Objective. To study topographic and anatomical features of preauricular temporal region with development of access to the middle temporal vein.

Material and methods. Bilateral anatomical examination was carried out on 25 unfixed corpses aged 35-82 years. Microsurgical transplantation of free autografts was performed in 12 patients with alternative venous revascularization using the middle temporal vein.

Results. Middle temporal vein is located in deep layers (inside the temporal muscle distally and under superficial leaf of deep temporal fascia proximally). There are 4 types of branching of the middle temporal vein. Mean diameter of the middle temporal vein is 1.8±0.48 mm. This vein contains the valves. Complete postoperative engraftment of the flaps was noted in all patients after reconstructive interventions with venous revascularization of the flaps through the middle temporal vein.

Conclusion. Middle temporal vein is effective and safe for venous revascularization. This vessel is located in deep layers of preauricular temporal region and less prone to atherosclerotic, irradiation-induced and cicatricial lesions.

Keywords. middle temporal vein, venous drainage, microsurgery