THE DISTRIBUTION OF THE AURICULOTEMPORAL NERVE AROUND THE TEMPOROMANDIBULAR-JOINT

Objective. The purpose of this cadaver dissection was to study the pos ition of the auriculotemporal nerve in relation to the mandibular cond yle, capsular tissues, articular fossa, and lateral pterygoid muscle a nd to evaluate the anatomic possibility of nerve impingement or irrita tion by the surrounding structures. Study design. Eight cadaveric head s (16 sides) were dissected. The auriculotemporal nerve was identified by following its course around the middle meningeal artery. The cours e of the nerve trunk was dissected from the middle meningeal artery to the terminal branches within the temporomandibular disk. The horizont al distance between the auriculotemporal nerve and the medial portion of the condyle/condylar neck was measured. The vertical distance from the most superior portion of the articular condyle to the superior bor der of the auriculotemporal nerve was measured. Results, The auriculot emporal nerve was identified on each side, and a single trunk was evid ent along the medial aspect of the condylar neck. At the posterior bor der of the lateral pterygoid muscle, the nerve trunk was in direct con tact with the condylar neck in every specimen. The average vertical di stance between the superior condyle and the nerve was 7.06 mm (+/- 3.2 1 mm); the range was 0 to 13 mm. The vertical distance between the ner ve and the superior condyle on one side of the specimen did not correl ate with the distance on the contralateral side. Conclusion. The auric ulotemporal nerve trunk has a close anatomic relationship with the con dyle and the temporomandibular joint capsular region, and there is evi dence of a possible mechanism for sensory disturbances in the temporom andibular joint region. In all cases, the nerve was in direct contact with the medial aspect of the capsule or condylar neck. Because there is no correlation between the positions of the nerves on the right and left sides, only one side may be affected. The nerve was also observe d to course in direct apposition to the lateral pterygoid muscle. The findings support the hypothesis that the anatomic and clinical relatio nship of the auriculotemporal nerve to the condyle, articular fossa, a nd lateral pterygoid muscle may be causally related to compression or irritation of the nerve, producing numbness or pain, or both, in the t emporomandibular joint region.