Computed Tomography Angiographic Morphometry of the Maxillary Artery in Relation to Mandibular Landmarks

Background/Objectives: To establish normative CTA (computed tomography angiography) morphometry of the maxillary artery (MA) relative to the lateral pterygoid muscle (LPM) and mandibular landmarks in a European population. Methods: Bilateral CTA datasets from 164 patients (328 sides; mean age 67.2 ± 13.0 years) were analysed retrospectively. The MA course was classified relative to the inferior head of the LPM as superficial (S) or deep (D); patients were assigned to three bilateral types (Type 1: S + S; Type 2: D + D; Type 3: S + D), and MA-gonial angle, MA-mandibular notch, and MA-lingula distances were measured. Results: The MA was superficial in 61.0% of sides, with no transpterygoid course; Type 1 predominated (48.8%). The MA-gonial angle distance was 34.53 ± 5.31 mm, with marked sex dimorphism (males: 36.74 mm vs. females: 31.35 mm; p < 0.0001). Looping occurred on at least one side in 34.8% of patients, and the MA lay superior to the mandibular notch in 83.4% of superficial sides. The MA-lingula distance was 8.03 ± 2.54 mm; non-retrotuberosity looping was strongly associated with proximity below 5 mm (OR = 9.95). Conclusions: A three-type bilateral classification of the MA course, the first normative MA-gonial angle dataset, and the looping-proximity association provide actionable data for surgical risk stratification in infratemporal and mandibular ramus procedures.