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Mandal G, Montalbano M, Natsis K, Piagkou M, Tubbs RS, Loukas M. Musculus pterygoideus proprius: A meta-analysis. Clin Anat 2023. [PMID: 37964709 DOI: 10.1002/ca.24121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 09/14/2023] [Indexed: 11/16/2023]
Abstract
The pterygoideus proprius muscle can be found incidentally in the infratemporal fossa, where it is spatially associated with the muscles of mastication, the maxillary artery, and the trigeminal nerve and its branches. Anatomists have described the muscle in various ways over the past 160 years, chiefly as a musculotendinous structure that originates from the infratemporal crest of the sphenoid bone and inserts into the lateral pterygoid plate and the lateral pterygoid muscle. It is present in non-human primates, albeit rarely, with similar anatomical findings. Embryologically, the pterygoideus proprius is thought to have developed from the first pharyngeal arch mesenchyme along with other muscles of mastication. Its close association with the maxillary artery and trigeminal nerve suggests possible clinical significance in trigeminal neuralgia and temporomandibular joint disorders. The literature was reviewed systematically to detail the historical background of research on the pterygoideus proprius muscle and explain its morphology, prevalence, embryology, and potential clinical significance. Despite its rarity, we propose that it is important to recognize its presence when the infratemporal fossa is approached.
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Affiliation(s)
- Gaurav Mandal
- Department of the Internal Medicine, Trinity Health System, Steubenville, Ohio, USA
| | - Michael Montalbano
- Department of Anatomical Sciences, St. George's University, True Blue, Grenada
| | - Konstantinos Natsis
- Department of Anatomy and Surgical Anatomy, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - Maria Piagkou
- Department of Anatomy, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - R Shane Tubbs
- Department of Anatomical Sciences, St. George's University, True Blue, Grenada
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA
| | - Marios Loukas
- Department of Anatomical Sciences, St. George's University, True Blue, Grenada
- Department of Anatomy, University of Warmia and Mazury, Olsztyn, Poland
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Govender S, Cronjé JY, Keough N, Oberholster AJ, van Schoor AN, de Jager EJ, Naicker J. Emerging Imaging Techniques in Anatomy: For Teaching, Research and Clinical Practice. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1392:19-42. [DOI: 10.1007/978-3-031-13021-2_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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Lesions of the lateral pterygoid muscle-an overestimated reason for temporomandibular dysfunction: a 3T magnetic resonance imaging study. Int J Oral Maxillofac Surg 2020; 49:1611-1617. [PMID: 32475707 DOI: 10.1016/j.ijom.2020.04.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 03/08/2020] [Accepted: 04/22/2020] [Indexed: 01/18/2023]
Abstract
The aim of this study was to examine the lateral pterygoid muscle (LPM) parenchyma, myotendinous junction, and tendon in temporomandibular disorder (TMD) patients using 3T magnetic resonance imaging (MRI). Results were compared with findings reported in the literature, in which the LPM has been attributed a major role in triggering TMD. 3T MRI was used for temporomandibular joint (TMJ) imaging. The MRI images of 63 patients were analysed for muscle contracture and atrophy, tendon rupture, signal alterations of the tendon, tendon contrast enhancement, and peritendinous fluid collection. Descriptive statistics and the coefficient estimate method were used for statistical analysis. Focus was placed on the association between LPM tendon pathology and TMJ lesions like osteoarthritis and disc displacement. Severe lesions of the LPM tendon and muscle parenchyma, like rupture or fibrosis, were detected in very few cases. Only moderate signs of tendinosis were found in TMD patients. In contrast, there was a clear correlation between tendon lesions and osteoarthritis or anterior disc displacement. These results indicate the need to discuss and question the role of the LPM and its tendon in TMD. Data suggest that LPM and tendon lesions are part of complex degenerative changes of the TMJ, and it seems less likely that a LPM disorder is causative in TMD.
