New anatomo-radiological findings of the lateral pterygoid muscle

• Published in: Surgical and radiologic anatomy (English ed.) Vol. 38; no. 9; pp. 1033 - 1043
• Main Authors: Bernal-Mañas, C. M., González-Sequeros, O., Moreno-Cascales, M., Sarria-Cabrera, R., Latorre-Reviriego, R. M.
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01.11.2016; Springer Nature B.V
• Subjects: Aged; Anatomic Bases of Medical; Anatomy; Anatomy & physiology; Cryoultramicrotomy; Female; Humans; Imaging; Magnetic Resonance Imaging; Male; Medicine; Medicine & Public Health; Mouth; Muscular system; Orthopedics; Pterygoid Muscles - anatomy & histology; Pterygoid Muscles - diagnostic imaging; Radiological and Surgical Techniques; Radiology; Surgery; Teeth; Temporomandibular Joint Disorders - diagnostic imaging; TMJ; Human temporomandibular joint; Plastination; MRI; Lateral pterygoid muscle; Pterygoid venous plexus
• ISSN: 0930-1038; 1279-8517
• DOI: 10.1007/s00276-016-1665-2

Purpose The discrepancies in the literature regarding the anatomy of the temporomandibular joint (TMJ), particularly at the level of the lateral pterygoid muscle, led us to compare plastinated section techniques and magnetic resonance imaging (MRI) to enable the better interpretation of both, and to describe the features of the lateral pterygoid muscle and the exact location of its insertions. Methods A total of 24 blocks of human TMJ were used. Seven were studied by MRI, obtaining images of the oblique-sagittal, oblique-coronal, and axial planes. Four of these blocks were then cut and processed by means of the E12 plastination technique. The remaining blocks were dissected. Finally, we performed a comparative morphological analysis of the different techniques used. Results New aspects about the morphology and the insertions of the lateral pterygoid muscle are described. The muscle is inserted into the disc, capsule, condyle, and the pterygoid fovea, through muscle and tendon fibres that alternate, giving it the characteristic of a multipennate muscle. This insertion caudally exceeded the pterygoid fovea and descends to near the lingula of mandible. A profuse pterygoid venous plexus surrounds the whole joint complex, and also the insertion zone of the lateral pterygoid muscle. Conclusions We consider that the use of transparent-plastinated anatomical sections and its good correlation with MRI images (in axial and oblique-sagittal planes) led to an accurate identification of TMJ structures, especially in relation to the lateral pterygoid muscle, that is now described as a multipennate muscle.