The maxillary artery: Course, Branches and supply
- The larger of the two terminal branches of the ECA
- Enters the ITF by passing deep to the mandibular neck, between it & the sphenomandibular ligament, together with the maxillary veins & the auriculotemporal nerve
- It possesses a tortuous course passing usually (in 2/3 of individuals) lateral to lat. pterygoid according to which the artery is divided into three parts:
1- First “mandibular” part: before reaching the lateral pterygoid, it gives 5 branches each enters a bone.
2- Second “pterygoid” part: lies along (medial or lateral) to the lateral pterygoid, it gives 5 branches to soft tissue, 4 of them to the masticatory muscles & the 5th is the buccal.
3-Third “pterygopalatine” part: which enters the pterygopalatine fossa through the pterygomaxillary fissure & gives 5 branches that accompany those of the pterygopalatine ganglion & each branch of maxillary nerve.
Branches of the first part:
1- Deep auricular artery:
- Penetrates the external auditory meatus
- Gives a branch to the TM joint
- Supplies the skin of the meatus & outer surface of the tympanic membrane.
2- Anterior tympanic artery:
- Ascends parallel to the deep auricular artery
- Enters the tympanic cavity through petrotympanic fissure together with chorda tympani
- Supplies the tympanic cavity & the inner surface of the tympanic membrane
3- Middle meningeal artery:
- Is the prime artery of the cranial dura
- Ascends upward enclosed by the two roots of the auriculotemporal nerve, to enter the MCF through foramen spinosum
- At the floor of the MCF it lies between the greater wing of sphenoid & dura mater
- After a short course it divides into anterior & posterior divisions:
1-anterior; continues grooving the sphenoid then it reaches the parietal bone which it grooves near its anterior border as the artery ascends to the vertex.
2-posterior; goes back to groove the squamous temporal & ascends to the parietal bone near its posterior border, then along the superior sagittal sinus to reach the occipital bone.
4- Accessory meningeal artery:
- Frequently a branch of the middle meningeal
- Supplies some extracranial structures
- Enters foramen ovale to supply the trigeminal ganglion & adjacent dura mater
5- Inferior alveolar (dental) artery:
- Descends to the mandibular foramen behind the accompanying nerve
- Before it enters the foramen, the artery gives two branches:
1-lingual; with the lingual nerve
2-mylohoid; with mylohyoid nerve, piercing the sphenomandibular ligament & supplies the muscle
- In the bone, the artery supplies the teeth in a manner similar to nerve supply
- Terminates near the mental foramen by dividing into incisive & mental arteries
Branches from the second part:
1- Masseteric artery:
- Enters the mandibular notch
- Supplies masseter & anastomoses with the transverse facial artery
2- Anterior & posterior deep temporal arteries:
- Accompany the corresponding nerves to temporalis
- The accompanying veins impress the bone in the temporal fossa
3 & 4- Pterygoid branches:
- Supply the two pterygoids
5- Buccal artery:
- Accompanies the long buccal nerve
- Goes to the region of buccinator
- Supplies skin of the cheek & mucous membranes of the mouth
Branches from the third part:
A) Branches which accompany those of the pterygopaltine ganglion:
1-Posterior superior lateral nasal arteries.
2- Greater palatine artery.
3- Lesser palatine arteries.
4- Nasopalatine (anterior palatine) artery.
5- Pharyngeal artery.
B) Branches accompanying the maxillary nerve branches:
1- Posterior superior alveolar artery.
2- Infraorbital artery.
3- Anterior superior alveolar artery.