The maxillary nerve, or CN V2, begins at the trigeminal ganglion, leaves the skull through the foramen rotundum, passes through the pterygopalatine fossa, and continues as the infraorbital nerve.
On this page
The trigeminal nerve is the main sensory nerve of the face. It has three divisions: the ophthalmic division, the maxillary division, and the mandibular division. The ophthalmic and maxillary divisions are sensory; the mandibular division also carries motor fibres for muscles used in chewing.
Anatomy and course
The maxillary nerve begins at the trigeminal ganglion in the middle cranial fossa. It travels forward in the lateral wall of the cavernous sinus and leaves the cranial cavity through the foramen rotundum. It then enters the pterygopalatine fossa, where it gives off branches and continues toward the orbit as the infraorbital nerve.
After passing through the inferior orbital fissure, the infraorbital nerve runs along the floor of the orbit. It enters the infraorbital canal and emerges on the face through the infraorbital foramen, where it divides into cutaneous branches.
Main branches
Branches of CN V2 distribute sensory information from the midface and nearby mucous membranes. Their exact arrangement varies, but the principal routes include the following.
Infraorbital nerve
The infraorbital nerve is the terminal continuation of the maxillary nerve. It gives superior alveolar branches to the upper teeth and maxillary sinus, then ends in branches supplying the lower eyelid, side of the nose, cheek, and upper lip.
Zygomatic nerve
The zygomatic nerve enters the orbit and divides into zygomaticofacial and zygomaticotemporal branches. These carry sensation from parts of the cheek and temple. A communicating branch also contributes parasympathetic fibres toward the lacrimal gland.
Palatine and nasal branches
Branches associated with the pterygopalatine ganglion supply sensory fibres to areas including the nasal cavity, palate, and upper throat. The posterior superior alveolar nerve supplies parts of the upper jaw and maxillary sinus. The greater and lesser palatine nerves carry sensation from the palate.
Read more about cranial nerves
Sensory pathway
First-order sensory neurons have cell bodies in the trigeminal ganglion. Touch and pressure information is relayed mainly through the principal sensory nucleus in the pons, while pain and temperature information is processed through the spinal trigeminal nucleus, which extends into the medulla and upper cervical cord.
Functions and the sneeze reflex
The maxillary nerve carries general somatic sensation, including light touch, pressure, pain, temperature, and vibration, from the cheek, upper lip, upper teeth, nasal mucosa, palate, and maxillary sinus.
Sensory fibres from the nasal mucosa can also form the afferent limb of the sneeze reflex. Irritation is conveyed to brainstem centres, which coordinate activity in the palate, throat, chest, and diaphragm to expel air through the nose and mouth.
Clinical relevance
Changes in sensation
Injury or compression affecting the maxillary division may alter sensation in its distribution. A clinician may compare light touch and pin-prick sensation across appropriate facial areas, while also considering other causes and the function of neighbouring cranial nerves.
Trigeminal neuralgia
Trigeminal neuralgia is a condition involving brief, recurrent episodes of intense facial pain. The maxillary and mandibular divisions are commonly involved. Episodes may be triggered by activities such as speaking, chewing, brushing the teeth, or lightly touching the face. Assessment and treatment should be guided by a qualified healthcare professional.
Nerve blocks
A targeted nerve block can temporarily interrupt sensory signalling and may be used by trained clinicians for selected diagnostic or pain-management purposes. It does not by itself address an underlying cause.
Summary
The maxillary nerve is the sensory second division of the trigeminal nerve. It leaves the skull through the foramen rotundum, crosses the pterygopalatine fossa, and continues as the infraorbital nerve. Its branches provide sensation from the midface, upper teeth, nasal cavity, palate, and maxillary sinus, and contribute to the sensory pathway of the sneeze reflex.