Table of ContentsView AllTable of ContentsAnatomyFunctionAssociated Conditions
Table of ContentsView All
View All
Table of Contents
Anatomy
Function
Associated Conditions
The auriculotemporal nerve is a branch of the mandibular nerve that provides sensation to several regions on the side of your head, including the area around the jaw, ear, and scalp. For much of its course through the structures of your head and face, it runs along the superficial temporal artery and vein.
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Your nerves are complex structures. They branch out from their starting points, much like tree limbs. Branches run all throughout your body, connecting to different tissues such as skin, muscles, bones, joints, connective tissues, and even other nerves and clusters of nerves.
Some of your nerves carry information from your five senses—sensory information—to and from your brain. Others enable movement— motor function—in your muscles and other moving parts. Some of them provide both sensory and motor function and are thus called mixed nerves.
In your head, you have 12 symmetrical pairs ofcranial nerves. Each one has a right and left side, but they’re typically referred to as a single nerve unless it’s necessary to refer just to the left or right one.
While the rest of thenerves emerge from the spinal cord, the cranial nerves come directly from your brain. Most start at the brainstem, which sits low at the back of your brain and connects the brain to the spinal cord.
Structure
The fifth cranial nerve is called thetrigeminal nerve, which is responsible for biting and chewing motions of your jaw as well as sensation in some areas of your face. The trigeminal nerve splits into three main branches, the:
The mandibular nerve is the largest branch of the trigeminal nerve and connects to the lower jaw. Along its course, the mandibular nerve divides into four main sensory branches, which are called the:
After the two roots unite, the auriculotemporal nerve gives off several branches. These include:
Location
The trigeminal nerve travels from the brainstem and around your head toward your face before it gives rise to the mandibular nerve.
The auriculotemporal nerve, a branch of the posterior division of the mandibular nerve, typically arises as two roots that encircle the middle meningeal artery. The two roots quickly join together. The united nerve then dips down and back toward your ear, where it makes a sharp U-turn and then travels back up toward the top of your head, sending out branches along the way.
Inferior Branch
Nerve signals that help the parotid gland produce saliva start in the glossopharyngeal nerve. They pass through a small pathway (the tympanic and lesser petrosal nerves) until they reach a tiny nerve station called the otic ganglion, located deep in the jaw area. After they connect there, these signals travel along the inferior branch of the auriculotemporal nerve to reach the parotid gland and stimulate it to make saliva.
The parotid gland is one of three types of salivary glands you have. It sits in front of and a little below each of your ear canals, along the cheek and jaw.
The Parotid Gland: What It Does
Superior Branch
The sensory fibers of the auriculotemporal nerve’s superior branch, meanwhile, pass through the otic ganglion but don’t communicate with it. From there, several branches arise. These branches travel to and connect to various structures, providing nerve function (which is called “innervation”).
Anatomical Variations
While nerves have typical structures and paths through the body, they’re not exactly the same in everyone. It’s important for doctors and, especially, surgeons to know about the different anatomical variations of nerves so they can properly diagnose and treat nerve-related disorders. It’s of special importance to help them avoid damaging nerves during surgery, which may lead to pain, dysfunction, and/or permanent disability, depending on the nerve and the severity of the damage.
The most common known variation of the auriculotemporal nerve is in its number of roots. Having two roots is considered typical, but in studies of cadavers, researchers have found anywhere from one to four roots on each side.Additionally, some people had different numbers on each side, so doctors can’t assume the nerve structure is symmetrical.
Other variations involve the relationship of the auriculotemporal nerve roots to the middle meningeal artery. Typically, the nerve’s two roots encircle the artery, but anatomical studies have documented differences in how the roots and the artery are positioned relative to one another.
In the region of the temple, on the side of the forehead, branches of the nerve run close to the surface and therefore are vulnerable to being injured. Research shows considerable variation in the branches through that region, with some people having as few as two branches per side and others having as many as seven per side. Their distances from certain structures varied as well, and in some people, the communicating branches of the nerve formed a loop. In one case, it formed two loops.
Other research shows that the parotid branch varies in how far it lies from major structures. In addition, some people have also been found to have two parotid branches instead of the usual single branch per side.
Because the auriculotemporal nerve serves both sensory and specialized motor function, it’s classified as a mixed nerve.
Secretory-Motor Function
The single motor function of the auriculotemporal nerve’s inferior branch deals with the parotid gland. It is important to note that these fibers do not originally originate in the auriculotemporal nerve but rather hitchhike along the nerve to the parotid gland. These fibers stimulate the gland tosecretesaliva, which is where the term secretory-motor comes from.
