Anatomy of the structures medial to the temporomandibular joint

Objective. To define the relationship of the branches of the trigeminal ner ve and the infratemporal vessels to the zygomatic arch and medial capsular ligament of the temporomandibular joint (TMJ). Material and method. In a study of 20 cadaveric dissections of the infratem poral fossa, measurements were obtained in anterior-posterior and transvers e directions to identify the relationship of the trigeminal nerve, carotid artery, internal jugular vein, and middle meningeal artery to the zygomatic arch. The distance from the lateral to the medial aspect of the glenoid fo ssa was measured to further delineate the proximity of these structures to the medial portion of the capsule of the TMJ. Results. The mean transverse distance from the zygomatic arch to the middle meningeal artery was 31 mm (range, 21 mm to 43 mm). The mean anterior-post erior distance from the height of the glenoid fossa to the middle meningeal artery was 2.4 mm (-2 mm to 8 mm). The transverse distance from the caroti d artery to the zygomatic arch was a mean of 37.5 mm (29 mm to 48 mm) with the mean anterior-posterior distance of -6.5 mm (-21 mm to 6 mm). The mean distance from the internal jugular vein to the zygomatic arch was 38.3 mm ( 31 mm to 49 mm). The mean anterior-posterior distance was -8.7 mm (-20 mm t o 7 mm). The transverse distance from the trigeminal nerve to the arch was a mean distance of 35 mm (24 mm to 46 mm). The mean anterior-posterior dist ance was 9.2 mm (1 mm to 25 mm). The mean medial to lateral width of the gl enoid fossa was 18.7 mm (16 mm to 23 mm). Conclusion. The arteries, nerves, and veins are close to the medial aspect of the TMJ. A knowledge of these relationships can guide the surgeon on the medial aspect of the TMJ and can help to prevent complications associated with these structures.