Vascular supply and drainage for auricle (cadaveric dissection) (Figure 2):
We dissected cadavers to confirm the vascular structures related to the auricle (Fig. 2A). The main arterial supply to this area is the branches of the external carotid artery: posterior auricular artery and superficial temporal artery. The external carotid artery (ECA) gives off the posterior auricular artery just before it divides into the maxillary and superficial temporal arteries, which are terminal branches of the ECA in the parotid gland. These arteries play an important role in vascularizing the auricle. Separating the parotid and the auricle/external auditory canal exposes the middle auricular artery (Fig. 2B). The superior auricular artery diverges from the superficial temporal artery and courses superior to the auricle, forming the arterial network with the posterior auricular artery (Fig. 2B). Partial removal of the preauricular parotid gland exposes the course of the middle and inferior auricular artery and posterior auricular artery (Fig. 2C). The superior, middle, and inferior auricular arteries branch from the superficial temporal artery and supply the lateral surface of the auricle. The posterior auricular artery passes anterior to the mastoid process and supplies the mastoid branch to the skin on the mastoid process (Fig. 2D), which passes upward to supply the medial surface of the auricle with three main branches: superior, middle, and inferior (Fig. 2E). There are several perforating branches that penetrate the cartilage to form a complex arterial network between the lateral and medial surface of the auricle (Fig. 2F). The venous drainage from the auricle follows these arteries and connects to the superficial temporal vein anteriorly and the posterior auricular vein posteriorly. The venous plexus around the condyle of the mandible connects to the superficial temporal vein. The superficial temporal vein also receives venous flow from the middle temporal, parotid, and transverse facial veins and forms the retromandibular vein (Fig. 1C, 2G, and H). The middle temporal vein courses beneath the superficial layer of the deep temporal fascia and joins the superficial temporal vein approximately 1 cm below the upper border of the zygomatic root. It connects the supraorbital vein and the superficial temporal vein. The retromandibular vein divides into two branches. The anterior branch passes forward and joins the facial vein to form the common facial vein, which ultimately drains into the internal jugular vein. The posterior auricular vein descends behind the auricle and joins the posterior branch of the retromandibular vein to form the external jugular vein (Fig. 2I).