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 palate ...
, itself a branch of the
trigeminal nerve
In neuroanatomy, the trigeminal nerve (literal translation, lit. ''triplet'' nerve), also known as the fifth cranial nerve, cranial nerve V, or simply CN V, is a cranial nerve responsible for Sense, sensation in the face and motor functions ...
(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 a ...
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 artery ...
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 anatomic ...
. 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 palate ...
(CN V
2), itself a branch of the
trigeminal nerve
In neuroanatomy, the trigeminal nerve (literal translation, lit. ''triplet'' nerve), also known as the fifth cranial nerve, cranial nerve V, or simply CN V, is a cranial nerve responsible for Sense, sensation in the face and motor functions ...
(CN V).
It travels with the
infraorbital artery
The infraorbital artery is an artery in the head that branches off the maxillary artery, emerging through the infraorbital foramen, just under the orbit of the eye.
Course
The infraorbital artery appears, from its direction, to be the continu ...
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 oxygenate ...
. 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
The inferior orbital fissure is formed by the sphenoid bone and the maxilla. It is located posteriorly along the boundary of the floor and lateral wall of the orbit. It transmits a number of structures, including:
* the zygomatic branch of the ...
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 a ...
.
It runs anteriorly along the floor of the orbit in the
infraorbital groove
The infraorbital groove (or sulcus) is located in the middle of the posterior part of the orbital surface of the maxilla. Its function is to act as the passage of the infraorbital artery, the infraorbital vein, and the infraorbital nerve.
Stru ...
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 artery ...
of the maxilla. Within the infraorbital canal it has three branches, the
posterior superior alveolar nerve
The posterior superior alveolar branches (posterior superior dental branches) arise from the trunk of the maxillary nerve just before it enters the infraorbital groove; they are generally two in number, but sometimes arise by a single trunk.
The ...
,
middle superior alveolar nerve
The middle superior alveolar nerve is a nerve that drops from the infraorbital portion of the maxillary nerve to supply the sinus mucosa, the roots of the maxillary premolar
The premolars, also called premolar teeth, or bicuspids, are transition ...
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
Eyes are organs of the visual system. They provide living organisms with vision, the ability to receive and process visual detail, as well as enabling several photo respon ...
, nasal and
superior labial.
Branches
Within infraorbital canal from proximal to distal:
*
posterior superior alveolar nerve
The posterior superior alveolar branches (posterior superior dental branches) arise from the trunk of the maxillary nerve just before it enters the infraorbital groove; they are generally two in number, but sometimes arise by a single trunk.
The ...
.
*
middle superior alveolar nerve
The middle superior alveolar nerve is a nerve that drops from the infraorbital portion of the maxillary nerve to supply the sinus mucosa, the roots of the maxillary premolar
The premolars, also called premolar teeth, or bicuspids, are transition ...
.
*
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
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 eyel ...
,
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 pass ...
,
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 col ...
, 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 an ...
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 professionals ...
. 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 continues ...
,
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 anatomic ...
, which can be
palpated.
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, ma ...
.
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