An undocumented variation involving auriculotemporal nerve, inferior alveolar nerve and middle meningeal artery

Auriculotemporal nerve typically has two roots, encircling the middle meningeal artery, one anterior to it and another posterior to it as well as maxillary artery. The middle meningeal artery is largest of the meningeal arteries, ascends between the sphenomandibular ligament and lateral pterygoid muscle and traverses between the roots of the auriculotemporal nerve before entering the cranial cavity through the foramen spinosum. The knowledge of the neurovascular relationships of the infratemporal region is significant in surgical practice. We present a case of unusual communication between the auriculotemporal nerve and inferior alveolar nerve together with an extraordinary change in relations with the middle meningeal artery. Some clinical implications that these relations may have on the development of the supplementary innervations and the surgical interventions in this region are discussed in this article.