Facial Pain And Sensory Loss

Anterior division

Lingual nerve •

The peripheral course of the V nerve

The motor and sensory nerve roots emerge separately from the lateral aspect of the brain stem at the midpontine level. The Gasserian ganglion of the sensory root contains bipolar sensory nuclei and lies on the apex of the petrous bone in the middle fossa. Here the three divisions of the trigeminal nerve merge. Each passes through its own foramen and carries sensation from a specific area of the face.

Supraorbital _ nerve

Supratrochlear nerve

Lacrimal nerve

(Superior aspect)

Gasserian ganglion —

The maxillary division passes through the foramen rotundum into the pterygopalatine fossa, then through the infraorbital foramen to become the infraorbital nerve.

The ophthalmic division passes through the superior orbital fissure, divides into branches within the orbit and emerges from the supraorbital foramen to innervate the forehead.

Supraorbital nerve

Buccal nerve

Middle fossa

Inferior alveolar nerve

The mandibular division exits from the foramen ovale. The anterior division incorporates the motor branch of the V nerve, innervating the muscles of mastication - masseter, pterygoids and temporalis - as well as innervating the cheek and gums (buccal nerve).

The lingual branch of the posterior trunk innervates the anterior two-thirds of the tongue (and is joined by the chordi tympani from the facial nerve carrying salivary secretomotor fibres and taste from the anterior two-thirds of the tongue).

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