Anatomical variations and clinical implications of the artery to the lingual nerve

The pterygomandibular space is a critical anatomic area for the delivery of local anesthesia in the practice of dentistry. The neurovascular contents of this area are subject to trauma and its resultant local and systemic complications. This study of 202 cadaveric specimens reaffirms the literature as to the percent distributions of the superficial and deep routes of the maxillary artery and details for the first time the anatomic variations of the artery to the lingual nerve. This artery courses through the pterygomandibular space placing it at risk for injection trauma along with the other neurovascular contents. It has been uncommonly identified and referred to in the literature, yet it may be the first artery encountered when entering the space with a needle or during surgical intervention in the area.