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Evaluation of lateral pterygoid muscles in painful temporomandibular joints by signal intensity on fluid-attenuated inversion recovery images. Oral Radiol 2017; 34:17-23. [PMID: 30484089 DOI: 10.1007/s11282-017-0272-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 01/11/2017] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Pathological changes of the lateral pterygoid muscle (LPM) have been investigated using various modalities, including magnetic resonance (MR) imaging and electromyography. Fluid-attenuated inversion recovery (FLAIR) is an MR sequence that we hypothesized can be used to evaluate abnormalities of the LPM. The purpose of this study was to analyze the FLAIR signal intensity of the LPM in painful temporomandibular joints (TMJs) and investigate the pathological changes of the muscle. METHODS The study was based on 149 TMJs of 77 patients who were referred for MR imaging of the TMJ. Patients rated their degree of pain during chewing and mouth opening using a visual analog scale (VAS). Regions of interest were placed over the superior and inferior heads of the LPM and gray matter on FLAIR sagittal images. Using the signal intensity of gray matter as a reference, the signal intensity ratio (SIR) of the LPM was calculated. Spearman's rank-correlation coefficient was used to analyze the correlation between the SIR and the VAS score (p < 0.05). RESULTS A significant correlation was present between the SIR on FLAIR images and the VAS score. CONCLUSIONS These results suggest that the FLAIR signal intensity of the superior and inferior heads of the LPM significantly increases as TMJ pain becomes more severe. Thus, FLAIR could be useful in assessing the relationship between the MR signals of the LPM and clinical symptoms.
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Litko M, Szkutnik J, Berger M, Różyło-Kalinowska I. Correlation between the lateral pterygoid muscle attachment type and temporomandibular joint disc position in magnetic resonance imaging. Dentomaxillofac Radiol 2016; 45:20160229. [PMID: 27506381 DOI: 10.1259/dmfr.20160229] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate the correlation between the lateral pterygoid muscle (LPM) attachment type and temporomandibular joint (TMJ) disc position on sagittal and coronal MR scans. METHODS 191 patients (148 females, 43 males), aged 14-60 years, underwent MR investigations of the TMJs in the intercuspal position (IP) and open-mouth position (OMP). The disc position was evaluated on oblique sagittal and coronal images in the IP and OMP on many MRI sections showing all portions of the joint. Relationships between the LPM attachment patterns and articular disc positions were evaluated by z and χ2 tests. RESULTS Three types of the LPM attachment were found. There was a statistically significant correlation between the LPM attachment type and the disc position in IP (χ2 = 24.29; p < 0.01). The type of muscle attachment did not determine the prevalence of normal, lateral and medial disc positions. There were differences between the muscle attachment types in the anterior, anteromedial and anterolateral disc positions. There was a statistically significant association between TMJ disc position in OMP and particular attachment types in the sagittal plane (χ2 = 9.702; p < 0.01). CONCLUSIONS Certain types of the LPM insertion are correlated with TMJ disc position.
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Affiliation(s)
- Monika Litko
- 1 Department of Functional Masticatory Disorders, Medical University of Lublin, Lublin, Poland
| | - Jacek Szkutnik
- 1 Department of Functional Masticatory Disorders, Medical University of Lublin, Lublin, Poland
| | - Marcin Berger
- 1 Department of Functional Masticatory Disorders, Medical University of Lublin, Lublin, Poland
| | - Ingrid Różyło-Kalinowska
- 2 Independent Unit of Propedeutics of Dentomaxillofacial Radiology, Medical University of Lublin, Lublin, Poland
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Yang HM, Cha JY, Hong KS, Park JT. Three-dimensional finite element analysis of unilateral mastication in malocclusion cases using cone-beam computed tomography and a motion capture system. J Periodontal Implant Sci 2016; 46:96-106. [PMID: 27127690 PMCID: PMC4848384 DOI: 10.5051/jpis.2016.46.2.96] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Accepted: 02/27/2016] [Indexed: 11/23/2022] Open
Abstract
Purpose Stress distribution and mandible distortion during lateral movements are known to be closely linked to bruxism, dental implant placement, and temporomandibular joint disorder. The present study was performed to determine stress distribution and distortion patterns of the mandible during lateral movements in Class I, II, and III relationships. Methods Five Korean volunteers (one normal, two Class II, and two Class III occlusion cases) were selected. Finite element (FE) modeling was performed using information from cone-beam computed tomographic (CBCT) scans of the subjects’ skulls, scanned images of dental casts, and incisor movement captured by an optical motion-capture system. Results In the Class I and II cases, maximum stress load occurred at the condyle of the balancing side, but, in the Class III cases, the maximum stress was loaded on the condyle of the working side. Maximum distortion was observed on the menton at the midline in every case, regardless of loading force. The distortion was greatest in Class III cases and smallest in Class II cases. Conclusions The stress distribution along and accompanying distortion of a mandible seems to be affected by the anteroposterior position of the mandible. Additionally, 3-D modeling of the craniofacial skeleton using CBCT and an optical laser scanner and reproduction of mandibular movement by way of the optical motion-capture technique used in this study are reliable techniques for investigating the masticatory system.
