84��1.74 mm, 2.94��0.52 mm, respectively. The course pattern of the MA at the AP24534 subcondylar level was found to be as follows: 41% of the MAs passed supracervically (n=14), 29.5% passed midcervically (n=10), and the remaining 29.5% arteries passed infracervically (n=10). The distances measured between the tip of the lingula and the determined points are summarized in Table 1. No significant difference was computed between the mandibular rami and the glenoid fossa (P>.05). Table 1. The mean distances between the lingula and the specific landmarks for mandibular osteotomy. DISCUSSION In our study, we investigated the trajectory of the MA at the infratemporal fossa and the distances between the MA and the bony references on the glenoid fossa and the medial side of the mandibular ramus.

To facilitate orientation during ramus osteotomies, the studied parameters were selected as the key bony landmarks of the ramus since these landmarks are used as intraoperative guiding points for bony osteotomies and are dissected to some extent intraoperatively. The possible risk of injuring the MA is greater in resection of TMJ ankylosis among arthroplastic procedures; since the pattern of ossification and the fibrosis of pericapsular tissues differ greatly in every patient, it is more difficult to predict the course of MA due to anatomical variations and access restrictions.12,13 Few cadaver studies have focused on the possible risk of injuring the MA during mandibular ramus osteotomies.9,14 The position of the lingula is of critical importance for SSRO, whereas the relevant importance is attributed to the antilingula on the lateral aspect of the ramus for IVRO.

15 In IVRO, extreme care is required to prevent damage to the maxillary artery when performing bicortical osteotomy from the mandibular notch inferiorly, since the maxillary artery passes upward across the lower head of the lateral pterygoid muscle inside the mandibular notch.5,9 Therefore, the medial aspect of the mandibular notch should be exposed carefully in the IVRO, and then a Levasseur-Merill or a Bauer retractor should be inserted to protect the MA from any damage.9 The reference line for performing the vertical bony cut passes behind the antilingula, which is found approximately with 54% predominance. The distance from the mandibular notch to the maxillary artery was reported to be 3.3��1.

6 mm (n=8; range, 2 to 6 mm).15 These findings were consistent with ours: 2.94��0.52 mm. We found the ratio of the posterior margin of the ramus to the total ramus width (the sum of the distances between the lingula and the posterior margin of the ramus and anterior margin of the ramus) to be 0.52. Da Fontoura et al14 found a similar value for the ratio of the mandibular Carfilzomib foramen-posterior ramus to the total ramus width: 0.32. The slight difference could be explained by the location of the tip of the lingula, which lies in front of the mandibular foramen.