Anatomical Science International

, Volume 86, Issue 4, pp 232–236 | Cite as

Divided and reunited maxillary artery: developmental and clinical considerations

  • Philip G. Claire
  • Kathryn Gibbs
  • Sunny H. Hwang
  • Robert V. Hill
Case Report


We describe an anatomical variation of the right maxillary artery, discovered during dissection of a male human cadaver. The right maxillary artery bifurcates into unequal superficial (larger) and deep (smaller) divisions. Each division gives off several branches that distribute to the muscles of mastication, facial structures, and teeth. The superficial and deep divisions then reunite to form a complete loop, before giving off terminal branches in the pterygopalatine fossa. The entire arterial loop lies superficial to the branches of the mandibular nerve. This case provides further evidence for a network of vascular rings that surround soft tissue structures in the developing infratemporal fossa. Persistence of all or part of these rings determines adult anatomy. Extreme anatomical variations such as this one may complicate major procedures such as radical maxillectomy, as well as simple procedures such as inferior alveolar nerve blocks.


Anatomical variation Clinical anatomy Infratemporal fossa Maxillary artery Pterygopalatine fossa 



We thank James Giannone for helpful comments that improved the manuscript. This research was supported by the New York College of Osteopathic Medicine Office of Research.


  1. Adachi B (1928) Das Arteriensystem der Japaner. Maruzen, Kyoto, pp 85–90Google Scholar
  2. Choi J, Park H-S (2003) The clinical anatomy of the maxillary artery in the pterygopalatine fossa. J Oral Maxillofac Surg 61:72–78PubMedCrossRefGoogle Scholar
  3. Choi EC, Choi YS, Kim CH et al (2004) Surgical outcome of radical maxillectomy in advanced maxillary sinus cancers. Yonsei Med J 45:621–628PubMedGoogle Scholar
  4. Gilroy AM, MacPherson BR, Ross LM (2008) Atlas of anatomy. Thieme, StuttgartGoogle Scholar
  5. Hogg ID, Stephens CB, Arnold GE (1972) Theoretical anomalies of the stapedial artery. Ann Otol Rhinol Laryngol 81:860–870PubMedGoogle Scholar
  6. Jergenson MA, Norton NS, Opack JM, Barritt LC (2005) Unique origin of the inferior alveolar artery. Clin Anat 18:597–601PubMedCrossRefGoogle Scholar
  7. Kim JK, Cho JH, Lee Y-J et al (2010) Anatomical variability of the maxillary artery: findings from 100 Asian cadaveric dissections. Arch Otolaryngol Head Neck Surg 136:813–818PubMedCrossRefGoogle Scholar
  8. Klisović D, Šikić E, Krmpotić-Nemanić J (1993) Variations of the middle meningeal artery: significance for surgery and practice. Clin Anat 6:289–294CrossRefGoogle Scholar
  9. Lasker GW, Opodyke DL, Miller H (1951) The position of the internal maxillary artery and its questionable relation to the cephalic index. Anat Rec 109:119–126PubMedCrossRefGoogle Scholar
  10. Lauber H (1901) Über einige varietäten im Verlaufe der Arteria maxillaries interna. Anat Anz 19:444–448Google Scholar
  11. Lesley WS (2007) Endoscopic repair of an iatrogenic facial arteriovenous fistula due to percutaneous trigeminal balloon rhizotomy. J Neurosurg Sci 51:177–180PubMedGoogle Scholar
  12. Moore KL, Agur AMR, Dalley AF (2011) Essential clinical anatomy. Lippincott Williams & Wilkins, PhiladelphiaGoogle Scholar
  13. Orbay H, Kerem M, Ünlü RE, Cömert A, Tüccar E, Şensöz Ö (2007) Maxillary artery: anatomical landmarks and relationship with the mandibular subcondyle. Plast Reconstr Surg 120:1865–1870PubMedCrossRefGoogle Scholar
  14. Rogers SN, Patel M, Beirne JC, Nixon TE (1995) Traumatic aneurysm of the maxillary artery: the role of interventional radiology. Int J Oral Maxillofac Surg 24:336–339PubMedCrossRefGoogle Scholar
  15. Seno S, Arikata M, Sakurai H et al (2009) Endoscopic ligation of the sphenopalatine artery and the maxillary artery for the treatment of intractable posterior epistaxis. Am J Rhinol Allergy 23:197–199PubMedCrossRefGoogle Scholar
  16. Stern JT Jr (1988) Essentials of gross anatomy. Davis, PhiladelphiaGoogle Scholar
  17. Tadokoro O, Umemura Y, Utsuno H, Inoue K (2008) A case of a divided maxillary artery in the infratemporal fossa. Okajimas Folia Anat Jpn 85:97–101PubMedCrossRefGoogle Scholar
  18. Tank PW (2005) Grant’s dissector. Lippincott Williams & Wilkins, PhiladelphiaGoogle Scholar
  19. Tiwari R, Quak J, Egeler S et al (2000) Tumors of the infratemporal fossa. Skull Base Surg 10:1–9PubMedCrossRefGoogle Scholar
  20. Webber B, Orlansky H, Lipton C, Stevens M (2001) Complications of an intra-arterial injection from an inferior alveolar nerve block. J Am Dent Assoc 132:1702–1704PubMedGoogle Scholar
  21. Wilkie GJ (2000) Temporary uniocular blindness and ophthalmoplegia associated with mandibular block injection. A case report. Aust Dent J 45:131–133PubMedCrossRefGoogle Scholar

Copyright information

© Japanese Association of Anatomists 2011

Authors and Affiliations

  • Philip G. Claire
    • 1
  • Kathryn Gibbs
    • 1
  • Sunny H. Hwang
    • 1
    • 2
  • Robert V. Hill
    • 1
  1. 1.Department of AnatomyNew York College of Osteopathic MedicineOld WestburyUSA
  2. 2.Kaplan PublishingNew YorkUSA

Personalised recommendations