Clinical importance of morphology and nomenclature of distal attachment of temporalis tendon

Abstract

Purpose: The objective of the present study was to examine and clinically relate the morphology of the anterior distal temporalis tendon attachment and describe its osseous nomenclature. The temporalis tendon muscle is arguably 1 of the 2 most important muscles of mastication.

Materials and methods: Contemporary anatomy texts and atlases regarding the anterior distal temporalis tendon attachment demonstrate a coronoid process attachment and/or an extension inferiorly along the anterior border of the ramus, and its representation is often unclear and inconsistent. The osseous nomenclature of the retromolar triangle or fossa where the anterior distal temporalis tendon attaches is even less clear in most texts and atlases. We conducted a literature review and dissected 30 embalmed human cadavers to examine the morphology of the anterior distal temporalis tendon, including an analysis of commonly used anatomic texts and atlases.

Results: Only 2 of 24 texts described or illustrated a retromolar triangle area (although not labeled) for anterior distal temporalis tendon insertion. Including the variations, we observed that the distal insertion continues downward onto the retromolar triangle, posterior to the mandibular third molar. The dissection results revealed that the anterior distal temporalis tendon consistently attached onto the medial and lateral borders of the retromolar triangle or fossa. Clinically, the anterior distal temporalis tendon is a landmark for manual temporomandibular junction reduction and identifying the long buccal nerve.

Conclusions: The results of the present study suggest the anterior distal temporalis tendon attachment could be further depicted and that the nomenclature of the retromolar triangle and fossa should be consistently included because of their clinical relevance.