En Bloc Removal of the Mandible, the Masticatory

En Bloc Removal of the Mandible, the Masticatory

The Open Anatomy Journal, 2011, 3, 21-33 21 Open Access En Bloc Removal of the Mandible, the Masticatory Muscles and the Mandibular Nerve in the Chimpanzee (Pan troglodytes, Blumenbach 1799), with a Review and Critique of the Methods Used to Expose the Trigeminal Musculature in Derived Primates M. Ashraf Aziz1, Kerrie Lashley1, Cecile E. Skinner2 and Rui Diogo*,3 1Department of Anatomy, Howard University, College of Medicine, 520 W Street, N.W., Washington, DC 20059, USA 2Department of Fixed Prosthodontics and Restorative Dentistry, Howard University, College of Dentistry, 620 W Street, N.W., Washington, DC 20059, USA 3Center for the Advanced Study of Hominid Paleobiology, Department of Anthropology, George Washington University, 2110 G Street, N.W., Washington, DC 20052, USA Abstract: The detailed protocol of the en bloc removal of the mandible, the muscles supplied by the mandibular nerve tree and the maxillary artery is described in the chimpanzee (Pan troglodytes). This new method allows integrated observations of the masticatory muscles, their ontogenetic associates and the specific branches of the mandibular nerve that supply them. The topographic relationships of the muscles, including their subparts, are seen in light of the specific nerve branches that supply and interconnect them. Previous methods that examine parts of the trigeminal musculature and the mandibular nerve in a fragmented manner are described and critiqued. The present method allows us to arrive at a sounder classification of the trigeminal muscles based on the integrated observation of their nerve supply; this approach was first proposed by Toldt and more recently used by Tomo. The anatomical, functional, clinical, ontogenetic and phylogenetic aspects of the new approach are discussed. Keywords: Trigeminal musculature, mandibular arch derivatives, mandibular nerve, en bloc dissection method, ontogeny, phylogeny. INTRODUCTION suggesting depth) diagram summarizing a number of superficial yet salient aspects of “the pterygoid…and Since the beginning of morphological investigations on palatine..regions” of the Hominodea. It is not clear if the the head myology of the chimpanzee, its muscles of facial schematic diagram actually refers to the structures as seen in expression have received the greatest scrutiny [1-10]. More a dissected chimpanzee or represent a composite of those recently, Burrows et al. [11] developed the novel “face structures as seen in humans and/or other hominoids. mask” dissection method to elucidate hitherto unrecognized morphological complexity of the facial muscles in the Yoshikawa and Suzuki [12] and Gaspard et al. [13] have chimpanzee. The “face mask” dissection has elucidated the reported on the detailed lamination and organization of the functional morphology of the facial muscles, leading to masseter in the chimpanzee. Göllner [14] and Swindler and fresher insights regarding this important group of cranial Wood [15] have provided a somewhat detailed and muscles of communication. comprehensive description of the masticatory muscles that are innervated by the trigeminal nerve (Cranial Nerve V) in Curiously, another equally prominent group of head adult and neonatal chimpanzees. However, these muscles - those that control the actions of the investigations do not include other, “non-masticatory” head temporomandibular joint and their myological relations - muscles that are also supplied by the mandibular branch of have yet to be subjected to equally detailed, comprehensive the trigeminal nerve. Despite Göllner’s [14] efforts to study. Sonntag [4] provides an early summary of what was provide a detailed description of the masticatory muscles and then known of these muscles. He wrote a sketchy description the branches of the mandibular nerve (the only branch of the of the masseter and the temporalis; with reference to the trigeminal nerve that actually supplies these muscles), he did pterygoid muscles he writes that “they are disposed as in not map them in the way that Schwartz and Huelke [16], man, and their relations to the vessels and nerves in the Tomo [17], Tomo et al. [18, 19] and Aziz et al. [20] have pterygoid space are similar”. His book includes a flat, two- done in the rhesus monkey, the dog, and in humans, dimensional (i.e., devoid of any artistic techniques respectively. Traditionally, the masticatory muscles have been *Address correspondence to this author at the Center for the Advanced described as distinct muscles enclosed in their fascial Study of Hominid Paleobiology, Department of Anthropology, George compartments. Furthermore, the descriptions include their Washington University, 2110 G Street, N.W., Washington, DC 20052, positional relationships to each other, and the