Schmidt B L, Pogrel M A, Necoechea M, Kearns G
Department of Oral and Maxillofacial Surgery, University of California at San Francisco, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998 Aug;86(2):165-8. doi: 10.1016/s1079-2104(98)90119-6.
The purpose of this cadaver dissection was to study the position of the auriculotemporal nerve in relation to the mandibular condyle, capsular tissues, articular fossa, and lateral pterygoid muscle and to evaluate the anatomic possibility of nerve impingement or irritation by the surrounding structures.
Eight cadaveric heads (16 sides) were dissected. The auriculotemporal nerve was identified by following its course around the middle meningeal artery. The course of the nerve trunk was dissected from the middle meningeal artery to the terminal branches within the temporomandibular disk. The horizontal 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 border of the auriculotemporal nerve was measured.
The auriculotemporal nerve was identified on each side, and a single trunk was evident along the medial aspect of the condylar neck. At the posterior border of the lateral pterygoid muscle, the nerve trunk was in direct contact with the condylar neck in every specimen. The average vertical distance between the superior condyle and the nerve was 7.06 mm (+/- 3.21 mm); the range was 0 to 13 mm. The vertical distance between the nerve and the superior condyle on one side of the specimen did not correlate with the distance on the contralateral side.
The auriculotemporal nerve trunk has a close anatomic relationship with the condyle and the temporomandibular joint capsular region, and there is evidence of a possible mechanism for sensory disturbances in the temporomandibular 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 observed to course in direct apposition to the lateral pterygoid muscle. The findings support the hypothesis that the anatomic and clinical relationship of the auriculotemporal nerve to the condyle, articular fossa, and lateral pterygoid muscle may be causally related to compression or irritation of the nerve, producing numbness or pain, or both, in the temporomandibular joint region.
本次尸体解剖的目的是研究耳颞神经相对于下颌髁突、关节囊组织、关节窝和翼外肌的位置，并评估周围结构压迫或刺激该神经的解剖学可能性。
解剖了8个尸体头部（16侧）。通过追踪耳颞神经围绕脑膜中动脉的走行来识别该神经。将神经干从脑膜中动脉至颞下颌关节盘内的终末分支进行解剖。测量耳颞神经与髁突/髁突颈部内侧部分之间的水平距离。测量关节髁突最上部至耳颞神经上缘的垂直距离。
每侧均识别出耳颞神经，且在髁突颈部内侧可见单一神经干。在每个标本中，在翼外肌后缘处，神经干与髁突颈部直接接触。髁突上部与神经之间的平均垂直距离为7.06 mm（±3.21 mm）；范围为0至13 mm。标本一侧神经与髁突上部之间的垂直距离与对侧的距离无相关性。
耳颞神经干与髁突及颞下颌关节囊区域存在密切的解剖关系，有证据表明颞下颌关节区域存在感觉障碍的可能机制。在所有病例中，神经均与关节囊内侧或髁突颈部直接接触。由于左右两侧神经位置无相关性，可能仅一侧会受到影响。还观察到神经与翼外肌直接相邻走行。这些发现支持以下假设，即耳颞神经与髁突、关节窝及翼外肌之间的解剖学和临床关系可能与神经受压或受刺激存在因果关系，从而在颞下颌关节区域产生麻木或疼痛，或两者皆有。
