The relationship between the Auriculotemporal nerve and middle Meningeal artery in a sample of the South African population.

Abstract

Introduction: Within the infratemporal fossa, the auriculotemporal nerve arises as two roots from the mandibular division of the trigeminal nerve and forms a buttonhole through which the middle meningeal artery courses. Thereafter, the two roots of the auriculotemporal nerve re-join and proceeds to provide sensory innervation to multiple structures of the head. The middle meningeal artery branches from the maxillary artery and enters the cranium through foramen spinosum. Variations of the auriculotemporal nerve and the middle meningeal artery have been documented in several populations. However, there is a paucity of literature regarding the South African population group. The aim of this study was to document the relationship between the auriculotemporal nerve and the middle meningeal artery and their variations (if any) within a South African population. Materials and methods: Sixteen (n=32) adult cadavers were dissected to reveal the infratemporal fossae regions. The auriculotemporal nerve and middle meningeal arteries were observed, and the morphology and morphometry were documented. Results: The auriculotemporal nerve arose as one to four roots. The most common variation was the two-root auriculotemporal nerve (14/32; 43.75%). The inferior alveolar nerve was observed to contribute to the formation of the auriculotemporal nerve in the majority of the individuals. The roots of the auriculotemporal nerve were either anterior, deep, or superficial to the middle meningeal artery. Although the V-shapes were present in 23/32 infratemporal fossae, only 13/32 middle meningeal arteries passed through them. In the South African cohort, the maxillary artery was found to course deep to the lateral pterygoid muscle in 19/32 (59.38%) individuals and superficial in 13/32 (40.63%). Fifteen accessory middle meningeal arterieswere present in 14/32 (43.75%) infratemporal fossae – one individual displayed a double accessory middle meningeal artery. The accessory middle meningeal artery originated from the middle meningeal artery or the maxillary artery in (8/15) 53.33% and (7/15) 46.67% of the individuals, respectively. Conclusion: This study showed numerous anatomical variations of the neurovasculature within the infratemporal fossa. Furthermore, this study provides novel information about the auriculotemporal nerve and middle meningeal artery in a South African population, which has not been previously reported. The results may be beneficial to medical professionals during surgical interventions to the infratemporal fossa.