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This case study describes anatomical variations in the branching pattern of the posterior division of the trigeminal nerve and its clinical implications for dental and craniofacial surgery. The study presents two uncommon variations observed in an elderly male cadaver. A communicating branch connecting one of three roots of the auriculotemporal nerve and inferior alveolar nerve just before entering the mandibular foramen on the right side, and three communicating branches between the IAN and lingual nerve on the left side. The presence of such variations may complicate anesthesia associated with oral surgery procedures. [ABSTRACT FROM AUTHOR]

Background: The auriculotemporal nerve is one of the main branches of the mandibular nerve. It provides sensory innervation to the auricle, the scalp in the temporal region, the temporomandibular joint and part of the dura mater, the parasympathetic innervation of the parotid salivary gland, as well as the external surface of the tympanic membrane, and the sympathetic innervation of the sweat glands and of the blood vessels passing through the parotid gland. Its interruption during surgical interventions or trauma can results in its most common disease - Frey's syndrome. This article is an overview and is based on 23 foreign scientific works - articles published in refereed and renowned scientific publications and anatomy atlases by world-renowned and proven specialists in their field. Review Results: The auriculotemporal nerve is a sensory nerve which includes secretory parasympathetic vasomotor sympathetic fibers coming from the otic ganglion. It is a branch of the mandibular nerve (V3). Its five terminal nerve branches are front auricular branches, branches for the external auditory canal, branches for the temporomandibular joint, branches for the parotid gland and superficial temporal branches. Frey's syndrome occurs when the auriculotemporal nerve is cut or injured proximal to the site of separation of the branches for the parotid gland or are severed themselves. The clinical picture characteristic of Frey's syndrome includes redness, sweating, warmth and itching in the area of innervation of the nerve and less often pain. Conclusion: Knowledge of the anatomy of the auriculotemporal nerve and Frey's syndrome are essential for understanding its nature and stand on the basis of its prevention.

Introduction: Stimulation of the nonauditory nervous systems via the trigeminal nerve pathways can be a promising intervention for patients with tinnitus refractory to medical, conservative, and other treatment options. Therapy of the mandibular division of the trigeminal nerve through the auriculotemporal nerve has been reported as useful for patients with tinnitus. Objectives: The objective of our study was to study the long-term effects of pulsed radiofrequency of the auriculotemporal nerve in a large group of tinnitus sufferers and to find predictors for a prosperous result. Design: A monocenter backward-looking group study. Results: In a two-year period, 67 tinnitus patients had pulsed radiofrequency of the auriculotemporal nerve. Twenty- three (35%) reported reduced tinnitus loudness at the 7-week post-treatment follow-up. These patients valued the improvements as: 61% good, 22% moderate, and 17% slight. In 3% of patients, tinnitus magnified after the treatment. The odds of permanent tinnitus relief after successful pulsed radiofrequency of the auriculotemporal nerve are 68% at 1 year postoperative. In tinnitus patients without cervical pain 62% had an improvement following pulsed radiofrequency of the auriculotemporal nerve compared to 28% in those not fulfilling this criterion (p=0.024). Conclusions: Neuromodulation of the auriculotemporal nerve is an uncomplicated remedy for tinnitus. In a select group of tinnitus patients this treatment can a good relief of their tinnitus for a long period. Especially, tinnitus sufferers without cervical pain will benefit of this therapy [ABSTRACT FROM AUTHOR]

The studies on the auriculotemporal nerve in humans are limited. However, we considered crucial to investigate the topographic relation between the auriculotemporal nerve and the TMJ region that can explain some of the symptoms in TMDs. The results derived from our experience in the anatomic dissection on 16 adult cadaveric heads were compared with what literature describes from 1971 to 2023. The results confirm the existence of a particular anatomic position of the ATN within the infratemporal fossa in direct contact with the lateral pterygoid muscle and the TMJ capsular region. Therefore, there is evidence of a potential entrapment mechanism involving the ATN caused by an internal derangement of TMJ or a spastic condition of the lateral pterygoid muscle. Through a detailed anatomical description of the ATN the present study aims to offer an explanation to the main sensory and otological symptoms that patients with TMJ disorders often complaint, from facial pain and paresthesias to external ear pruritus. [ABSTRACT FROM AUTHOR]

