Babu, Prakash Billakanti and Bhat, Ramachandra K and Nayak, Vanishree S (2011) Perforation of inferior alveolar nerve by malillary artery. Rev Arg de Anat Clin, 3 (3).

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Abstract

Infratemporal fossa is clinically important anatomical area for the delivery of local anesthetic agents in dentistry and maxillofacial surgery. Variations in the anatomy of the inferior alveolar nerve and maxillary artery were studied in infratemporal dissection. During routine dissection of the head in an adult male cadaver an unusual variation in the origin of the inferior alveolar nerve and its relationship with the surrounding structures was observed. The inferior alveolar nerve originated from the mandibular nerve by two roots and the first part of the maxillary artery was incorporated between them. An embryologic origin of this variation and its clinical implications is discussed. Becasue the maxillary artery runs between the two roots of the inferior alveolar nerve, and the nerve was fixed between the foramaen ovale and manidbular foramen, neurovascular entrapment may cause pain numbness or headache and may interfere with the injection of local anesthetics into the infratemporal fossa. Anatomical variation in this region should be kept in mind, particularly in cases of failed treatment of trigeminal neuralgia.

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