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Topographic anatomy of the deep temporal nerves, with references to the superior head of lateral pterygoid

Summary

Commonly, the nerve branches from the anterior mandibular nerve trunk pass between the roof of infratemporal fossa and the superior head of lateral pterygoid. However, varied courses of the mandibular nerve branches can be frequently observed. The purpose of this study was to clarify the positional relationships and the clinical relevance of the course variations of the branches of the anterior mandibular nerve trunk with reference to the surrounding anatomical structures. Thirty-six hemi-sectioned heads were studied in detail. In 20 cases, the posterior deep temporal nerve had a common trunk with the masseteric nerve and was then divided anteriorly (15 cases) or posteriorly (five cases). In 16 cases, the posterior deep temporal nerve arose from the mandibular nerve trunk independently. Based on the branching patterns of the middle deep temporal nerve, type A (one twig of the middle deep temporal nerve) was most frequent and occurred in 41.7%. Similarly, type B (two twigs), type C (three twigs) and type D (four twigs) were observed in 36.1%, 16.7%, and 5.5%, respectively. The twigs of the middle deep temporal nerve, which pierced the muscle fibers of the superior head of lateral pterygoid, were found in 21 cases (58.3%). Cases in which the middle deep temporal nerve pierced through all areas of the superior head were most frequent (56.5%). These results suggest that the piercing patterns of the middle deep temporal nerve show there is a possibility that it may be compressed during the actions of the superior head of lateral pterygoid.

Résumé

Habituellement, les rameaux nés du tronc antérieur du nerf mandibulaire passent entre le toit de la fosse infra-temporale et le chef supérieur du muscle ptérygoïdien latéral. Cependant, des trajets variés des branches du nerf mandibulaire peuvent être fréquemment observés. Le but de cette étude était de clarifier les rapports et l'importance clinique des variations de trajet des branches du tronc antérieur du nerf mandibulaire par rapport aux structures anatomiques environnantes. 36 demi-têtes ont été étudiées en détail. Dans 20 cas, le nerf temporal profond postérieur naissait d'un tronc commun avec le nerf massétérique, puis se divisait en avant (15 cas) oui en arrière (5 cas). Dans 16 cas, le nerf temporal profond postérieur naissait indépendamment du tronc du nerf mandibulaire. Sur la base des modes d'origine du nerf temporal profond moyen, le type A (une seule racine) était la plus fréquente et survenait dans 41,7% des cas. De même, les types B (2 racines) C (3 racines) et D (4 racines) étaient observés respectivement dans 31.6%, 16.7%, et 5.5%. Les branches du nerf temporal profond moyen traversaient les fibres musculaires du chef supérieur du muscle ptérygoïdien latéral dans 21 cas (58.3%). Les cas dans lesquels le nerf temporal profond moyen traversait toutes les zones du chef supérieur étaient les plus fréquents (56,5%). Ces résultats suggèrent que les modes de traversée du nerf temporal profond moyen montrent la possibilité qu'il soit comprimé au cours de l'action du chef supérieur du muscle ptérygoïdien latéral.

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Acknowledgements

This study was supported by a Faculty Research Grant of Yonsei University, College of Dentistry, Seoul, Korea (2001).

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Correspondence to H. J. Kim.

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Kwak, H.H., Ko, S.J., Jung, H.S. et al. Topographic anatomy of the deep temporal nerves, with references to the superior head of lateral pterygoid. Surg Radiol Anat 25, 393–399 (2003). https://doi.org/10.1007/s00276-003-0171-5

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  • DOI: https://doi.org/10.1007/s00276-003-0171-5

Keywords

  • Deep temporal nerves
  • Superior head of lateral pterygoid
  • Mandibular nerve