The auriculotemporal nerve supplies sensation to parts of the auricle, the external auditory meatus, the tympanic membrane, and the skin in the temporal area. It courses from the medial side of the posterior neck of the condyle and turns superiorly, running over the zygomatic root of the temporal bone (see Fig. 12-1). Just anterior to the auricle, the nerve divides into its terminal branches in the skin of the temporal area. Preauricular exposure of the TMJ area almost invariably injures this nerve. Damage is minimized by incision and dissection in close apposition to the cartilaginous portion of the external auditory meatus, realizing that this structure runs somewhat anteriorly as it courses from lateral to medial. Temporal extension of the skin incision should be located posteriorly so that the main distribution of the nerve is dissected and retracted forward within the flap. Fortunately, patients rarely complain about sensory disturbances that result from damage to this nerve.
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