The clinical anatomy of the maxillary artery in the pterygopalatine fossa

Abstract

Purpose: The purposes of this study were to delineate the maxillary artery and its branching arteries and to develop a classification of the various branching patterns by means of serial cadaver dissections of the pterygopalatine fossa region. Materials and Methods: Fifteen Korean adult cadavers were used; 2 sides of each cadaver were examined, for a total of 30 sides. Before dissection of the pterygopalatine region, computed tomography scan was taken of 20 cadaver heads. Sectioned specimens of 9 sides of the cadaver heads in 3.0-mm thickness were made for this study. Then we dissected 21 sides of fresh cadavers under the microscope. In this investigation, we observed branching patterns of the third portion of the maxillary artery, a relationship of the terminal branches of the maxillary artery to the pterygomaxillary junction, and the course of descending palatine artery. Then we classified the branching patterns of the maxillary artery in the pterygopalatine fossa. Results: From the pterygomaxillary junction to the pterygopalatine fossa region, the maxillary artery was usually branched into 5 arteries in the following order: posterior superior alveolar artery, infraorbital artery, artery of the pterygoid canal, descending palatine artery, and sphenopalatine artery. Of 21 cadavers, 18 showed this order (85.7%). There were 2 types of branching patterns of the posterior superior alveolar artery and the infraorbital artery. The average distance from the most inferior point of the pterygomaxillary junction to the posterosuperior alveolar artery, infraorbital artery, and descending palatine artery was 15.2, 32.2, and 24.8 mm, respectively. In most cases (95.2%), the greater and lesser palatine arteries were divided from the short descending palatine artery. According to the contours of the third portion of the maxillary artery, we classified them into 5 types: the “Y” type (19%), “intermediate” type (33.3%), “T” type (23.8%), and “M” type (14.3%). Conclusion: The results of this investigation show the common patterns of the maxillary artery. © 2003 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 61:72-78, 2003