Frey syndrome is a condition of gustatory sweating and hyperemia related to damage of the auriculotemporal nerve. It affects around 80% of patients after parotidectomy. Syndrome may be easily diagnosed with an iodine-starch test, even in patients without symptoms, which are about 20% depending on studies. Authors searched PubMed and Google Scholar using searchterms Frey syndrome, auriculotemporal nerve, greater auricular nerve, tympanic nerve, parotidectomy. We manually searched the references of selected articles for additional relevant articles. We selected articles relevant to a general medicine readership and prioritized systematic reviews, clinical practice guidelines and cases. The literature contains the latest reports on Frey syndrome. Symptoms of Frey syndrome are: redding of the skin due to vasodilatation, excessive sweating or tingling and burning sensation of the cheek skin. Clinicians should pay attention to frey syndrome in patients after parotid gland surgery. Treatment includes botulinum toxin type A most commonly, topical injection of alcohol, scopolamine, glycopyrrolate and less common surgical treatment including transection of auriculotemporal nerve. Frey syndrome is not such a rare disease and should be always considered by clinicians because it may worsen the quality of patients' life.

Abstract Objectives Frey's syndrome (FS) describes the phenomenon of gustatory sweating and is a cause of significant social embarrassment for sufferers. It has been attributed to aberrant growth of parasympathetic salivatory fibers in the auriculotemporal nerve toward overlying sweat glands. However, the exact mechanism behind this growth is unknown. This review aims to expand and elucidate the theory of aberrant regeneration in FS. Methods A review of the recent literature on nerve regeneration was conducted in order develop further insights into the etiology of both adult onset and pediatric FS. Results Neurturin, a neurotrophic factor released by both salivary and sweat glands, was identified as a possible key player in the etiology of FS. Conclusion Further research into the role of neurturin could help to elucidate the pathogenic mechanisms underlying the condition and might reveal neurturin to be a potential target for pharmacological intervention. Level of Evidence NA (Basic Science Review).

Objectives: Frey's syndrome (FS) describes the phenomenon of gustatory sweating and is a cause of significant social embarrassment for sufferers. It has been attributed to aberrant growth of parasympathetic salivatory fibers in the auriculotemporal nerve toward overlying sweat glands. However, the exact mechanism behind this growth is unknown. This review aims to expand and elucidate the theory of aberrant regeneration in FS. Methods: A review of the recent literature on nerve regeneration was conducted in order develop further insights into the etiology of both adult onset and pediatric FS. Results: Neurturin, a neurotrophic factor released by both salivary and sweat glands, was identified as a possible key player in the etiology of FS. Conclusion: Further research into the role of neurturin could help to elucidate the pathogenic mechanisms underlying the condition and might reveal neurturin to be a potential target for pharmacological intervention. Level of Evidence: NA (Basic Science Review). [ABSTRACT FROM AUTHOR]

Frey's syndrome in children is rare and often erroneously attributed to food allergy. A description of a case of Frey's syndrome in a child and a review of the literature is provided. Awareness of this condition is important for the pediatric dentist to avoid unnecessary medical procedures and provide reassurance to the dental team in the setting of this benign condition.

The auriculotemporal nerve (ATN) is an important structure lying within a limited area of an infratemporal region (ITR). The ATN is originated from the posterior branch of the mandibular division of the trigeminal nerve (V3). The ATN conveys somatosensory, secretomotor, and parasympathetic fibres of the V3 and gustatory nerve (CN IX). In literature, the most common pattern of the ATN is composed of 2 roots that encloses the middle meningeal artery (MMA). However, in many studies, it has been reported that there are many variations in ATN pattern formation. To study the variation of ATN pattern formation in Thai cadavers, 73 hemifaces from 39 Thai embalmed cadavers were dissected and the relations of the ATN to the MMA were recorded. This study concluded that there were 4 patterns observed in Thai cadavers. The common pattern is 2 roots (67.1 %), 3 roots (15.1 %), 1 root (9.6 %), and 4 roots (8.2 %). Knowledge of this variation in the ATN may be useful in understanding the symptoms of temporo-orofacial pain, paresthesia of temporomandibular joint (TMJ), possible side effects from the TMJ surgery and the efficiency of auriculotemporal nerve block for regional anesthesia of the temporomandibular joint in Thai people. [ABSTRACT FROM AUTHOR]

Objective To evaluate the effect of selective auriculotemporal nerve block(ANB)on postoperative analgesia after the operation of ROSA robot assisted intracranial electrode implantation. Methods Sixty patients with the application of ROSA robot assisted intracranial electrode implantation， aged 13-65 years old，16

