Auriculotemporal nerve

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Auriculotemporal nerve
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Sympathetic connections of the otic and superior cervical ganglia. (Auriculotemporal labeled at top right.)
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Distribution of the maxillary and mandibular nerves, and the submaxillary ganglion.
Details
From mandibular nerve
Innervates temple
Identifiers
Latin nervus auriculotemporalis
TA98 A14.2.01.074
TA2 6261
FMA 53000
Anatomical terms of neuroanatomy

The auriculotemporal nerve is a sensory branch of the mandibular nerve (CN V3) that runs with the superficial temporal artery and vein, and provides sensory innervation to parts of the external ear, scalp, and temporomandibular joint. The nerve also conveys post-ganglionic parasympathetic fibres from the otic ganglion to the parotid gland. [1]

Contents

Structure

Origin

The auriculotemporal nerve arises from the posterior division of [2] :497 the mandibular nerve (CN V3) (which is itself a branch of the trigeminal nerve (CN V)). [3] It arises by two roots [2] :497 that circle around either side of the middle meningeal artery [1] [2] :363 before uniting to form a single nerve. [1]

Course

Roots of the auriculotemporal nerve circle around both sides of the middle meningeal artery before uniting to form a single nerve. The nerve passes deep to the neck of the mandible [1] - between it and the sphenomandibular ligament [2] :364 - andthen courses deep to the lateral pterygoid muscle. [1] It issues parotid branches and then turns superiorly, posterior to its head and moving anteriorly, gives off anterior branches to the auricle. It then crosses over the root of the zygomatic process of the temporal bone, deep to the superficial temporal artery.[ citation needed ] Shortly after the secretomotor parasympathetic fibers branch from the auriculotemporal nerve (parotid branches) to innervate the parotid gland, the auriculotemporal nerve comprises exclusively somatosensory fibers. It ascends to reach the superficial temporal region and innervate its target structures.[ citation needed ]

The auriculotemporal nerve communicates with the facial nerve (CN VII). [1]

Parasympathetic component

Post-ganglionic parasympathetic secretomotor nerve fibres from the otic ganglion join and "hitch-hike" along the auriculotemporal nerve, leaving the nerve as it passes across the anteromedial surface of the parotid gland to enter and innervate said gland. [2] :359–360

Distribution

The auriculotemporal nerve provides sensory innervation to the auricle, external acoustic meatus, outer side of the tympanic membrane and the skin in the temporal region (superficial temporal branches). It also carries a few articular branches that innervate the temporomandibular joint.[ citation needed ]

Clinical significance

This nerve, as it courses posteriorly to the condylar head, is frequently injured in temporomandibular joint (TMJ) surgery, causing an ipsilateral paresthesia of the auricle and skin surrounding the ear. It is the main nerve that supplies the TMJ, along with branches of the masseteric nerve and the deep temporal.

After a parotidectomy, the nerves from the Auriculotemporal Nerve that previously innervated the parotid gland can reattach to the sweat glands in the same region. The result is sweating along the cheek with the consumption of foods (Frey's syndrome). Treatment involves the application of an antiperspirant or glycopyrrolate to the cheek, Jacobsen's neurectomy along the middle ear promontory, and lifting of the skin flap with the placement of a tissue barrier (harvested or cadaveric) to interrupt the misguided innervation of the sweat glands.

Pain from parotitis, a condition that can be caused by mumps, will be carried by the auriculotemporal nerve and great auricular nerve to the brain.

See also

Additional images

Related Research Articles

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<span class="mw-page-title-main">Temporomandibular joint</span> Joints connecting the jawbone to the skull

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<span class="mw-page-title-main">Facial nerve</span> Cranial nerve VII, for the face and tasting

The facial nerve, also known as the seventh cranial nerve, cranial nerve VII, or simply CN VII, is a cranial nerve that emerges from the pons of the brainstem, controls the muscles of facial expression, and functions in the conveyance of taste sensations from the anterior two-thirds of the tongue. The nerve typically travels from the pons through the facial canal in the temporal bone and exits the skull at the stylomastoid foramen. It arises from the brainstem from an area posterior to the cranial nerve VI and anterior to cranial nerve VIII.

<span class="mw-page-title-main">Glossopharyngeal nerve</span> Cranial nerve IX, for the tongue and pharynx

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<span class="mw-page-title-main">Great auricular nerve</span> Cutaneous nerve of the head

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<span class="mw-page-title-main">Mandibular nerve</span> Branch of the trigeminal nerve responsible for the lower face and jaw

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<span class="mw-page-title-main">Otic ganglion</span> Parasympathetic ganglion of the head and neck

The otic ganglion is a small parasympathetic ganglion located immediately below the foramen ovale in the infratemporal fossa and on the medial surface of the mandibular nerve. It is functionally associated with the glossopharyngeal nerve and innervates the parotid gland for salivation.

