Rusu Mugurel Constantin, Toader Corneliu, Tudose Răzvan Costin, Grigoriţă Laura Octavia
Division of Anatomy, Faculty of Dentistry, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Division of Neurosurgery, Department 6-Clinical Neurosciences, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Medicina (Kaunas). 2024 Nov 21;60(12):1913. doi: 10.3390/medicina60121913.
The lateral pterygoid muscle (LPM), a critical component of the masticatory muscles, typically comprises upper (SLPM) and lower (ILPM) heads. However, it is essential to note that the LPM's structure is not a constant feature, as the number of bundles and their topography can vary. Moreover, additional heads, such as medial and middle heads, and unique-headed configurations of the LPM have been reported. Several studies have demonstrated the penniform structure of the LPM, which is further supported by its diverse pattern of innervation. Anatomically, the LPM originates from the greater wing and lateral pterygoid plate of the sphenoid bone, with variations in these origins being common. For instance, the presence of a broad lateral pterygoid plate or extensions from it can enlarge the origin area of the LPM. Equally variable are the insertions of the LPM, which can include attachments to the mandibular condyle and the temporomandibular joint disc. In some cases, aberrant LPM bundles may attach to the mandibular condyle outside the mandibular notch. Rarely encountered muscles like the pterygoideus proprius, pterygospinosus, and pterygofacialis further add to the diversity of this muscle. The anatomy of the LPM is subject to modification due to factors like atrophy or hypertrophy. Therefore, it is imperative to recognize that a one-size-fits-all anatomical pattern for the LPM does not exist. Instead, a personalized therapeutic approach should be based on a case-by-case determination of the LPM's specific anatomical configuration. This nuanced understanding challenges the simplistic view of the LPM and underscores the need for individualized clinical considerations.
翼外肌（LPM）是咀嚼肌的重要组成部分，通常由上头（SLPM）和下头（ILPM）组成。然而，必须注意的是，翼外肌的结构并非一成不变，因为肌束数量及其形态可能会有所不同。此外，还报道了翼外肌的其他头，如内侧头和中间头，以及独特的头型配置。多项研究已证实翼外肌的羽状结构，其多样的神经支配模式进一步支持了这一点。从解剖学角度来看，翼外肌起自蝶骨大翼和翼突外侧板，这些起始部位存在变异很常见。例如，宽阔的翼突外侧板或其延伸部分的存在可扩大翼外肌的起始区域。翼外肌的止点同样多变，可包括附着于下颌髁突和颞下颌关节盘。在某些情况下，异常的翼外肌束可能附着于下颌切迹外侧的下颌髁突。诸如翼突固有肌、翼突棘肌和翼突面肌等罕见肌肉进一步增加了该肌肉的多样性。翼外肌的解剖结构会因萎缩或肥大等因素而发生改变。因此，必须认识到不存在适用于所有情况的翼外肌解剖模式。相反，个性化的治疗方法应基于对翼外肌具体解剖结构的逐案判定。这种细致入微的理解挑战了对翼外肌的简单化看法，并强调了个体化临床考量的必要性。
