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The infraorbital nerve is a branch of the
maxillary nerve In neuroanatomy, the maxillary nerve (V) is one of the three branches or divisions of the trigeminal nerve, the fifth (CN V) cranial nerve. It comprises the principal functions of sensation from the maxilla, nasal cavity, sinuses, the pala ...
, itself a branch of the
trigeminal nerve In neuroanatomy, the trigeminal nerve ( lit. ''triplet'' nerve), also known as the fifth cranial nerve, cranial nerve V, or simply CN V, is a cranial nerve responsible for sensation in the face and motor functions such as biting and che ...
(CN V). It travels through the
orbit In celestial mechanics, an orbit is the curved trajectory of an object such as the trajectory of a planet around a star, or of a natural satellite around a planet, or of an artificial satellite around an object or position in space such as ...
and enters the
infraorbital canal The infraorbital canal is a canal found at the base of the orbit that opens on to the maxilla. It is continuous with the infraorbital groove and opens onto the maxilla at the infraorbital foramen. The infraorbital nerve and infraorbital arte ...
to exit onto the face through the
infraorbital foramen In human anatomy, the infraorbital foramen is one of two small holes in the skull's upper jawbone (maxillary bone), located below the eye socket and to the left and right of the nose. Both holes are used for blood vessels and nerves. In anatomica ...
. It provides sensory innervation to the skin and mucous membranes around the middle of the face.


Structure

The infraorbital nerve is a branch of the
maxillary nerve In neuroanatomy, the maxillary nerve (V) is one of the three branches or divisions of the trigeminal nerve, the fifth (CN V) cranial nerve. It comprises the principal functions of sensation from the maxilla, nasal cavity, sinuses, the pala ...
(CN V2), itself a branch of the
trigeminal nerve In neuroanatomy, the trigeminal nerve ( lit. ''triplet'' nerve), also known as the fifth cranial nerve, cranial nerve V, or simply CN V, is a cranial nerve responsible for sensation in the face and motor functions such as biting and che ...
(CN V). It travels with the infraorbital artery and
vein Veins are blood vessels in humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are the pulmonary and umbilical veins, both of which carry oxygenated ...
. It branches from the maxillary nerve in the
pterygopalatine fossa In human anatomy, the pterygopalatine fossa (sphenopalatine fossa) is a fossa in the skull. A human skull contains two pterygopalatine fossae—one on the left side, and another on the right side. Each fossa is a cone-shaped paired depression deep ...
and travels through the inferior orbital fissure to enter the
orbit In celestial mechanics, an orbit is the curved trajectory of an object such as the trajectory of a planet around a star, or of a natural satellite around a planet, or of an artificial satellite around an object or position in space such as ...
. It runs anteriorly along the floor of the orbit in the infraorbital groove to the
infraorbital canal The infraorbital canal is a canal found at the base of the orbit that opens on to the maxilla. It is continuous with the infraorbital groove and opens onto the maxilla at the infraorbital foramen. The infraorbital nerve and infraorbital arte ...
of the maxilla. Within the infraorbital canal it has three branches, the posterior superior alveolar nerve, middle superior alveolar nerve and
anterior superior alveolar nerve The anterior superior alveolar nerve (or anterior superior dental nerve), is a branch of the infraorbital nerve, itself a branch of the maxillary nerve (V2). It branches from the infraorbital nerve within the infraorbital canal before the infraorbi ...
. After traversing the canal it emerges onto the anterior surface of the maxilla through the infraorbital foramen. Here, it divides into its terminal branches;
palpebral An eyelid is a thin fold of skin that covers and protects an eye. The levator palpebrae superioris muscle retracts the eyelid, exposing the cornea to the outside, giving vision. This can be either voluntarily or involuntarily. The human eye ...
, nasal and
superior labial The superior labial artery (superior labial branch of facial artery) is larger and more egregious than the inferior labial artery. It follows a similar course along the edge of the upper lip, lying between the mucous membrane and the orbicularis ...
.