precise USA; Tel: 2026510439; Fax: 2029946097; E-mails: [email protected], [email protected] attachments of their tendons. However, the painstaking 1877-6094/11 2011 Bentham Open 22 The Open Anatomy Journal, 2011, Volume 3 Aziz et al. comparative studies using such an approach have led to pterygoids, the tensor veli palatini and especially the tensor unsatisfactory results [21-27]. Of particular concern have tympani have posed challenges because they are enclosed in been those muscle bundles that have been found between the spaces bounded by bony plates which require a complicated masseter and the temporalis, on one hand, and between the series of osteotomies for full exposure [20, 50-60]. The temporalis and the lateral pterygoid, on the other [28-30]. piecemeal exposure of parts of the infratemporal fossa, the Furthermore, there is a lack of agreement regarding the pterygoid fossa and the auditory tube have prevented partitions of each specific masticatory muscle (e.g., the investigators from viewing these muscles as distinct parts masseter, medial pterygoid, etc.) [21-28]. that can be arranged – individually or collectively – into an ontogenetic (and phylogenetic) sequence [17-19, 48, 49]. Toldt [31] was among the first investigators to study the comparative morphology of the masticatory muscles based A major impediment to the detailed and comprehensive on their nerve supply. This approach has been further study of the “trigeminal musculature” is thus an issue of developed by other authors [32-43]. Lubosch [37] referred to methodology. Even when these muscles have been dissected the muscles supplied by the mandibular branch of the on a piecemeal basis, the methods – a few exceptions trigeminal nerve as “trigeminusmuskulatur”. His notwithstanding [55, 56] – of exposing the deep-seated investigations involved fish, amphibians and reptiles. Tomo “trigeminal muscles” and their neurovascular associates have extended Toldt’s classification of the masticatory muscles not been described with sufficient clarity. Therefore, based on their specific nerve supply from the mandibular subsequent studies have faced difficulty in reproducing the nerve to mammals, in particular the dog [17-19]. Göllner earlier work with precision. Then, too, the methods which [14] used this approach in his description of selected have been used so far only allow restricted parts of the craniomandibular muscles including the masticatory muscles masticatory or other neighboring spaces to be exposed; this of the chimpanzee and the gorilla. These investigations have prevents us from seeing these structures as integrated provided a strong justification for the nerve supply-based components derived from a common source. Another reason classification of the masticatory muscles (including isolated for the fragmentary description of the “trigeminal muscles or muscle bundles that accompany the commonly musculature” is the need to divide the head anatomy into named muscles of mastication) [44-47] and their subparts regions that are associated with the dissection-based study [29, 30, 48, 49]. The other advantage of such an approach to and instruction [61-63]. Thus, the masticatory muscles, the the classification of the masticatory muscles is that it muscles of the floor of the oral cavity, the muscles of the soft elucidates their ontogenetic and phylogenetic relationships palate and the otic muscles are dissected and studied as [17-19]. Clearly, this is the biologically rational method for isolated subregions. There is seldom an attempt to integrate classifying muscles because it is grounded in evolutionary the information and see them as a single developmental studies. neuromuscular field. However, all the above-mentioned studies relate to the The objective of our paper is to describe a method by masticatory muscles and their immediate functional which the entire mandible, the TMJ disc, the masticatory associates (i.e. the anterior digastric and the mylohyoid) muscles, their functional associates, the tensor veli palatini, only. They have not been extended to the entire myological the entire mandibular nerve tree, and the proximal parts of field of the mandibular nerve tree which, in mammals, in the maxillary artery can be removed en bloc and studied as addition to the muscles of mastication and their functional an interconnected set of functional components; within the associates, also includes a muscle of the soft palate (tensor “trigeminal muscles”, only the tensor tympani remains veli palatini) and an auditory muscle (tensor tympani) [10, inaccessible using this method (although there are ways by 35, 36, 42, 43, 50, 51]. The “trigeminal musculature” – or which it too can be extracted along with its relations: we mandibular musculature sensu Diogo et al. [10] - comprises

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