Variations of the lingual and inferior alveolar nerves and their anomalous relationship with the maxillary artery

The infratemporal fossa is a compact space with multiple contents. Explicit anatomical knowledge regarding the relationship between these neuro-vascular structures becomes imperative during any surgical intervention. Literature is abounding with variations in this region. It encompasses communication between branches of the mandibular nerve or entrapment of nerves by bony bridges, or even abnormal course and branching pattern of the arteries. However, there are many other variabilities in these structures that are less reported or unre-ported. The present study is an effort to report the characteristic variations of the lingual and inferior alveolar nerves and their anomalous relationship with the maxillary artery in the infratemporal fossa. The study was conducted bilaterally on 26 adult cadavers. The variations in the origin and course of the lingual & inferior alveolar nerves were noted. The course of the maxillary artery and its relation to the lingual and inferior alveolar nerves was also recorded. The variations were explained under the following types: a) communication between the lingual and inferior alveolar nerves, b) existence of a pterygospinous ligament/bar overlying/separating the lingual and inferior alveolar nerves, c) abnormal course/absence of the chorda tympani nerve and an alternate taste pathway, d) multiple roots of the lingual and inferior alveolar nerves and e) the unusual course of the maxillary artery. Knowledge of these variations would aid the head & neck surgeons in minimizing the compression symptoms and also avoiding postoperative complications.