<span class="mw-page-title-main">Pterygopalatine ganglion</span> Parasympathetic ganglion in the pterygopalatine fossa

The pterygopalatine ganglion is a parasympathetic ganglion in the pterygopalatine fossa. It is one of four parasympathetic ganglia of the head and neck,.

<span class="mw-page-title-main">Greater petrosal nerve</span> Nerve in the skull

The greater petrosal nerve is a nerve of the head mainly containing pre-ganglionic parasympathetic fibres which ultimately synapse in the pterygopalatine ganglion. It branches from the facial nerve and is derived from the parasympathetic part of the nervus intermedius component of CN VII, with its cell bodies located in the superior salivary nucleus. In the connective tissue substance of the foramen lacerum, the greater petrosal nerve unites with the (sympathetic) deep petrosal nerve to form the nerve of the pterygoid canal which proceeds to the pterygopalatine ganglion.

<span class="mw-page-title-main">Lacrimal nerve</span> Branch of the ophthalmic nerve

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<span class="mw-page-title-main">Zygomaticotemporal nerve</span> Small nerve of the face

The zygomaticotemporal nerve (zygomaticotemporal branch, temporal branch) is a cutaneous (sensory) nerve of the head. It is a branch of the zygomatic nerve (itself a branch of the maxillary nerve (CN V2)). It arises in the orbit and exits the orbit through the zygomaticotemporal foramen in the zygomatic bone to enter the temporal fossa. It is distributed to the skin of the side of the forehead. It also contains a parasympathetic secretomotor component for the lacrimal gland which it confers to the lacrimal nerve (which then delivers it to the gland).

<span class="mw-page-title-main">Maxillary artery</span> Artery supplying face structures in humans

The maxillary artery supplies deep structures of the face. It branches from the external carotid artery just deep to the neck of the mandible.

<span class="mw-page-title-main">Infratemporal fossa</span> Cavity that is part of the skull

The infratemporal fossa is an irregularly shaped cavity that is a part of the skull. It is situated below and medial to the zygomatic arch. It is not fully enclosed by bone in all directions. It contains superficial muscles, including the lower part of the temporalis muscle, the lateral pterygoid muscle, and the medial pterygoid muscle. It also contains important blood vessels such as the middle meningeal artery, the pterygoid plexus, and the retromandibular vein, and nerves such as the mandibular nerve (CN V3) and its branches.

<span class="mw-page-title-main">Tympanic nerve</span>

The tympanic nerve is a branch of the glossopharyngeal nerve found near the ear. It gives sensation to the middle ear, the Eustachian tube, the parotid gland, and mastoid air cells. It gives parasympathetic to supply to the parotid gland via the otic ganglion and the auriculotemporal nerve.

<span class="mw-page-title-main">Lesser petrosal nerve</span>

The lesser petrosal nerve is the general visceral efferent (GVE) nerve conveying pre-ganglionic parasympathetic secretomotor fibers for the parotid gland from the tympanic plexus to the otic ganglion. It passes out of the tympanic cavity through the petrous part of the temporal bone into the middle cranial fossa of the cranial cavity, then exits the cranial cavity through its own canaliculus to reach the infratemporal fossa.

<span class="mw-page-title-main">Parasympathetic ganglia</span> Autonomic ganglia of the parasympathetic nervous system

Parasympathetic ganglia are the autonomic ganglia of the parasympathetic nervous system. Most are small terminal ganglia or intramural ganglia, so named because they lie near or within (respectively) the organs they innervate. The exceptions are the four paired parasympathetic ganglia of the head and neck.

<span class="mw-page-title-main">Nerve of pterygoid canal</span>

The nerve of the pterygoid canal is formed by the union of the (parasympathetic) greater petrosal nerve and (sympathetic) deep petrosal nerve within the cartilaginous substance filling the foramen lacerum. From the foramen lacerum, the nerve of the pterygoid canal passes through the pterygoid canal to reach the pterygopalatine fossa, ending at the pterygopalatine ganglion.

<span class="mw-page-title-main">Salivatory nuclei</span>

The salivatory nuclei are two parasympathetic general visceral efferent cranial nerve nuclei - the superior salivatory nucleus and the inferior salivatory nucleus - that innervate the salivary glands. Both are located in the pontine tegmentum of the brainstem.

References

  1. 1 2 3 4 5 6 Fehrenbach, Margaret J.; Herring, Susan W. (2017). Illustrated Anatomy of the Head and Neck (5th ed.). St. Louis: Elsevier. p. 189. ISBN   978-0-323-39634-9.
  2. 1 2 3 4 5 Sinnatamby, Chummy S. (2011). Last's Anatomy (12th ed.). ISBN   978-0-7295-3752-0.
  3. Moran, Steven L. (2009). "16 - Temporoparietal fascia flap". Flaps and Reconstructive Surgery - Section 2. Saunders. pp. 157–173. doi:10.1016/B978-0-7216-0519-7.00016-2. ISBN   978-0-7216-0519-7.