Unusual Organization of Auriculotemporal Nerve and Its Clinical Implications

Soni, Simmi; Rath, Goutam; Suri, Rajesh Kumar; Vollala, Venkat Ramana

doi:10.1016/j.joms.2008.09.012

Cited by 11 publications

(8 citation statements)

References 8 publications

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“…(i.) The Number of Roots—Historically, the literature on the infratemporal section of ATN identifies equivalently used terms, such as, root [ 5 , 11 – 13 , 15 ] and branch [ 9 , 16 , 17 ] to name the ramus of the nerve. The reason of this equivalency is that ATN roots could start on MN as well as on IAN.…”

Section: Discussionmentioning

confidence: 99%

“…Few papers considered the analysis of the root variations of ATN [ 10 – 14 ]. It is very important to note that all cited studies of ATN variation concern data from adults only, omitting data from the fetus population, and that the publication of Soni [ 13 ] is a mere case study. The knowledge of changes that occur within the infratemporal fossa over the course of ontogeny will enable to understand the mechanism concerning the development of craniofacial malformations and their consequences.…”

Section: Introductionmentioning

confidence: 99%

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Proposed Classification of Auriculotemporal Nerve, Based on the Root System

et al. 2015

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The topography of the auriculotemporal nerve (ATN) root system is the main criterion of this nerve classification. Previous publications indicate that ATN may have between one and five roots. Most common is a one- or two-root variant of the nerve structure. The problem of many publications is the inconsistency of nomenclature which concerns the terms “roots”, “connecting branches”, or “branches” that are used to identify the same structures. This study was performed on 80 specimens (40 adults and 40 fetuses) to propose a classification based on: (i) the number of roots, (ii) way of root division, and (iii) configuration of interradicular fibers that form the ATN trunk. This new classification is a remedy for inconsistency of nomenclature of ATN in the infratemporal fossa. This classification system has proven beneficial when organizing all ATN variants described in previous studies and could become a helpful tool for surgeons and dentists. Examination of ATN from the infratemporal fossa of fetuses (the youngest was at 18 weeks gestational age) showed that, at that stage, the nerve is fully developed.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Proposed Classification of Auriculotemporal Nerve, Based on the Root System

et al. 2015

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“…Unusual organization of auriculotemporal nerve was reported by Simmi Soni et al, 17 They reported that the auriculotemporal nerve originated in two roots and called them upper and lower roots from the posterior division of mandibular nerve. They found that the roots were lateral and medial to the middle meningeal artery.…”

Section: Discussionmentioning

confidence: 93%

Communicating root of auriculotemporal nerve with inferior alveolar nerve-looping around accessory meningeal artery

et al. 2015

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Background: The auriculotemporal nerve has been described as having two roots in standard textbooks of anatomy. It lies on the tensor veli palatini muscle while passing backwards behind the lateral pterygoid muscle. It runs behind the temporomandibular joint after passing between the sphenomandibular ligament and the neck of mandible. It ascends over the posterior root of zygoma posterior to superficial temporal vessels. It gives superficial temporal branches and also branches to facial nerve and otic ganglion. The branches to the facial nerve join at the posterior border of masseter. On the face the cutaneous branches supply the tragus, part of the adjoining auricle of the ear and posterior part of temple. Methods: Variations in the origin of the auriculotemporal nerve have been described by many authors in the past and this prompted the study of the auriculotemporal nerve, its origin and course, in 36 specimens (18 cadaveric heads) in bodies that were allotted for dissection purpose to first year medical students in the department of anatomy in P.E.S Medical College, Kuppam. Results: It was seen that the auriculotemporal nerve had two roots of origin and they formed a loop to enclose the middle meningeal artery in all the 35 specimens except in one side of the cadaveric heads. In only one half of a cadaveric head it was found to arise by three roots which formed two nerve loops. The first and second nerve roots joined with each other to form a nerve loop. The third root joined with the inferior alveolar nerve and formed the second nerve loop. The accessory meningeal artery passed through the second nerve loop. The normal presentation of two roots enclosing the middle meningeal artery was not present. Instead the accessory meningeal artery was enclosed between the third root and the inferior alveolar nerve. The middle meningeal artery entered the skull through the foramen spinosum as usual but was not enclosed by the nerve roots. The trunk of the auriculo temporal nerve was seen between the middle meningeal artery and inferior alveolar nerve and the study reports the presence of variant nerve loops encircling the accessory meningeal artery. Conclusion: The variations in the roots of auriculotemporal nerve have been reported in the past and since it is important in the clinical implications of the region especially for the facio-maxillary surgeons and dental surgeons. The incidence of variation has to be documented as this helps in updating the clinical database for surgical procedures and treatment in the region of infratemporal fossa.

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“…The ATN communicates with the facial nerve at the posterior border of the ramus where the ATN passes posterior to the neck of the condyle. The ATN is in close anatomic relation to the condylar process, the TMJ, the superficial temporal artery, and the LPt (Johansson et al, 1990;Akita et al, 2001;Soni et al, 2009).…”

Section: Anatomy Of the Mnmentioning

confidence: 99%

“…In addition, the altered position of the ATN and its extensive or multiple loops may render the ATN more liable to entrapment neuropathy. Temple headaches occur frequently due to entrapment of ATN, which sometimes is throbbing in nature, due to its proximity to superficial temporal artery (Soni et al, 2009). In joints, with a displaced disc, the ATN trunk can be almost in contact with the medial aspect of the condyle (Johansson et al, 1990).…”

Section: Entrapment Of the Remaining Branches Of The Mn Posterior Trunkmentioning

confidence: 99%

Functional anatomy of the mandibular nerve: Consequences of nerve injury and entrapment

et al. 2010

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Various anatomic structures including bone, muscle, or fibrous bands may entrap and potentially compress branches of the mandibular nerve (MN). The infratemporal fossa is a common location for MN compression and one of the most difficult regions of the skull to access surgically. Other potential sites for entrapment of the MN and its branches include, a totally or partially ossified pterygospinous or pterygoalar ligament, a large lamina of the lateral plate of the pterygoid process, the medial fibers of the lower belly of the lateral pterygoid muscle and the inner fibers of the medial pterygoid muscle. The clinical consequences of MN entrapment are dependent upon which branches are compressed. Compression of the MN motor branches can lead to paresis or weakness in the innervated muscles, whereas compression of the sensory branches can provoke neuralgia or paresthesia. Compression of one of the major branches of the MN, the lingual nerve (LN), is associated with numbness, hypoesthesia, or even anesthesia of the tongue, loss of taste in the anterior two thirds of the tongue, anesthesia of the lingual gums, pain, and speech articulation disorders. The aim of this article is to review, the anatomy of the MN and its major branches with relation to their vulnerability to entrapment. Because the LN expresses an increased vulnerability to entrapment neuropathies as a result of its anatomical location, frequent variations, as well as from irregular osseous, fibrous, or muscular irregularities in the region of the infratemporal fossa, particular emphasis is placed on the LN.

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Unusual Organization of Auriculotemporal Nerve and Its Clinical Implications

Cited by 11 publications

References 8 publications

Proposed Classification of Auriculotemporal Nerve, Based on the Root System

Proposed Classification of Auriculotemporal Nerve, Based on the Root System

Communicating root of auriculotemporal nerve with inferior alveolar nerve-looping around accessory meningeal artery

Functional anatomy of the mandibular nerve: Consequences of nerve injury and entrapment

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