Copyright of Polish Otorhinolaryngological Review / Polski Przegląd Otorynolaryngologiczny (Index Copernicus) is the property of Index Copernicus International and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Stimulation of the nonauditory nervous systems via the trigeminal nerve pathways can be a promising intervention for patients with tinnitus refractory to medical, conservative, and other treatment options. Therapy of the mandibular division of the trigeminal nerve through the auriculotemporal nerve has been reported as useful for patients with tinnitus., Objectives: The objective of our study was to study the long-term effects of pulsed radiofrequency of the auriculotemporal nerve in a large group of tinnitus sufferers and to find predictors for a prosperous result., Design: A monocenter backward-looking group study., Results: In a two-year period, 67 tinnitus patients had pulsed radiofrequency of the auriculotemporal nerve. Twentythree (35%) reported reduced tinnitus loudness at the 7-week post-treatment follow-up. These patients valued the improvements as: 61% good, 22% moderate, and 17% slight. In 3% of patients, tinnitus magnified after the treatment. The odds of permanent tinnitus relief after successful pulsed radiofrequency of the auriculotemporal nerve are 68% at 1 year postoperative. In tinnitus patients without cervical pain 62% had an improvement following pulsed radiofrequency of the auriculotemporal nerve compared to 28% in those not fulfilling this criterion (p=0.024)., Conclusions: Neuromodulation of the auriculotemporal nerve is an uncomplicated remedy for tinnitus. In a select group of tinnitus patients this treatment can a good relief of their tinnitus for a long period. Especially, tinnitus sufferers without cervical pain will benefit of this therapy.

Objectives: Cluster headache is a primary headache disorder, which has affected up to 0.1% population. Superficial temporal artery ligation combined with auriculotemporal nerve transection (SLAT) is one of the surgical alternatives to treat the drug-resistant temporal cluster headache (TCH). The current work aimed to assess the effect of SLAT on TCH patients based on the very long-term clinical follow-up. Methods: The current retrospective study had enrolled 20 adolescent TCH patients undergoing SLAT between December 2016 and January 2018. The headache diaries as well as the pain severity questionnaire of the visual analog scale (VAS) had been collected to measure the pain severity before and after surgery. Results: The pain-free rates 3 days, as well as 1, 6, and 12 months, after SLAT surgery were 2.00%, 10.00%, 25.00%, and 70.00%, respectively. The frequency of TCH attack daily was found to be markedly reduced on the whole; besides, the pain degree was also remarkably decreased. Conclusions: Results in this study indicate that the sustained headache can be relieved after SLAT in adolescent patients with intractable TCH. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Orofacial Pain is the property of Quintessence Publishing Company Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Botulinum toxin type-A (BTX-A) injection for treating chronic migraine (CM) has developed into a new technique covering distinct injection points in the head and neck regions. The postulated analgesic mechanism implies that the injection should be administered to sensory nerves rather than to muscles. This study aimed to determine the topographical site of the auriculotemporal nerve (ATN) and to propose the effective injection points for treating CM. ATNs were investigated on 36 sides of 25 Korean cadavers. The anatomical structures of the ATN were investigated focusing on the temporal region. A right-angle ruler was positioned based on two clearly identifiable orthogonal reference lines based on the canthus and tragus as landmarks, and photographs were taken. The ATN appeared superficially in the anterosuperior region of the tragus. The nerve is located deeper than the superficial temporal artery. And it runs between the artery and the superficial temporal vein. In the superficial layer, it is divided into anterior and posterior divisions. The anterior division runs in a superior direction, while the posterior division runs in front of the ear and the several branches are distributed to the skin. We suggest that the optimal BTX-A injection points for CM are in the temporal region. The first point is about 2 cm anterior and 3 cm superior to two orthogonal reference lines defined based on the tragus and canthus, and the second point is about 4 cm superior to the first point. The third and fourth points are recommended about 2 cm superior to the first point, but respectively 1 cm anterior and posterior to it.