Branches

Within infraorbital canal from proximal to distal: * posterior superior alveolar nerve. * middle superior alveolar nerve. *
anterior superior alveolar nerve The anterior superior alveolar nerve (or anterior superior dental nerve), is a branch of the infraorbital nerve, itself a branch of the maxillary nerve (V2). It branches from the infraorbital nerve within the infraorbital canal before the infraorbi ...
. After it exits the infraorbital foramen: * palpebral branches. * nasal branches. * superior labial branches. The palpebral branches ascend deep to the orbicularis oculi and pierce the muscle to supply the skin of the lower eyelid. The nasal branches supply the skin of the side of the nose and the moveable part of the nasal septum. The superior labial branches descend deep to the levator labii superioris to supply the skin of the anterior cheek and upper lip.


Function

The infraorbital nerve provides sensation to the skin of the lower eyelid, the side of the
nose A nose is a protuberance in vertebrates that houses the nostrils, or nares, which receive and expel air for respiration alongside the mouth. Behind the nose are the olfactory mucosa and the sinuses. Behind the nasal cavity, air next passe ...
, the moveable part of
nasal septum The nasal septum () separates the left and right airways of the nasal cavity, dividing the two nostrils. It is depressed by the depressor septi nasi muscle. Structure The fleshy external end of the nasal septum is called the columella or co ...
, the anterior
cheek The cheeks ( la, buccae) constitute the area of the face below the eyes and between the nose and the left or right ear. "Buccal" means relating to the cheek. In humans, the region is innervated by the buccal nerve. The area between the insi ...
, and part of the
upper lip The lips are the visible body part at the mouth of many animals, including humans. Lips are soft, movable, and serve as the opening for food intake and in the articulation of sound and speech. Human lips are a tactile sensory organ, and can be ...
. It does not provide motor supply to any muscles.


Clinical significance


Infraorbital nerve block

The infraorbital nerve is often blocked with
local anesthetic A local anesthetic (LA) is a medication that causes absence of pain sensation. In the context of surgery, a local anesthetic creates an absence of pain in a specific location of the body without a loss of consciousness, as opposed to a general a ...
to induce
analgesia Pain management is an aspect of medicine and health care involving relief of pain (pain relief, analgesia, pain control) in various dimensions, from acute and simple to chronic and challenging. Most physicians and other health professional ...
. This may be due to
chronic pain Chronic pain is classified as pain that lasts longer than three to six months. In medicine, the distinction between acute and chronic pain is sometimes determined by the amount of time since onset. Two commonly used markers are pain that continue ...
, or during dental or surgical procedures of the face such as for the management of postoperative pain associated with cleft lip correction. Zdilla, M. J., Russell, M. L., & Koons, A. W. (2018). Infraorbital foramen location in the pediatric population: A guide for infraorbital nerve block. Paediatric Anaesthesia, 28(8), 697–702. https://doi.org/10.1111/pan.13422 The needle is inserted (aiming medially) near to the
infraorbital foramen In human anatomy, the infraorbital foramen is one of two small holes in the skull's upper jawbone (maxillary bone), located below the eye socket and to the left and right of the nose. Both holes are used for blood vessels and nerves. In anatomica ...
, which can be
palpated Palpation is the process of using one's hands to check the body, especially while perceiving/diagnosing a disease or illness. Usually performed by a health care practitioner, it is the process of feeling an object in or on the body to determine ...
. The nerve may be blocked using either a transcutaneous or intraoral approach.


Trigeminal neuralgia

The infraorbital nerve can be implicated in
trigeminal neuralgia Trigeminal neuralgia (TN or TGN), also called Fothergill disease, tic douloureux, or trifacial neuralgia is a long-term pain disorder that affects the trigeminal nerve, the nerve responsible for sensation in the face and motor functions such as ...
, where patients have severe
orofacial pain Orofacial pain is a general term covering any pain which is felt in the mouth, jaws and the face. Orofacial pain is a common symptom, and there are many causes. Orofacial Pain (OFP) is the specialty of dentistry that encompasses the diagnosis, ...
.


Orbital fracture

A fracture of the floor of the orbit can injure the infraorbital nerve resulting in anesthesia in its sensory distribution.


References

{{Authority control Maxillary nerve Nose