Parotid, Teporal and Infra –Temporal

Fossa
 Parotid gland
• The parotid gland is
enclosed within a tough,
unyielding, fascial capsule,
the parotid sheath
(capsule), from deep
cervical fascia.
• It has an irregular shape
because the area occupied
by the gland, the parotid
bed, is anteroinferior to the
external acoustic meatus,
where it is wedged between
the ramus of the mandible
and the mastoid process.
• Fatty tissue between the
lobes of the gland confers
the flexibility the gland
must have to accommodate
the motion of the mandible.

• The apex of the parotid

gland is posterior to the
angle of the mandible, and
its base is related to the
zygomatic arch.

• The subcutaneous lateral

surface of the parotid gland
is almost flat.
• The parotid duct passes
horizontally from the
anterior edge of the
gland.
• At the anterior border of
the masseter, the duct
turns medially, pierces
the buccinator, and
enters the oral cavity
through a small orifice
opposite the 2nd
maxillary molar tooth.
• Embedded within the substance of the parotid
gland, from superficial to deep, are:
– The parotid plexus of the facial nerve (CN VII)
and its branches,
– The retromandibular vein, and
– The external carotid artery.
• On the parotid sheath and within the gland are
parotid lymph nodes.
• Although the parotid plexus of CN VII is embedded
within it, the CN VII does not provide innervation to
the gland.

• The auriculotemporal nerve, a branch of CN V3, is

closely related to the parotid gland and passes superior
to it with the superficial temporal vessels.

• The auriculotemporal nerve and the great auricular

nerve, a branch of the cervical plexus composed of
fibers from C2 and C3 spinal nerves, innervates the
parotid sheath as well as the overlying skin.
• The parasympathetic component of the
glossopharyngeal nerve (CN IX) supplies
presynpatic secretory fibers to the otic ganglion.
• The postsynaptic parasympathetic fibers are
conveyed from the ganglion to the gland by the
auriculotemporal nerve.
• Sympathetic fibers are derived from the cervical
ganglia through the external carotid nerve plexus
on the external carotid artery.

• The vasomotor activity of these fibers may

reduce secretion from the gland.

• Sensory nerve fibers pass to the gland through

the great auricular and auriculotemporal nerves.
• Arteries:
– External carotid
• Superficial temporal transverse facial
artery (superior aspect of the gland, duct
and nearby masseter muscle)
• Maxillary (medial aspect of the gland)
 Infratemporal Fossa
• The infratemporal fossa is an irregularly
shaped space deep and inferior to the
zygomatic arch, deep to the ramus of the
mandible and posterior to the maxilla.

• It communicates with the temporal fossa

through the interval between (deep to) the
zygomatic arch and (superficial to) the cranial
bones.
• The boundaries of the infratemporal fossa are as
follows
– Laterally: the ramus of the mandible.
– Medially: the lateral pterygoid plate sphenoid bone.
– Anteriorly: the posterior aspect of the maxilla.
– Posteriorly: the tympanic plate and the mastoid and
styloid processes of the temporal bone.
– Superiorly: the inferior (infratemporal) surface of the
greater wing of the sphenoid.
– Inferiorly: where the medial pterygoid muscle
attaches to the mandible near its angle.
• The infratemporal fossa contains the:
– Inferior part of the temporalis muscle.
– Lateral and medial pterygoid muscles.
– Maxillary artery.
– Pterygoid venous plexus.
– Mandibular, inferior alveolar, lingual, buccal, and
chorda tympani nerves
– Otic ganglion.
• The parotid and temporal regions and the
infratemporal fossa collectively include the
temporomandibular joint and the muscles of
mastication that produce its movements.
Innervation : Mandibular nerve
• Anterior division

•Nerve to medial pterygoid

21
 Communications of the infratemporal fossa

• Anteriorly- orbital
cavity through the
inferior orbital fissure

• Superiorly- middle
cranial fossa through
the foramen spinosum
and ovale Pterygomaxillary fissure- between
posterior of maxilla and the upper part of
lateral pterygoid; forthe passage of the
maxillary artery and nerve 22
 Temporo-Mandibular Joint (TMJ)
Articulating surfaces
• Head of mandible
• Mandibular fossa and articular tubercle of the
temporal bone
Type of joint
• Condyloid synovial type
Articular Capsule
• surround the joint
• thickened laterally to form ligaments
Articular disc (fibrocartilage)
• attached to the capsule & lateral Pt. & dividing
joint into a lower compartment & upper
compartment
23
24
TMJ…

• Nerve supply – Auriclotemporal and nerve to

masseter
• Arterial supply – from superficial temporal
• Relations
– Posteriorly – external acoustic meatus
– Laterally – parotid gland
– Medially – maxillary vessels and
auriclotemporal nerve

25
TMJ…
• Major supportive elements of
the TMJ
– muscles of mastication
• Ligaments of TMJ; Minor
supportive of TMJ
– Temporomandibular
ligament - thickening of the
joint capsule
– Stylomandibular ligament -
behind and medial
– Sphenomandibular
ligament - medially
attached to the sphenoid
and mandible
26
27
 Movements of the mandible:
1. Elevation – Temporalis , masseter, medial Pt.
2. Depression – gravity, lat. Pterygoid ,
mylohyoid, geniohyoid, Digastric (anterior b)
3. Protrusion - masseter, medial & lat. Pt. of
both sided
4. Retraction- posterior fibers of Temporalis and
masseter
5. Side movement - Temporalis of same side,
pterygoids of opposite side.
6. Opening - the disc moves fore ward
7. Closing- disc moves backward