Maxillary artery

Anatomy of maxillary artery in detail.

1. MAXILLARY ARTERY

2. CONTENT

3. OVERVIEW ON CAROTID ARTERIES

4. The common carotid and internal carotid are slightly dilated in an area known as the  carotid sinus , and is a baroreceptor that reacts to changes in arterial blood pressure. The artery ends within the  parotid gland  by dividing into the superficial temporal artery and the maxillary artery .

5. INTRODUCTION

6. COURSE OF MAXILLARY ARTERY T he maxillary artery at its origin is embedded in the parotid gland . 1 st part runs horizontally between the neck of the mandible and sphenomandibular   ligament on the lower border of the lateral pterygoid muscle. 2 nd part runs superficial to the lower head of the lateral pterygoid muscle. 3 rd part turns medially, between the two heads of lateral pterygoid and ends in the  pterygopalatine fossa and terminates into the  sphenopalatine artery near the nasal cavity.

7. MANDIBULAR PART (1 ST PART) 1. Deep auricular artery   - S uperficially to the tympanic membrane, passing between the cartilage and bone to supply the external acoustic meatus . 2. A nterior tympanic artery  -  It passes deep to the membrane, through the petro-tympanic fissure to the middle ear to join the circular anastomosis around the tympanic membrane . 3. Middle meningeal artery   - It ascends between the two roots of the auriculo -temporal nerve through foramen spinosum. BRANCHES AND DISTRIBUTION

8. I t then runs forward in a groove on the great wing of the sphenoid bone, and divides into two branches ; Anterior Division and Posterior Division.

9. 4. Inferior alveolar artery  -  The artery runs along the canal , accompanying the nerve and divides near the 1 st premolar giving of INCISAL and MENTAL. Near the origin it gives of LINGUAL and MYLOHYOID.

10. 5. Accessory meningeal artery  - It passes upwards through the foramen ovale to supply the dura mater of the floor of the middle fossa and of the trigeminal cave (Meckel’s cave).

11. 1. Masseteric artery  - accompanies the lingual nerve. It is small, and passes laterally through the mandibular notch to the deep surface of the  masseter muscle , which it supplies . PTERYGOID PART ( 2 ND PART )

12. 2. Pterygoid artery  - It supplies the  lateral pterygoid muscle  and  medial pterygoid muscle .

13. 3. Deep temporal artery   -They  course between the  temporalis  and the pericranium respectively, supplying the muscles, and anastomose with the middle temporal artery. The anterior division communicates with the lacrimal artery by means of small branches which perforate the  zygomatic bone  and great wing of the  sphenoid .

14. 4 . Buccal or buccinator artery  -  It anastomoses with branches of the facial artery and with the infraorbital artery. From the infraorbital area, the buccal artery descends bilaterally in the superficial face along the lateral margin of the nose, then running anti-parallel to the facial artery across the lateral oral region.

15. PTERYGOPALATINE PART ( 3 RD PART ) 1 . Sphenopalatine artery  - It passes through the sphenopalatine foramen into the cavity of the nose, at the back part of the superior meatus. Crossing the inferior surface of the sphenoid, the sphenopalatine artery ends on the nasal septum as the posterior septal branches.

16. 2 . D escending palatine artery  - It descends through the greater palatine canal with the greater and lesser palatine branches.  It emerges from the greater palatine foramen, runs forward in a groove on the medial side of the alveolar border of the hard palate to the incisive canal; the terminal branch of the artery passes upward through this canal to anastomose with the sphenopalatine artery .

17. 3. Infraorbital artery  - passes forwards through the inferior orbital fissure, along the floor of the  orbit   in infraorbital canal to emerge with the infraorbital nerve on the face . In canal it gives a) ORBITAL BRANCH and b) ANTERIOR and MIDDLE SUPERIOR ALVEOLAR BRANCH.

18. 4 . Posterior superior alveolar artery  - Gives numerous branches that accompany the corresponding nerves through foramina in the posterior wall of the maxilla supplying the molars and premolars and the lining of sinus and gums.

19. 5 . Pharyngeal artery   - I t runs backward through the pharyngeal canal with the pharyngeal nerve , and supplies structures such as the  pharynx,  the posterior aspect of the roof of the nasal cavity, sphenoid sinus, and Eustachian tube.

20. 6. Artery of the pterygoid canal  - It passes backwards along the pterygoid canal and supplies the upper part of the pharynx, and auditory tube and sends a small division into the tympanic cavity to anastomose with the tympanic arteries.

21. CLINICAL SIGNIFICANCE

22. PTERYGOID PLEXUS It anastomoses anteriorly with facial vein and superiorly with cavernous sinus. C linical significance is the spread of infection from the dental area (drained by the pterygoid plexus)which can travel to cavernous sinus via emissary vein and cause intracranial infections from an extracranial source .

23. Refers to nose bleed or hemorrhage from the nose. Two types based on location. Treatments to be considered include topical vasoconstriction, chemical cautery, electrocautery, nasal packing (nasal tampon or gauze impregnated with petroleum jelly), posterior gauze packing, and arterial ligation or embolization.  EPISTAXIS ( NOSE BLEED )

24. EPIDURAL HEMATOMA Pterion is the w eakest part of the skull . Overlies anterior branch of middle meningeal artery . Located in the temporal fossa above posterolateral margin of fronto-zygomatic suture . A ccumulation of blood in the epidural space. Treatment may require decompression of the hematoma , usually by craniotomy.

25. Injury to the descending palatine artery can be minimized by not extending the osteotomy more than 30mm to 35mm posterior to the piriform rim. Pterygomaxillary separation should be made along the pterygomaxillary fissure with either a curved osteotome or a right-angled oscillating saw. Because the descending palatine artery travels in an anterior-inferior direction as it enters the greater palatine canal, injury can be prevented by closely adapting the cutting edge of the osteotome or the saw to the pterygomaxillary fissure. LE FORT 1 OSTEOTOMY

26. Facial blanching after IANBA can be caused by anesthetic injection into the maxillary artery area, affecting the infraorbital artery. Studies have suggested that peripheral vasoconstriction occurs because of the effect of the α-receptor agonist. The pain was caused by the sudden contraction of blood vessels in the region supplied by the maxillary artery and the subsequent reduction of blood supply . INTRA-VASCULAR INJECTION COMPLICATION

27. CONCLUSION Maxillary artery is one of the largest of the terminal branch of external carotid artery. It supplies deep structures of the face. It is divided into 3 parts; mandibular part, pterygoid part and the pterygopalatine part. It is surrounded by a small network of vessels known as pterygoid plexus.

28. REFERENCES 1. B.D Chaurasia’s Human Anatomy 6 TH Edition. 2. Cunningham’s Manual of Practical Anatomy. 3. CHAPTER VI: Arteries, Gray’s Anatomy. 4 . Images from KENHUB.COM. 5. Adriana L. Natali 1 ;  Vamsi Reddy 2 ; Jonathan T. Leo 3 . Neuroanatomy , Middle Meningeal Arteries [PUBMED]. 6. Ekramul M. Gofur 1 ;  Yasir Al Khalili 2 . Anatomy, Head and Neck, Internal Maxillary Arteries. 7. Sang- Hoon Kang and Yu- JinWon . Facial blanching after inferior alveolar nerve block anesthesia: an unusual complication. 8. K K Li,  J G Meara, A Alexander Jr. Location of the descending palatine artery in relation to the Le Fort I osteotomy

29. THANK YOU