Maxillary artery:: Anatomical landmarks and relationship with the mandibular subcondyle

Background: The maxillary artery can be injured during procedures in the subcondylar portion of the mandible. Thorough knowledge of this region is mandatory to avoid accidental puncture of the maxillary artery, which can lead to profuse bleeding that is hard to control. Methods: In 16 halves of eight embalmed cadaver heads, the maxillary artery was dissected from the branching point to the entrance point to the maxillary sinus. Its anatomical relationships with certain landmarks were recorded numerically. Results: The mean distance of the branching point of the maxillary artery to the tragal pointer was 16.2 mm (range, 14.97 to 16.80 mm) in the horizontal plane and 21.4 mm (range, 19.14 to 23.53 mm) in the vertical plane. The mean vertical distance of the branching point to the Frankfort horizontal plane was 25.7 mm (range, 24.86 to 27.47 mm). The mean distance of the branching point of the maxillary artery to the tip of the condyle was 22.4 mm (range, 21.66 to 23.99 mm). The mean distance of the artery to the medial border of the subcondylar portion of the mandible was 6.8 mm (range, 4.06 to 8.47 mm). The mean distance between the deepest point of the sigmoid notch and the junction of the maxillary artery and sigmoid notch was 5.1 mm (range, 4.97 to 5.95 mm). The mean distance of the maxillary artery-sigmoid notch junction to the tragal pointer was 22.9 mm (range, 20.95 to 25.05 mm). Conclusions: The maxillary artery can be injured during surgical procedures performed in the temporomandibular region. Its relationship with the subcondylar portion of the mandible varies.