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Affiliation(s)
- Hun-Mu Yang
- Department of Anatomy, Dankook University College of Medicine, Cheonan, Korea
| | - Jung-Yul Cha
- Department of Orthodontics, Yonsei University College of Dentistry, Seoul, Korea
| | - Ki-Seok Hong
- Perio-Implant Research Center, Dankook University College of Dentistry, Cheonan, Korea
| | - Jong-Tae Park
- Department of Oral Anatomy, Dankook University College of Dentistry, Cheonan, Korea
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Lopes SLPDC, Costa ALF, Gamba TDO, Flores IL, Cruz AD, Min LL. Lateral pterygoid muscle volume and migraine in patients with temporomandibular disorders. Imaging Sci Dent 2015; 45:1-5. [PMID: 25793177 PMCID: PMC4362986 DOI: 10.5624/isd.2015.45.1.1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 01/01/2015] [Accepted: 01/03/2015] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Lateral pterygoid muscle (LPM) plays an important role in jaw movement and has been implicated in Temporomandibular disorders (TMDs). Migraine has been described as a common symptom in patients with TMDs and may be related to muscle hyperactivity. This study aimed to compare LPM volume in individuals with and without migraine, using segmentation of the LPM in magnetic resonance (MR) imaging of the TMJ. MATERIALS AND METHODS Twenty patients with migraine and 20 volunteers without migraine underwent a clinical examination of the TMJ, according to the Research Diagnostic Criteria for TMDs. MR imaging was performed and the LPM was segmented using the ITK-SNAP 1.4.1 software, which calculates the volume of each segmented structure in voxels per cubic millimeter. The chi-squared test and the Fisher's exact test were used to relate the TMD variables obtained from the MR images and clinical examinations to the presence of migraine. Logistic binary regression was used to determine the importance of each factor for predicting the presence of a migraine headache. RESULTS Patients with TMDs and migraine tended to have hypertrophy of the LPM (58.7%). In addition, abnormal mandibular movements (61.2%) and disc displacement (70.0%) were found to be the most common signs in patients with TMDs and migraine. CONCLUSION In patients with TMDs and simultaneous migraine, the LPM tends to be hypertrophic. LPM segmentation on MR imaging may be an alternative method to study this muscle in such patients because the hypertrophic LPM is not always palpable.
