WordNet

any bundle of nerve fibers running to various organs and tissues of the body (同)nervus
control of your emotions; "this kind of tension is not good for my nerves"

PrepTutorEJDIC

〈C〉『神経』 / 〈C〉《複数形で》『神経過敏』,いらだち / 〈U〉『勇気』,度胸(courage) / 〈U〉《時にa ~》厚かましさ,ずぶとさ;無礼 / 〈C〉葉脈;(昆虫の)翅脈(しみゃく) / 〈人,特に自分〉‘に'力を与える,‘を'元気づける

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/05/04 01:44:31」(JST)

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The auriculotemporal nerve is a branch of the mandibular nerve (V3) that runs with the superficial temporal artery and vein, and provides sensory innervation to various regions on the side of the head.

Structure

Origin

The auriculotemporal nerve arises as two roots from the posterior division of the mandibular nerve. The mandibular nerve is a branch of the trigeminal nerve, and the mandibular nerve exits the skull through the foramen ovale.^[1] These roots encircle the middle meningeal artery (a branch of the mandibular part of the maxillary artery, which is in turn a terminal branch of the external carotid artery). The roots encompass the middle meningeal artery then converge to form a single nerve.

Course

The auriculotemporal nerve passes between the neck of the mandible and the sphenomandibular ligament, gives off parotid branches and then turns superiorly, posterior to its head and moving anteriorly, gives off anterior branches to the auricle. It then crosses over the root of the zygomatic process of the temporal bone, deep to the superficial temporal artery.

Innervation

The somatosensory root (superior) originates from branches of the mandibular nerve (cranial nerve V), which pass through the otic ganglion without synapsing. Then they form the somatosensory (superior) root of the auriculotemporal nerve. The two roots re-unite, and shortly after the branching of secretomotor fibers to the parotid gland (parotid branches), the auriculotemporal nerve comprises exclusively somatosensory fibers, which ascend to the superficial temporal region. There, it supplies the auricle, external acoustic meatus, outer side of the tympanic membrane and the skin in the temporal region (superficial temporal branches). It also carries a few articular branches that go on to supply the temporomandibular joint.

The parasympathetic root (inferior) carries postganglionic fibers to the parotid gland. These parasympathetic, preganglionic secretomotor fibers originate from the glossopharyngeal nerve (CN IX) as one of its branches, the tympanic nerve, which enters the tympanic cavity through the inferior tympanic canaliculus. The tympanic nerve and postganglionic sympathetic fibers, which come with the arteries-related head, make the tympanic plexus on the promontorium. This plexus gives off the lesser petrosal nerve. This nerve synapses in the otic ganglion and its postganglionic fibers form the inferior, parasympathetic root of the auriculotemporal nerve. The two roots re-unite and shortly after the "united" auriculotemporal branch gives off parotid branches, which serve as secretomotor fibers for the parotid gland.

Clinical significance

This nerve as it courses posteriorly to the condylar head, is frequently injured in temporomandibular joint (TMJ) surgery, causing an ipsilateral parasthesia of the auricle and skin surrounding the ear. It is the main nerve that supplies the TMJ, along with branches of the masseteric nerve and the deep temporal.

After a parotidectomy, the nerves from the Auriculotemporal Nerve that previously innervated the parotid gland can reattach to the sweat glands in the same region. The result is sweating along the cheek with the consumption of foods (Frey's syndrome). Treatment involves the application of an antiperspirant or glycopyrrolate to the cheek, Jacobsen's neurectomy along the middle ear promontory, and lifting of the skin flap with the placement of a tissue barrier (harvested or cadaveric) to interrupt the misguided innervation of the sweat glands.

Pain from parotitis, a condition that can be caused by mumps, will be carried by the auriculotemporal nerve to the brain.

Additional images

Mandible of human embryo 24 mm. long. Outer aspect.

References

^ Gray's Anatomy for Students, 2nd edition (2010), Drake Vogel and Mitchell, Elseview

External links

Anatomy figure: 27:03-04 at Human Anatomy Online, SUNY Downstate Medical Center - "Illustration of the nerves within the infratemporal fossa after removal of the lateral pterygoid muscle."
MedEd at Loyola GrossAnatomy/h_n/cn/cn1/cnb3.htm
lesson4 at The Anatomy Lesson by Wesley Norman (Georgetown University) (mandibularnerve)
cranialnerves at The Anatomy Lesson by Wesley Norman (Georgetown University) (V)
http://www.dartmouth.edu/~humananatomy/figures/chapter_47/47-2.HTM

UpToDate Contents

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English Journal

Management of Pain Secondary to Temporomandibular Joint Syndrome with Peripheral Nerve Stimulation.

