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Infratemporal and Pterygopalatine Fossa

Surgical Correlation


Infratemporal and Pterygopalatine Fossa. A, Coronal section just behind the pterygopalatine fossa. The right lateral pterygoid muscle has been removed from the pterygoid venous plexus and posterior division of the mandibular nerve. The nerve to the lateral pterygoid muscle originates from the buccal nerve passing between the two heads of the lateral pterygoid. B, The right pterygoid venous plexus and pterygoid plates have been removed to expose the branches of the mandibular nerve. The posterior division of the mandibular nerve descends between the lateral pterygoid muscle (removed) and tensor veli palatini muscle (cut). The palatovaginal canal is located media to the vidian canal. C, Enlarged view of the proximal portion of the right mandibular nerve. The nerve to the medial pterygoid muscle arises from the medial aspect of the mandibular nerve close to the otic ganglion. D, Lateral view of the right infratemporal fossa. The mandibular ramus and lateral pterygoid muscle have been removed. The buccal, deep temporal, and masseter nerves have been elevated with the dissector. This division passes in the horizontal plane. The auriculotemporal nerve passes backward between the sphenomandibular ligament and the ramus of the mandible (removed). E, The masseter muscle has been removed from the mandible to expose the masseter nerve. The masseter nerve passes laterally above the lateral pterygoid muscle in front of the temporomandibular joint and behind the tendon of the temporal muscle. It runs to the deep surface of the master muscle. F, The mandibular ramus has been removed to expose the lingual and the inferior alveolar nerves. G, Anterior view of the right cheek. The buccal nerve emerges from the undersurface of the ramus of mandible and unites with the buccal branches of the facial nerve. (Images courtesy of AL Rhoton, Jr.)