Infratemporal Fossa Anatomy
Boundaries
• Anterior
▫ Posterior surface of the
maxilla
• Posterior
▫ Styloid apparatus, carotid
sheath and deep part of ...
Contents
• The lateral and medial
pterygoid muscles
• The mandibular division of the
trigeminal nerve
• The chorda tympani...
Lateral pterygoid relations
• Deep to the muscle
▫ Branches of the mandibular nerve
and the main origin of the medial
pter...
Lateral pterygoid relations
The Masticatory Muscles
• The four primary
masticatory muscles
▫ Temporalis
▫ Media pterygoid
▫ Lateral pterygoid
▫ Masset...
Lateral Pterygoid Muscle
• Two heads
▫ Large Lower (pterygoid)
▫ Small upper (infratemporal)
• Origin
▫ Lower head: latera...
Medial Pterygoid Muscle
• Two heads
▫ Deep
▫ Superficial (tuberal)
• Origin
▫ Deep head: Medial of the lateral pterygoid
▫...
Pterygoid Hiatus Sphenomandibular Muscle
• Superiorly
▫ The inferior margin of the
lower head of the lateral
pterygoid mus...
The Otic Ganglion
• Below the foramen ovale
• Parotid gland
• The lesser petrosal nerve
The Maxillary Artery
• Arises within the parotid
gland
▫ At the level of the neck
of the condyle
• Enters the
infratempora...
The Maxillary Artery
• It lies near the inferior border of the muscle,
crossing the inferior alveolar nerve.
The Maxillary Artery
• 1st part:
▫ 5 branches
▫ Enter bone
• 2nd part:
▫ 5 branches
▫ Not Entering
• 3rd part:
▫ pterygopa...
Pterygoid Venous Plexus
▫ Within, the lateral
pterygoid muscle and it
surrounds the maxillary
artery.
▫ Allows for the rap...
Other contents
▫ Sphenomandibular ligament
▫ The tensor veli palatini muscle
▫ The insertion of the temporalis
muscle
▫ Th...
Infratemporal Fossa
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Infratemporal Fossa

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Surgical anatomy of the infratemporal fossa
boundaries and clinical significances

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Infratemporal Fossa

  1. 1. Infratemporal Fossa Anatomy
  2. 2. Boundaries • Anterior ▫ Posterior surface of the maxilla • Posterior ▫ Styloid apparatus, carotid sheath and deep part of the parotid gland • Medial ▫ Lateral pterygoid plate and the superior constrictor muscle of the pharynx • Lateral ▫ Ramus • Roof ▫ Greater wing of the sphenoid
  3. 3. Contents • The lateral and medial pterygoid muscles • The mandibular division of the trigeminal nerve • The chorda tympani branch of the facial nerve • The otic parasympathetic ganglion • The maxillary artery and branches • The pterygoid venous plexus • The deep ‘lobe’ of the parotid gland.
  4. 4. Lateral pterygoid relations • Deep to the muscle ▫ Branches of the mandibular nerve and the main origin of the medial pterygoid muscle. • Superficial to the lower head ▫ The maxillay artery • Between the two heads ▫ The buccal branch of the mandibular nerve • Below the inferior border ▫ Medial pterygoid muscle and the lingual and inferior alveolar nerves. • Upper border ▫ The deep temporal nerves and vessels. • Around and within the lateral muscle ▫ The pterygoid venous plexus.
  5. 5. Lateral pterygoid relations
  6. 6. The Masticatory Muscles • The four primary masticatory muscles ▫ Temporalis ▫ Media pterygoid ▫ Lateral pterygoid ▫ Masseter • Derived from the first branchial arch • Supplied by the mandibular nerve.
  7. 7. Lateral Pterygoid Muscle • Two heads ▫ Large Lower (pterygoid) ▫ Small upper (infratemporal) • Origin ▫ Lower head: lateral surface of pterygoid plate ▫ Upper head: infratemporal surface of greater wing • Insertion ▫ Lower: Pterygoid fovea (condyle) ▫ Upper: Capsule and articular disc • Innervation ▫ Anterior trunk of mandibular nerve • Vasculture ▫ Pterygoid branches of maxillary ▫ Ascending palatine from facial • Action ▫ Opening the mouth ▫ protrusion and in lateral movements of the mandible
  8. 8. Medial Pterygoid Muscle • Two heads ▫ Deep ▫ Superficial (tuberal) • Origin ▫ Deep head: Medial of the lateral pterygoid ▫ Superficial head: Maxillary tuberosity and pyramidal process • Insertion ▫ Roughened surface of the angle of the mandible on its medial aspect. • Innervation ▫ The mandibular nerve (trunk) • Vasculture ▫ Pterygoid branches of maxillary • Action ▫ Elevate the mandible ▫ Lateral and protrusive movements
  9. 9. Pterygoid Hiatus Sphenomandibular Muscle • Superiorly ▫ The inferior margin of the lower head of the lateral pterygoid muscle • Inferiorly ▫ The posterior margin of the medial pterygoid muscle. • In this space ▫ The lingual and inferior alveolar nerves, ▫ The first part of the maxillary artery ▫ Part of the pterygoid venous plexus ▫ The sphenomandibular ligament. • 5th masticatory muscle? • Origin: ▫ Greater wing of sphenoid • Insertion: ▫ Inner anterior coronoid ▫ Anterior ramus • Action ▫ Elevation (protrusion?) • Alternative explaination: ▫ Unidentified component of temporalis or medial pterygoid Contents
  10. 10. The Otic Ganglion • Below the foramen ovale • Parotid gland • The lesser petrosal nerve
  11. 11. The Maxillary Artery • Arises within the parotid gland ▫ At the level of the neck of the condyle • Enters the infratemporal fossa between the deep surface of the condyle and the sphenomandibular ligament. ▫ Below the auriculotemporal nerve and above the maxillary vein. • Firmly adherent to the
  12. 12. The Maxillary Artery • It lies near the inferior border of the muscle, crossing the inferior alveolar nerve.
  13. 13. The Maxillary Artery • 1st part: ▫ 5 branches ▫ Enter bone • 2nd part: ▫ 5 branches ▫ Not Entering • 3rd part: ▫ pterygopalatine fossa
  14. 14. Pterygoid Venous Plexus ▫ Within, the lateral pterygoid muscle and it surrounds the maxillary artery. ▫ Allows for the rapid take-up of blood ▫ Communicates with the cavernous sinus, the facial vein, the inferior ophthalmic vein and the pharyngeal plexus
  15. 15. Other contents ▫ Sphenomandibular ligament ▫ The tensor veli palatini muscle ▫ The insertion of the temporalis muscle ▫ The maxillary nerve  As it passes from the pterygopalatine fossa into the inferior orbital fissure ▫ The posterior superior alveolar nerve(s), ▫ A loop of the facial artery ▫ The deep ‘lobe’ of the parotid gland

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