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Anterior View of Right Infratemporal Fossa and Related Structures

Surgical Correlation

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Anterior view of right infratemporal fossa and related structures. On the left side of the image is the temporalis muscle attached to the temporal fossa of the skull. It descends medial to the zygomatic arch onto which attaches the masseter muscle to the lateral surface of the mandibular ramus. Medial to the ramus of the mandible is the infratemporal fossa containing two other muscles of mastication, the lateral and medial pterygoid muscles. The lateral pterygoid has two heads - superior and inferior. The superior head (shown in this specimen) attaches to the undersurface of the greater wing of the sphenoid. The inferior head (removed) attaches to the lateral surface of the lateral pterygoid plate. The pterygoid venous plexus surrounds the lateral pterygoid and communicates through the foramen ovale with the cavernous sinus. It receives venous return from areas supplied by branches of the maxillary artery. The muscular nerve to the lateral pterygoid and the long buccal nerve (branches of the mandibular nerve) emerge between the two heads of the lateral pterygoid. The roots of the auriculotemporal nerve can be seen enclosing the middle meningeal artery. The medial pterygoid muscle arises largely from the medial surface of the lateral pterygoid plate. Between the two pterygoids emerge the lingual and inferior alveolar nerves to the oral cavity. The deep temporal arteries usually ascend on the deep surface of the temporalis muscle. The pterygoid process forms the posterior boundary of the pterygopalatine fossa. This space will receive along its posterior wall the maxillary nerve via the foramen rotundum and a bit more inferomedially the Vidian nerve via the pterygoid canal located at the base of the medial pterygoid plate. This canal courses along the floor of the sphenoid sinus. The orbital apex can be seen with its contents enclosed by periorbita. These include the optic nerve, the ophthalmic artery, the origins of the recti muscles, and their motor nerve supply, principally the oculomotor nerve, and also abducens and trochlear nerves. Medial and posterior to the pterygoid process is the opening of the auditory tube along the lateral wall of the nasopharynx. (Image courtesy of AL Rhoton, Jr.)

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