title: The maxillary artery and its variants: an anatomical study with neurosurgical applications.
abstract: The maxillary artery (MA) has gained attention in neurosurgery particularly in cerebral revascularization techniques, intracranial endonasal approaches and endovascular procedures.
  
  
  
  To describe and illustrate the anatomy of the MA and its neurosurgical importance in a detailed manner.
  
  
  
  Six cadaveric heads (12 MAs) were injected with latex. The arteries and surrounding structures were dissected and studied using microsurgical techniques. The dimensions, course and branching patterns of the MA were recollected. In addition, 20 three-dimensional reconstruction CT head and neck angiograms (3D CTAs) of actual patients were correlated with the cadaveric findings.
  
  
  
  The MA can be divided in three segments: mandibular, pterygoid and pterygopalatine. Medial and lateral trunk variants regarding its course around the lateral pterygoid muscle can be found. The different branching patterns of the MA have a direct correlation with the course of its main trunk at the base of the skull. Branching and trunk variants on one side do not predict the findings on the contralateral side.
  
  
  
  In this study the highly variable course, branching patterns and relations of the MA are illustrated and described in human cadaveric heads and 3D CTAs. MA 3D CTA with bone reconstruction can be useful preoperatively for the identification of the medial or lateral course variants of this artery, particularly its pterygoid segment, which should be taken into account when considering the MA as a donor vessel for an EC-IC bypass.
authors.affiliation: Neurosurgery and Skull Base Simulation Laboratory, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA. jalvernia@yahoo.com.
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Alvernia
authors.affiliation: Neurosurgery and Skull Base Simulation Laboratory, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.|Department of Neurological Surgery, University of Mississippi Medical Center, Jackson, MS, USA.
authors.forename: Joaquin
authors.initials: J
authors.lastname: Hidalgo
authors.affiliation: CHU de Lyon-Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Lyon, France.
authors.forename: Marc P
authors.initials: MP
authors.lastname: Sindou
authors.affiliation: Department of Neurological Surgery, University of Mississippi Medical Center, Jackson, MS, USA.
authors.forename: Chad
authors.initials: C
authors.lastname: Washington
authors.affiliation: Department of Neurological Surgery, University of Mississippi Medical Center, Jackson, MS, USA.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Luzardo
authors.affiliation: Neurosurgery and Skull Base Simulation Laboratory, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.|Department of Neurological Surgery, University of Mississippi Medical Center, Jackson, MS, USA.
authors.forename: Eddie
authors.initials: E
authors.lastname: Perkins
authors.affiliation: Texas Center for Neuroscience, Houston, TX, USA.
authors.forename: Remi
authors.initials: R
authors.lastname: Nader
authors.affiliation: CHU de Lyon-Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Lyon, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Mertens
mesh_terms: D000328:Adult; D000792:Angiography; D005260:Female; D006801:Humans; D008297:Male; D008438:Maxillary Artery / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery*; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods*; D009666:Nose / Q000033:anatomy & histology / Q000601:surgery; D011626:Pterygoid Muscles / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery; D012886:Skull / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed
keywords: Angiography; Cerebral revascularization; Infratemporal fossa; Maxillary artery; Pterygoid muscles; Skull base