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Infratemporal Fossa

fossa infratemporalis

The infratemporal fossa is the irregular space deep to the zygomatic arch and posterior to the maxilla, containing the lower head of the lateral pterygoid muscle, the medial pterygoid muscle, the pterygoid venous plexus, the maxillary artery and its branches, and the mandibular nerve (V3) with its branches as they emerge from the foramen ovale. It communicates with the temporal fossa above the zygomatic arch, the pterygopalatine fossa medially, and the oral cavity via the pterygomandibular space.

Region: Head & Skull

Clinical Relevance

Clinical Notes

The infratemporal fossa is a complex anatomical crossroads relevant in oral and maxillofacial surgery (access for deep space tumours, pterygoid region injection), neurosurgery (middle fossa and extended middle fossa approaches), and otolaryngology (skull base tumours). Infratemporal fossa approaches (Fisch type A, B, C) are used for glomus jugulare, large acoustic neuromas, and clivus lesions. Complications include trismus from pterygoid damage, V3 injury, and internal carotid artery injury from the carotid canal adjacent to the fossa.

Pathology

Common Injuries & Conditions

Infratemporal Fossa Abscess from Deep Space Dental Infection

Mandibular molar periapical abscess penetrating the medial pterygoid fascia produces a deep infratemporal fossa abscess with limited trismus, ipsilateral jaw pain, and obliteration of the pterygomaxillary space on CT; surgical drainage requires a transcutaneous submandibular approach or transoral approach posterior to the last molar.