Sensory Function
The auriculotemporal nerve, a branch of the mandibular division (V3) of the trigeminal nerve, provides sensory innervation to the skin and associated structures in the regions it supplies. This allows sensations such as touch and temperature to be transmitted to the brain:
Associated Conditions and Treatments
The most common problems that are directly related to this nerve are entrapment or compression, neuralgia, Frey syndrome, and injury during TMJ surgery.
Entrapment/Compression
Neuralgia
Neuralgia (pain from nerve damage) of the auriculotemporal nerve can cause throbbing pain at any of the sites where it connects to structures, including:
Treatment options vary, and may include medications typically used for neuropathic pain, nerve blocks, and, in some cases, botulinum toxin injections..
Frey Syndrome
Surgical removal of the parotid gland can result in a complication called Frey syndrome. After the gland is gone from the cheek, parasympathetic nerve fibers that once innervated the parotid gland mistakenly grow into the skin and connect with sweat glands after surgery.
That leads to sweating along the cheek while you eat, which is when the parotid branch would normally be causing the parotid gland to release saliva.
Conservative treatment can involve antiperspirant on the cheek. There’s also a surgical option, which involves placing a different tissue in between the nerve and the sweat gland so the nerve can no longer cause the gland to activate.
All About Frey Syndrome
Injury During TMJ Surgery
Because of its relationship to the temporomandibular joint and the parotid gland, the auriculotemporal nerve is vulnerable to injury during TMJ surgery. The result of this injury can be abnormal nerve sensations such as tingling, burning, itching, or electrical “zings,” which are called paresthesias.
Nerve Block as TMJ Pain Relief
Is TMJ Surgery Right for You?
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Dias GJ, Koh JM, Cornwall J.The origin of the auriculotemporal nerve and its relationship to the middle meningeal artery.Anat Sci Int. 2015;90(4):216–221. doi:10.1007/s12565-014-0247-9Iwanaga J, Watanabe K, Saga T, Fisahn C, Oskouian RJ, Tubbs RS.Anatomical study of the superficial temporal branches of the auriculotemporal nerve: Application to surgery and other invasive treatments to the temporal region.J Plast Reconstr Aesthet Surg. 2017;70(3):370–374. doi:10.1016/j.bjps.2016.10.025Iwanaga J, Fisahn C, Watanabe K, et al.Parotid branches of the auriculotemporal nerve: An anatomical study with implications for Frey syndrome.J Craniofac Surg. 2017;28(1):262–264. doi:10.1097/SCS.0000000000003260Piagkou M, Demesticha T, Skandalakis P, Johnson EO.Functional anatomy of the mandibular nerve: consequences of nerve injury and entrapment.Clin Anat. 2011;24(2):143–150. doi:10.1002/ca.21089Trescot AM, Rawner E.Auriculotemporal nerve entrapment. In: Trescot AM, ed.Peripheral Nerve Entrapments. Switzerland: Springer, 2016: 105-115. doi:10.1007/978-3-319-27482-9_15Stuginski-Barbosa J, Murayama RA, Conti PC, Speciali JG.Refractory facial pain attributed to auriculotemporal neuralgia.J Headache Pain. 2012;13(5):415–417. doi:10.1007/s10194-012-0439-4Wilhour D, Nahas SJ.The neuralgias.Curr Neurol Neurosci Rep. 2018;18(10):69. doi:10.1007/s11910-018-0880-0Rodriguez-Lopez MJ, Fernandez-Baena M, Aldaya-Valverde C.Management of pain secondary to temporomandibular joint syndrome with peripheral nerve stimulation.Pain Physician. 2015;18(2):E229–E236.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Dias GJ, Koh JM, Cornwall J.The origin of the auriculotemporal nerve and its relationship to the middle meningeal artery.Anat Sci Int. 2015;90(4):216–221. doi:10.1007/s12565-014-0247-9Iwanaga J, Watanabe K, Saga T, Fisahn C, Oskouian RJ, Tubbs RS.Anatomical study of the superficial temporal branches of the auriculotemporal nerve: Application to surgery and other invasive treatments to the temporal region.J Plast Reconstr Aesthet Surg. 2017;70(3):370–374. doi:10.1016/j.bjps.2016.10.025Iwanaga J, Fisahn C, Watanabe K, et al.Parotid branches of the auriculotemporal nerve: An anatomical study with