Maxillary Artery: Functional and Imaging Anatomy for Safe and Effective Transcatheter Treatment

Abstract

The maxillary artery is a terminal branch of the external carotid artery. Although the main maxillary artery trunk and most of its branches course within the extracranial space and supply the organs and muscles of the head and neck, other surrounding soft tissues, and the oral and rhinosinusal cavities, other branches supply the dura mater and cranial nerve and can anastomose to the internal carotid artery (ICA). Various pathologic conditions of the intracranial, head, and neck regions can involve the branches of the maxillary artery. Many of these diseases can be treated with endovascular approaches; however, there is a potential risk of complications in the brain parenchyma and cranial nerves related to the meningoneuronal arterial supply and anastomoses to the ICA. Therefore, familiarity with the functional and imaging anatomy of the maxillary artery is essential. In the past, conventional angiography has been the standard imaging technique for depicting the maxillary artery anatomy and related pathologic findings. However, recent advances in computed tomographic, magnetic resonance, and rotational angiography have further elucidated the maxillary artery anatomy by means of three-dimensional representations. Understanding the functional and imaging anatomy of the maxillary artery allows safe and successful transcatheter treatment of pathologic conditions in the maxillary artery territories.

Artery of the Superior Orbital Fissure: An Undescribed Branch from the Pterygopalatine Segment of the Maxillary Artery to the Orbital Apex Connecting with the Anteromedial Branch of the Inferolateral Trunk

“…The maxillary arterial branches from the third segment run through various fissures, canals, and foramina to supply various tissues and organs of the surrounding areas. [1][2][3][4][5][6][7] The artery of the foramen rotundum is thought to be the sole arterial branch of the third segment of the internal maxillary artery to enter the cavernous sinus through the foramen rotundum. 1,5,6 It can supply skull base tumors and dural arteriovenous fistulas, and it has a potential anastomosis with the anterolateral branch of the inferolateral trunk (ILT).…”

Arterial Blood Supply of the Nose: An Angiographic Study

“…However, one should be aware that the peripheral segment of the SPA can anastomose with the ethmoidal branch of the ophthalmic artery. The careless wedge injection of embolic material, even injection from the peripheral SPA, can result in visual disturbance [17].…”

The maxillary artery as a recipient vessel option for complex midface and anterior skull base microsurgical repair: A cadaveric study

“…The anatomy of the maxillary artery has received substantive attention with descriptions of its morphologic and morphometric qualities (Choi & Park, ; Kwak et al, ; Roberti, Boari, Mortini, & Caputy, ; Tanoue et al, ; Uysal et al, ) Its presentation in the PPF can be variable, even between sides (Choi & Park, ; Kwak et al, ).…”

“…The third segment also has important accessory branches (Artery to Foramen Rotundum (AFR) and Vidian Artery) to be aware of that are less commonly depicted in anatomical texts. An imaging study and review by Tanoue et al () presents figures for appreciating these uncommonly shown accessory arterial vessels. This study identified a larger accessory branch of the AFR on 5 hemifaces (29%) diverging obscurely from the posterior surface of the pterygopalatine segment (Figure ).…”

“…The first and second maxillary segments serve an important role in blood supply to the meninges, muscles of mastication, and auditory organs of the inner ear. The third segment supplies the mucosal and denticulate areas of the nasal and oral cavities (Choi & Park, ; Kwak et al, ; Tanoue, Kiyosue, Mori, Hori, Okahara, & Sagara, ; Uysal et al, ) It presents as a more proximal recipient vessel to consider in procedures where the distance of the defect to traditional anastomosis sites (Chia, Wong, Tan, & Ong, ; Yazar, ) may be limited by the vascular pedicle length of the flap. While the third segment has been reported to be successfully utilized for intracranial‐extracranial bypass, there are no descriptions in the literature for its use in microvascular tissue transfers (Nossek et al, ).…”