An undocumented variation involving auriculotemporal nerve, inferior alveolar nerve and middle meningeal artery

Sunita Kalra, Swati Thamke, Ankit Khandelwal


Auriculotemporal nerve typically has two roots, encircling the middle meningeal artery, one anterior to it and another posterior to it as well as maxillary artery. The middle meningeal artery is largest of the meningeal arteries, ascends between the sphenomandibular ligament and lateral pterygoid muscle and traverses between the roots of the auriculotemporal nerve before entering the cranial cavity through the foramen spinosum. The knowledge of the neurovascular relationships of the infratemporal region is significant in surgical practice. We present a case of unusual communication between the auriculotemporal nerve and inferior alveolar nerve together with an extraordinary change in relations with the middle meningeal artery. Some clinical implications that these relations may have on the development of the supplementary innervations and the surgical interventions in this region are discussed in this article.


Auriculotemporal nerve, Inferior alveolar nerve, Middle meningeal artery, Variation, Decompression

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Williams PL, Bannister LH, Berry MM, Collins P, Dyson M, Dussek JE, et al. Auriculotemporal nerve and Middle meningeal artery. In: Williams PL, Bannister LH, Berry MM, Collins P, Dyson M, Dussek JE, et al., eds. Gray’s Anatomy. 38th ed. New York: Churchill Livingstone; 1995: 1238-1239; 1519-1520.

Gülekon N, Anil A, Poyraz A, Peker T, Turgut HB Karaköse M. Variations in the anatomy of the auriculotemporal nerve. Clin Anat. 2005;18(1):15-22.

Anıl T, Peker T, Turgut HB, Gülekon N Liman F. Variations in the anatomy of the inferior alveolar nerve. Br J. Oral Maxillofac Surg. 2003;41:236-9.

Roy TS, Sarkar AK, Panicker HK. Variation in the origin of the alveolar inferior nerve. Clin Anat. 2002;15(2):143-7.

Kim SY, Hu KS, Chung IH, Lee EW, Kim HJ. Topographic anatomy of the lingual nerve and variation in communication pattern of the mandibular nerve branches. Surg Radiol Anat. 2004;26(2):128-35.

Komarnitki I, Andrzejczak-Sobocinska A, Tomczyk J, Deszczynska K, Ciszek B. Clinical anatomy of the auriculotemporal nerve in the area of the infratemporal fossa. Folia Morphologica. 2012;71(3):187.

Janis JE, Hatef DA, Ducic I, Ahmad J, Wong C, Hoxworth RE, Osborn T. Anatomy of the Auriculotemporal Nerve: Variations in Its Relationship to the Superficial Temporal Artery and Implications for the Treatment of Migraine Headaches. Plastic & Reconstructive Surgery 2010;125(5):1422-8.

Sandoval MC, lópez FB, suazo GI. An unusual relationship between the inferior alveolar nerve, lingual nerve and maxillary artery. Int J Odontostomat 2009;3(1):51-3.