implications for Frey syndrome.J Craniofac Surg. 2017;28(1):262–264. doi:10.1097/SCS.0000000000003260Piagkou M, Demesticha T, Skandalakis P, Johnson EO.Functional anatomy of the mandibular nerve: consequences of nerve injury and entrapment.Clin Anat. 2011;24(2):143–150. doi:10.1002/ca.21089Trescot AM, Rawner E.Auriculotemporal nerve entrapment. In: Trescot AM, ed.Peripheral Nerve Entrapments. Switzerland: Springer, 2016: 105-115. doi:10.1007/978-3-319-27482-9_15Stuginski-Barbosa J, Murayama RA, Conti PC, Speciali JG.Refractory facial pain attributed to auriculotemporal neuralgia.J Headache Pain. 2012;13(5):415–417. doi:10.1007/s10194-012-0439-4Wilhour D, Nahas SJ.The neuralgias.Curr Neurol Neurosci Rep. 2018;18(10):69. doi:10.1007/s11910-018-0880-0Rodriguez-Lopez MJ, Fernandez-Baena M, Aldaya-Valverde C.Management of pain secondary to temporomandibular joint syndrome with peripheral nerve stimulation.Pain Physician. 2015;18(2):E229–E236.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Dias GJ, Koh JM, Cornwall J.The origin of the auriculotemporal nerve and its relationship to the middle meningeal artery.Anat Sci Int. 2015;90(4):216–221. doi:10.1007/s12565-014-0247-9Iwanaga J, Watanabe K, Saga T, Fisahn C, Oskouian RJ, Tubbs RS.Anatomical study of the superficial temporal branches of the auriculotemporal nerve: Application to surgery and other invasive treatments to the temporal region.J Plast Reconstr Aesthet Surg. 2017;70(3):370–374. doi:10.1016/j.bjps.2016.10.025Iwanaga J, Fisahn C, Watanabe K, et al.Parotid branches of the auriculotemporal nerve: An anatomical study with implications for Frey syndrome.J Craniofac Surg. 2017;28(1):262–264. doi:10.1097/SCS.0000000000003260Piagkou M, Demesticha T, Skandalakis P, Johnson EO.Functional anatomy of the mandibular nerve: consequences of nerve injury and entrapment.Clin Anat. 2011;24(2):143–150. doi:10.1002/ca.21089Trescot AM, Rawner E.Auriculotemporal nerve entrapment. In: Trescot AM, ed.Peripheral Nerve Entrapments. Switzerland: Springer, 2016: 105-115. doi:10.1007/978-3-319-27482-9_15Stuginski-Barbosa J, Murayama RA, Conti PC, Speciali JG.Refractory facial pain attributed to auriculotemporal neuralgia.J Headache Pain. 2012;13(5):415–417. doi:10.1007/s10194-012-0439-4Wilhour D, Nahas SJ.The neuralgias.Curr Neurol Neurosci Rep. 2018;18(10):69. doi:10.1007/s11910-018-0880-0Rodriguez-Lopez MJ, Fernandez-Baena M, Aldaya-Valverde C.Management of pain secondary to temporomandibular joint syndrome with peripheral nerve stimulation.Pain Physician. 2015;18(2):E229–E236.
Dias GJ, Koh JM, Cornwall J.The origin of the auriculotemporal nerve and its relationship to the middle meningeal artery.Anat Sci Int. 2015;90(4):216–221. doi:10.1007/s12565-014-0247-9
Iwanaga J, Watanabe K, Saga T, Fisahn C, Oskouian RJ, Tubbs RS.Anatomical study of the superficial temporal branches of the auriculotemporal nerve: Application to surgery and other invasive treatments to the temporal region.J Plast Reconstr Aesthet Surg. 2017;70(3):370–374. doi:10.1016/j.bjps.2016.10.025
Iwanaga J, Fisahn C, Watanabe K, et al.Parotid branches of the auriculotemporal nerve: An anatomical study with implications for Frey syndrome.J Craniofac Surg. 2017;28(1):262–264. doi:10.1097/SCS.0000000000003260
Piagkou M, Demesticha T, Skandalakis P, Johnson EO.Functional anatomy of the mandibular nerve: consequences of nerve injury and entrapment.Clin Anat. 2011;24(2):143–150. doi:10.1002/ca.21089
Trescot AM, Rawner E.Auriculotemporal nerve entrapment. In: Trescot AM, ed.Peripheral Nerve Entrapments. Switzerland: Springer, 2016: 105-115. doi:10.1007/978-3-319-27482-9_15
Stuginski-Barbosa J, Murayama RA, Conti PC, Speciali JG.Refractory facial pain attributed to auriculotemporal neuralgia.J Headache Pain. 2012;13(5):415–417. doi:10.1007/s10194-012-0439-4
Wilhour D, Nahas SJ.The neuralgias.Curr Neurol Neurosci Rep. 2018;18(10):69. doi:10.1007/s11910-018-0880-0
Rodriguez-Lopez MJ, Fernandez-Baena M, Aldaya-Valverde C.Management of pain secondary to temporomandibular joint syndrome with peripheral nerve stimulation.Pain Physician. 2015;18(2):E229–E236.
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