Auriculotemporal nerve

The auriculotemporal nerve is a sensory branch of the posterior division of the mandibular division (V3) of the trigeminal nerve. Communicating rami within the parotid gland connect it with the facial nerve.

Reference Images

Labeled lateral skull illustration showing the auriculotemporal nerve and adjacent mandibular nerve branches. — Anatomical course of the auriculotemporal nerve, a sensory branch of CNV3, splitting around the middle meningeal artery and anastomosing with the facial nerve.Image 1 of 2 · Click to enlarge

Anatomic diagram of auriculotemporal and facial nerve connections beside axial contrast-enhanced fat-suppressed T1-weighted MRI annotated for perineural tumor spread. — Adenoid cystic carcinoma with PNT. (a) Axial T1WI +C FS shows enhancement along intraparotid CN7 (yellow arrow), extending along the auriculotemporal nerve (red arrow) connecting CN7 & V3. (b) Abnormal enhancement involves the mastoid segment of CN7 (green arrow) at the stylomastoid foramen and CN V3 (cyan arrow) in the masticator space.Image 2 of 2 · Click to enlarge

Gross anatomy

Origin and course

Arises posteriorly from the posterior division of the mandibular nerve.
Two separate roots encircle the middle meningeal artery as the artery ascends to enter the foramen spinosum.
The roots rejoin and pass medial to the neck of the mandible, deep to the sphenomandibular ligament.
The nerve ascends between the temporomandibular joint and external auditory meatus, giving off small articular branches to the joint.
At the upper border of the parotid gland, it supplies the gland sheath and terminates as auricular and temporal cutaneous branches ^1–3.

Parotid fibers and connections

The supplied text describes sympathetic fibers received from the middle meningeal artery and secretomotor parasympathetic fibers (derived from the otic ganglion) from the lesser petrosal nerve; both supply the parotid gland ^1–3.

Communicating rami link the auriculotemporal and facial nerves within the parotid gland ⁴.

Radiographic features

The auriculotemporal nerve is usually not seen on CT or MRI.

Expected location

Its expected course lies parallel to the posterior border of the mandible, just superior to the terminal bifurcation of the external carotid artery into the maxillary and superficial temporal arteries ⁴.

Related pathology

Perineural spread of head and neck malignancies, including cutaneous squamous cell carcinoma and salivary gland adenoid cystic carcinoma, can occur along the auriculotemporal nerve.

This route permits potential spread from the mandibular division (V3) of the trigeminal nerve to the facial nerve, or vice versa.

Teaching graphic context

Figure 1 describes the auriculotemporal nerve as a “bridge” between CNV3 in the masticator space and CN7 in the parotid space. It states that patients with perineural tumor involvement present with both trigeminal and facial neuropathies.

Cutaneous branches and sensory territory

Auricular branch

External acoustic meatus.
External surface of the tympanic membrane, along with the greater auricular nerve. The internal surface is supplied by the tympanic branch of the glossopharyngeal nerve.
Skin of the auricle anterior to the external acoustic meatus. The remainder of the auricle is supplied by the greater auricular nerve (C2, C3).

Temporal branch

Ascends posterior to the superficial temporal vessels over the root of the zygoma to supply the posterior half of the temple—the “hairy skin” of the temple.

The anterior half, or “skin of the hairless temple,” is supplied by the zygomaticotemporal nerve from the maxillary division of the trigeminal nerve.

Source limitations

The supplied prose includes reference markers 1–3 and 4, but no bibliography was provided. These markers are retained without invented citations.

The first graphic’s statement that patients present with both trigeminal and facial neuropathies is preserved as a teaching-slide claim; the supplied prose does not establish its frequency or whether it applies to every patient. The original graphics, labels, arrows, and embedded captions are preserved unchanged.