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Maxillary nerve

The maxillary nerve, also known as the V2 nerve, is the second branch of the trigeminal nerve (cranial nerve V). It plays a key role in transmitting sensory information from the midface, maxillary teeth, nasal cavity, and palate. As a purely sensory nerve, its clinical importance extends to dental, maxillofacial, and neurological conditions, and it is frequently evaluated in imaging studies.

Synonyms

  • Maxillary division of trigeminal nerve

  • V2 nerve

  • Second division of cranial nerve V

  • Trigeminal nerve, maxillary branch

Function

  • Purely sensory nerve (no motor fibers)

  • Supplies sensation to:

    • Skin of the midface (cheeks, lower eyelids, upper lip)

    • Maxillary sinus

    • Lateral nose

    • Nasal cavity mucosa

    • Upper teeth and gums (maxillary dentition)

    • Palate (hard and soft)

    • Part of the pharynx

MRI Appearance

  • T1-weighted images:

    • The maxillary nerve is seen as a thin, linear structure.

    • Appears isointense to muscle (intermediate signal).

    • Courses through the foramen rotundum and pterygopalatine fossa.

    • Surrounding fat in the pterygopalatine fossa appears hyperintense, helping to delineate the nerve.

  • T2-weighted images:

    • The nerve shows low-to-intermediate signal intensity.

    • Better contrast with surrounding hyperintense fat, particularly in the pterygopalatine fossa.

  • STIR (Short Tau Inversion Recovery):

    • STIR images suppress fat signal.

    • The maxillary nerve may appear as a linear structure with intermediate signal intensity within a dark (suppressed fat) background.

    • Useful for detecting nerve pathology (edema, inflammation) as affected nerves may show increased signal.

CT Appearance

  • Not directly visible on standard CT as a distinct structure due to small size and lack of contrast with surrounding soft tissues.

  • The maxillary nerve pathway can be inferred by identifying:

    • Foramen rotundum (entry point in the sphenoid bone)

    • Pterygopalatine fossa (contains the nerve and its branches)

    • Infraorbital canal (as the nerve courses toward the face)

  • CT is useful to assess bony canals, foramina, and any compressive or infiltrative lesions affecting the nerve's pathway.

MRI images

Maxillary nerve mri image

MRI image

Maxillary nerve