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Deep View of Left Infratemporal Fossa and Adjacent Structures

Surgical Correlation

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Deep view of left infratemporal fossa and adjacent structures. The mandibular ramus, zygomatic arch, and portion of lateral skull and meninges have been removed. The lateral surface of the temporal lobe is in view with the superior and middle temporal gyri separated by the superior temporal sulcus. The lateral pterygoid muscle has been removed and only the medial pterygoid remains within the infratemporal fossa. Posterior to the ramus of the mandible is the external carotid artery and its terminal branch, the maxillary artery, crosses the center of the image where it normally courses superficial to the lateral pterygoid. Branches in view here are the inferior alveolar, the middle meningeal, anterior deep temporal, posterior superior alveolar arteries, the infraorbital, and the sphenopalatine artery entering the pterygopalatine fossa through the pterygomaxillary fissure. The maxillary nerve can be seen emerging from the foramen rotundum and traversing the upper portion of the pterygopalatine fossa. The mandibular nerve emerges from the foramen ovale into the infratemporal fossa before dividing into branches. The auriculotemporal and buccal nerves lie posterior to the lateral pterygoid while the inferior alveolar and lingual nerves emerge between this muscle and the medial pterygoid to course toward the mandibular canal and floor of the mouth, respectively. The inferior alveolar nerve and artery gives rise to mylohyoid branches that supply the mylohyoid and anterior digastric muscles. The buccinator muscle forms the muscular wall of the cheek and contributes to the bulk of the lips. Deep to the mandibular ramus are the internal carotid artery and internal jugular vein. The cervical segment of the artery continues as the petrous segment as it passes into and through the carotid canal. The internal jugular vein emerges from the nearby jugular foramen. 

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