Unique variation in the course of maxillary artery in infratemporal fossa: a case report

Maxillary artery is one of the key contents of the infratemporal fossa. Mandibular nerve and its branches form a clinically important relation of maxillary artery in this region. A comprehensive knowledge of variations of maxillary artery in the fossa is of special relevance in oral maxillofacial surgeries, management of epistaxis, intractable neuralgias or headaches. We found a unique variation of maxillary artery, presenting bilaterally, in relation to branches of mandibular nerve. During routine dissection in a 55-year-old male cadaver, maxillary artery was seen passing deep to lateral pterygoid muscle and crossed through the nerve loop formed between two roots of auriculotemporal nerve and posterior division of mandibular nerve. Further course of maxillary artery was medial to the posterior division of mandibular nerve. Maxillary artery gave its middle meningeal artery branch as it traversed through the nerve loop. A tortuous course taken by maxillary artery can lead to its entrapment causing headaches or nerve irritation presenting with neuralgia.