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Affiliation(s)
| | - André Luiz Ferreira Costa
- Department of Pediatric Dentistry and Orthodontics, University of São Paulo City, UNICID, São Paulo, Brazil
| | | | - Isadora Luana Flores
- Department of Oral Diagnosis, School of Dentistry, UNICAMP, Piracicaba, São Paulo, Brazil
| | - Adriana Dibo Cruz
- Department of Specific Formation, Area of Radiology, Nova Friburgo Dental School, Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil
| | - Li Li Min
- Laboratory of Neuroimaging, Department of Neurology, Faculty of Medical Sciences, UNICAMP, Campinas, São Paulo, Brazil
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Warden JM, Roberts SL, Chang Y, Baker R, Boulias C, Ismail F, Agur AM. Neuromuscular Partitioning of Subscapularis Based on Intramuscular Nerve Distribution Patterns: Implications for Botulinum Toxin Injections. Arch Phys Med Rehabil 2014; 95:1408-15. [DOI: 10.1016/j.apmr.2014.01.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 01/17/2014] [Accepted: 01/21/2014] [Indexed: 11/25/2022]
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Joo W, Yoshioka F, Funaki T, Mizokami K, Rhoton AL. Microsurgical anatomy of the trigeminal nerve. Clin Anat 2013; 27:61-88. [PMID: 24323792 DOI: 10.1002/ca.22330] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 09/05/2013] [Indexed: 11/12/2022]
Affiliation(s)
- Wonil Joo
- Department of Neurosurgery; Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine; Seoul South Korea
- Department of Neurosurgery; University of Florida; Gainesville Florida
| | - Fumitaka Yoshioka
- Department of Neurosurgery; University of Florida; Gainesville Florida
| | - Takeshi Funaki
- Department of Neurosurgery; University of Florida; Gainesville Florida
| | - Koji Mizokami
- Department of Neurosurgery; University of Florida; Gainesville Florida
| | - Albert L. Rhoton
- Department of Neurosurgery; University of Florida; Gainesville Florida
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Chang Y, Cantelmi D, Wisco JJ, Fattah A, Hannam AG, Agur AM. Evidence for the functional compartmentalization of the temporalis muscle: a 3-dimensional study of innervation. J Oral Maxillofac Surg 2013; 71:1170-7. [PMID: 23806734 DOI: 10.1016/j.joms.2013.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 04/08/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE The temporalis muscle is commonly used for functional transfer. It is architecturally complex, but few studies have examined its intramuscular innervation and none has used 3-dimensional modeling techniques. Understanding neuromuscular compartmentalization may allow the design of local muscle transfers to minimize donor-site morbidity. The purpose of the present study was to document the intramuscular innervation patterns throughout the volume of the temporalis muscle and define functional units within the muscle. MATERIALS AND METHODS In 10 formalin-embalmed cadaveric specimens, the foramen ovale was exposed and the branches of the mandibular nerve were identified. Each branch was digitized in short segments extramuscularly and intramuscularly. Three-dimensional models were reconstructed from the digitized data using Maya software, and the innervation patterns were documented. RESULTS The temporalis muscle was found to have superior and inferior parts that were further grouped by innervation into regions, with each receiving its innervation from 1 primary nerve. The nerves originated directly from the mandibular nerve, except in 3 specimens, where the posterior deep temporal nerve arose from the masseteric nerve. CONCLUSION These results provide a detailed mapping of innervation patterns and suggest there are at least 5 functional compartments. Each of these has the capacity for selective activation, 3 of which have clinical value. These findings may allow for decreased donor-site morbidity and more functionally sophisticated designs in clinical practice.
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Affiliation(s)
- Youjin Chang
- Division of Anatomy, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
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Hermenegildo J, Roberts S, Kim S. Innervation pattern of the suprascapular nerve within supraspinatus: A three-dimensional computer modeling study. Clin Anat 2013; 27:622-30. [DOI: 10.1002/ca.22250] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 03/04/2013] [Indexed: 11/07/2022]
Affiliation(s)
- J.A. Hermenegildo
- Division of Anatomy; Department of Surgery; University of Toronto; Canada
| | - S.L. Roberts
- Division of Anatomy; Department of Surgery; University of Toronto; Canada
| | - S.Y. Kim
- School of Physical Therapy, College of Medicine; University of Saskatchewan; Canada
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Nowinski WL, Chua BC, Johnson A, Qian G, Poh LE, Yi SHW, Bivi A, Nowinska NG. Three-dimensional interactive and stereotactic atlas of head muscles and glands correlated with cranial nerves and surface and sectional neuroanatomy. J Neurosci Methods 2013; 215:12-8. [DOI: 10.1016/j.jneumeth.2013.02.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 02/06/2013] [Accepted: 02/06/2013] [Indexed: 11/15/2022]
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