Background: Frey's syndrome is a group of symptoms that include unilateral sweating with malar region and external ear reddening after eating or drinking some food. It is a lesion of the auriculotemporal nerve that is secondary to surgery, parotid gland infection or facial trauma. Clinical cases: Three children between 4 and two and a half years of age: two girls and one boy. They had self-limiting unilateral erythematous facial macules that reached the external ear, without rash, itching, angioedema and gastrointestinal or respiratory symptoms; its onset was associated with the consumption of acid and some sweet foods. Symptom reproduction of was observed in the path of the auriculotemporal nerve. Their histories included cesarean section delivery owing to cephalopelvic disproportion (case 1), birth by operative vaginal delivery with forceps (case 2) and cesarean delivery owing to preeclampsia (case 3). Conclusions: Frey's syndrome is often mistaken with food allergy, leading to unnecessary dietary restrictions. Sweating is often absent in children owing to possible eccrine glands immaturity. [ABSTRACT FROM AUTHOR]

Summary Background and aim The auriculotemporal nerve (ATN) is one of the branches of the mandibular division of the trigeminal nerve, which gives rise to many branches to the retromandibular and temporal regions. Of these, the superficial temporal branch can occasionally be the cause of migraine headaches and auriculotemporal neuralgia. The purpose of this study was to elucidate the anatomy of the superficial temporal branch, which has never been described in detail. Methods A total of 14 sides of cadaveric heads were used for this study. The number of superficial temporal branch was counted, and the horizontal and vertical distances from the middle of the tragus to the branching point were measured. Results Three of 14 sides had two main trunks, and 11 sides had one main trunk. Each of the duplicated ATN had already branches into two main trunks as they left the retromandibular space. The number of superficial temporal branches ranged from two to seven. The vertical and horizontal distances from the middle of the tragus to the branching point of the superficial temporal branch ranged from 6.19 to 25.65 mm and from 3.45 to 11.88 mm, respectively. The communicating branches occasionally formed a loop or so-called “ansa,” and a double ansa was identified in one case. Conclusions These data can provide surgeons a better view of the course of these distant branches, so that skin incisions can be better planned. [ABSTRACT FROM AUTHOR]

Frey's syndrome in children is rare and often erroneously attributed to food allergy. A description of a case of Frey's syndrome in a child and a review of the literature is provided. Awareness of this condition is important for the pediatric dentist to avoid unnecessary medical procedures and provide reassurance to the dental team in the setting of this benign condition. [ABSTRACT FROM AUTHOR]

Auriculotemporal nerve (ATN) is a branch of the posterior division of mandibular nerve. It presents two roots at its origin, which encircle the middle meningeal artery. In the present study of thirty hemi-sections of head and neck the roots of the ATN and its relation with middle meningeal artery (MMA) were observed and photographed. The number of roots in these thirty specimens were as follows: Single root – was observed in four specimens, two roots – were observed in twenty two specimens, three roots – were observed in three specimens and five roots – were observed in a single specimen. Since the infratemporal region is filled with the temporomandibular joint (TMJ), the muscles of mastication, important blood vessels and nerves, the variations described in the present study, may enlighten the surgeon towards the possible entrapment of the nerve roots due to the pressure exerted due to dislocation of TMJ or due to hypertrophic masticatory muscles.

Las variaciones en el curso de la arteria maxilar se describen a menudo, con sus relaciones con el músculo pterigoideo lateral. En el presente caso informamos una variación exclusiva en el curso de la arteria maxilar que no fue publicada antes. En un cadáver masculino de 75 años arteria maxilar derecho estaba pasando por el bucle del nervio auriculo-temporal. La arteria meníngea media provenía de la arteria maxilar con un bucle del nervio auriculo-temporal. La arteria maxilar pasaba profunda con respecto al nervio dentario inferior pero superficial al nervio lingual. El conocimiento de estas variaciones es importante para el cirujano y también serviría para explicar la posible participación de estas variaciones en la etiología del dolor mandibular. Variations in the course of the maxillary artery are often described with its relations to the lateral pterygoid muscle. In the present case we report a unique variation in the course of the maxillary artery which was not reported before. In a 75 years old male cadaver the right maxillary artery passed through the loop of the auriculotemporal nerve. The middle meningeal artery was arising from the maxillary artery within the nerve loop of auriculotemporal nerve. Further the maxillary artery passed deep to the inferior alveolar nerve but superficial to the lingual nerve. The knowledge of these variations is important for surgeons and it would also explain the possible involvement of these variations in etiology of the craniomandibular pain.