Rodriguez-Lopez MJ, Fernandez-Baena M1, Aldaya-Valverde C.
Pain physician.Pain Physician.2015 Mar-Apr;18(2):E229-E236.
BACKGROUND: Temporomandibular joint syndrome, or Costen syndrome, is a clinically diagnosed disorder whose most common symptoms include joint pain and clicking, difficulty opening the mouth, and temporomandibular joint discomfort. The temporomandibular joint (TMJ) is supplied by the auriculotemporal
PMID 25794224

Anatomic and histological study of great auricular nerve and its clinical implication.

Yang HM1, Kim HJ2, Hu KS3.
Journal of plastic, reconstructive & aesthetic surgery : JPRAS.J Plast Reconstr Aesthet Surg.2015 Feb;68(2):230-6. doi: 10.1016/j.bjps.2014.10.030. Epub 2014 Oct 31.
BACKGROUND: The great auricular nerve (GAN) is often sacrificed during parotidectomy, rhytidectomy, and platysma flap operation. Transection of the nerve results in a wooden numbness of preauricular region, pain, and neuroma. The aim of this study was to describe the branching patterns and distribut
PMID 25465135

Ear pain following temporomandibular surgery originating from the temporomandibular joint or the cranial nervous tissue? A case report.

Geerse WK1, von Piekartz HJ2.
Manual therapy.Man Ther.2015 Feb;20(1):212-5. doi: 10.1016/j.math.2014.05.006. Epub 2014 Jun 3.
A patient presenting with local pain and limitation of movement in the temporomandibular region following surgery of the left temporomandibular joint (TMJ) is described. Manual techniques like distraction of the TMJ combined with motor control exercises to restore TMJ function were not sufficient to
PMID 24948551

Japanese Journal

下顎骨関節突起骨折後に発症した Frey 症候群

藤井達也,合田正和,松田和徳 [他],宮崎かつし,峯田一秀,中川宏治,武田憲昭
耳鼻咽喉科臨床 106(1), 13-16, 2013-01-01
… Although he underwent manipulative reduction, but not an operation, it is suggested that the dislocated condyle injured the auriculotemporal nerve, resulting in the development of Frey's syndrome. …
NAID 10031141231

A Case of Frey's Syndrome after Fracture of the Mandibular Condyle

, , , , , ,
耳鼻咽喉科臨床　補冊 137(0), 44-45, 2013
… Although he underwent manipulative reduction, but not an operation, it is suggested that the dislocated condyle injured the auriculotemporal nerve, resulting in the development of Frey's syndrome. …
NAID 130004558710

側頭部有痛性索状腫瘤を呈し側頭動脈炎との鑑別を要した孤発性神経線維腫の１例

稲盛真人,土井光,立石貴久,松岡健,岩城徹,吉良潤一
臨床神経学 49(1), 27-31, 2009
症例は59歳の女性である．数年にわたる右側頭部痛のため当科を受診した．右側頭部に分枝状の圧痛をともなう索状腫瘤を触知し側頭動脈炎をうたがった．しかし，頭部MRIでは右側頭部皮下に多発性の結節を，超音波では低エコー域をともなう血流のない分枝状，索状腫瘤をみとめた．最終的に，腫瘤生検にて右耳介側頭神経に発症した孤発性神経線維腫と診断した．腫瘍は経過観察とし，疼痛は薬物療法にて著明に改善した．頭蓋外皮下 …
NAID 130004504529

Related Pictures

★リンクテーブル★

リンク元	「耳介側頭神経」
拡張検索	「auriculotemporal nerve syndrome」
関連記事	「nerve」

「耳介側頭神経」

Auriculotemporal nerve
	Sympathetic connections of the otic and superior cervical ganglia. (Auriculotemporal labeled at top right.)
	Distribution of the maxillary and mandibular nerves, and the submaxillary ganglion.
Details
From	mandibular nerve
Innervates	temple
Identifiers
Latin	Nervus auriculotemporalis
TA	A14.2.01.074
FMA	53000
	Anatomical terms of neuroanatomy [edit on Wikidata]