Anatomy and Variations of the Pterygomandibular Space
The pterygomandibular space (PM) is a space largely composed of connective tissue and muscle but also contains several neurovascular structures. It is triangular in shape and is bounded by the medial surface of the mandibular ramus laterally. The medial pterygoid muscle and associated fascia confine the space medially and the lateral pterygoid superiorly. The parotid gland lies posteriorly, and anteriorly, the buccinator, superior pharyngeal constrictors, and pterygomandibular raphe can be found. Of note, the inferior alveolar nerve, artery, and vein, along with the lingual nerve, traverse the PM. Detailed knowledge of the PM is important for the successful inferior alveolar nerve blockade. Awareness of the varying relationships of neurovascular structures to both osseous and connective tissue landmarks in the PM is essential for avoiding iatrogenic injury during nerve blocks and dental procedures in this specific region. In this chapter, the most common anatomy of the PM will be reviewed, along with common variants and their clinical implications.
- Huelke D (1973) Selected dissections of the facial regions for advanced dental students, 6th edn. Overbeck Co., Ann Arbor, MIGoogle Scholar
- Jorgensen N, Hayden J (1967) Premedication, local and general anesthesia in dentistry. Lea & Febiger, Philadelphia, PAGoogle Scholar
- Malamed S (2004) Handbook of local anesthesia, 5th edn. Mosby, St. Louis, MOGoogle Scholar
- Sicher H, DuBrul E (1975) Oral anatomy, 6th edn. C.V. Mosby Company, St. Louis, MOGoogle Scholar