Background. Auriculotemporal neuralgia (ATN) is an infrequent syndrome consisting in strictly unilateral pain in the temporal region associated with nerve tenderness, which can be successfully treated with anesthetic blockade. We analysed clinical characteristics and treatment response in a series of eight patients. Methods. Series of consecutive patients diagnosed with ATN at Headache Clinics of two university hospitals in Spain. Data on demographic and pain characteristics, as well as response to treatment are presented. Results. Eight patients (seven women). Mean age at onset was 52.8614.3 years. Pain was strictly unilateral (left-sided in five cases, right-sided in three), and triggered by pressing the preauricular area. Four patients presented background pain, mostly dull in quality, with an intensity of 5.7561.2 on the verbal analogical scale (VAS). In six, burning exacerbations occurred, ranging from 2 seconds to 30 minutes, with intensity 7.361.5 on VAS. Complete relief was achieved with gabapentin in three cases, anaesthetic blockade in three and spontaneously in two. Conclusion. ATN is uncommon in headache units. Gabapentin is a good alternative therapeutic option to anesthetic blockade. [ABSTRACT FROM AUTHOR]

Background: The auriculotemporal nerve is one of the peripheral nerves that communicates with the facial nerve. However, the function of these communications is poorly understood. Details of how these communications form and connect with each other are still unclear. In addition, a reliable anatomical landmark for locating these communications during surgery has not been sufficiently described. Methods: Microdissection was performed on 20 lateral hemifaces of 10 soft-embalmed cadavers to investigate facial-auriculotemporal nerve communications with emphasis on determining their function. The auriculotemporal nerve was identified in the retromandibular space and traced towards its terminations. The communicating branches were followed and the anatomical relationships to surrounding structures observed. Results: The auriculotemporal nerve is suspended above the maxillary artery in the dense retromandibular fascia behind the mandibular ramus. It forms a knot and fans out, providing multiple branches in all directions in the sagittal plane. Inferiorly, it connects the maxillary periarterial plexus, while minute branches supply the temporomandibular joint anteriorly. The larger branches mainly communicate with the branches of the temporofacial division of the facial nerve, and the auricular branches enter the fascia of the auricular cartilage posteriorly. The temporal branches and occasionally the zygomatic branches arise superiorly to distribute within the temporoparietal fascia. The auriculotemporal nerve forms the parotid retromandibular plexus through two types of communication. It sends one to three branches to join the zygomatic and buccal branches of the facial nerve at the branching area of the temporofacial division. It also communicates with the periarterial plexus of the superficial temporal and maxillary arteries. This plexus continues anteriorly along the branches of the facial nerve and the periarterial plexus of the transverse facial artery as the parotid periductal autonomic plexus, supplying the branches of the parotid duct within the loop of the two main divisions of the parotid gland. Conclusion: A single cutaneous zygomatic branch arising from the auriculotemporal nerve in some specimens, the intraparotid communications with the zygomatic and the buccal trunks of the facial nerve, the retromandibular communications with the superficial temporal-maxillary periarterial plexuses, and the periductal autonomic plexus between the loop of the two main facial divisions lead to the suggestion that these communications of the auriculotemporal nerve convey the secretomotor to the zygomatic and buccal branches of the facial nerve. No Level Assigned: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Knowledge of the anatomy of the auriculotemporal nerve (ATN) and middle meningeal artery (MMA) in the infratemporal fossa is necessary for assisting concise medical diagnosis and intervention. Current textbook descriptions describe a relationship between these structures that is not reported in previous studies. In addition, no previous studies have reported on symmetry or ethnicity affecting the relationship between these structures. This study aims to provide information on the relationship between the ATN and the meningeal artery in a specific ethnic group to further our understanding of normal morphology in this region. The infratemporal fossae of 19 Caucasian cadaveric heads were dissected bilaterally and the relationship between the ATN and MMA scrutinised. Twenty-five samples were included for analysis, including 6 bilateral (12 sides, 8 female) and 13 unilateral (9 female) specimens. Nerve root contributions to the ATN from the mandibular and inferior alveolar nerve included 8 specimens with 1 root, 12 with 2, 5 with 3, and 1 with 4. Three of six bilaterally dissected specimens had asymmetrical numbers of nerve roots. Two specimens were found with a 'button hole' arrangement of the ATN; these did not enclose the MMA. Variation was found both between and within specimens in relation to the relationship between the ATN and MMA. None of the specimens examined demonstrated a morphology that was consistent with common anatomical texts. Findings suggest modern texts require revision in order to accurately describe the relationship between these structures. [ABSTRACT FROM AUTHOR]