAA terminated on the posterior auricular surface, whereas in five auricles (33%) it continued and distributed to the parietotemporal area. The arterial network which was obvious in the middle region of the posterior auricular surface was formed from the middle branch and some sub-branches of the upper branch of the PAA, which was found in 10 auricles (67%). We are convinced that the PAA is the dominant artery for the auricle and the arterial network of posterior auricular surface is better developed in the middle region than the other regions.