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Skeletal system · Head and neck

Foramen ovale !

The foramen ovale is an oval opening in the skull base, in the sphenoid; it carries the mandibular nerve to the lower jaw and chewing muscles.

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What it is

An oval opening in the skull base.

What it does

Carries the mandibular nerve (V3).

Key facts

Where
Greater wing of the sphenoid
Function
Transmits the mandibular nerve (V3), lesser petrosal nerve, accessory meningeal artery and an emissary vein

Relations

Contents
Mandibular nerve (V3) with its motor root, the accessory meningeal artery, the lesser petrosal nerve (some texts: through a small hole of its own) and an emissary vein joining the cavernous sinus to the pterygoid plexus
Above
Trigeminal ganglion in Meckel's cave, above and behind; the temporal lobe on the floor of the middle cranial fossa
Below
Infratemporal fossa: V3 divides deep to the lateral pterygoid, with the otic ganglion on its medial side
Behind
Foramen spinosum, behind and lateral, with the middle meningeal artery
In front
Foramen rotundum, in front and medial, with V2
Medial
Foramen lacerum and the internal carotid artery turning up into the cavernous sinus

How to find it

It cannot be felt. From below, it lies just behind the root of the lateral pterygoid plate, the landmark used to guide a needle to it; inside the skull it sits in the floor of the middle cranial fossa below the trigeminal ganglion. A submental–vertex X-ray view or CT shows it during procedures that target it.

Examination

  • Jaw opening and clenching: the jaw swings toward the weak side on opening, and masseter and temporalis feel softer on that side when the teeth are clenched, pointing to the motor part of V3
  • Light touch and pinprick on the lower lip, chin, lower cheek and in front of the ear, compared side to side: less feeling there together with weak chewing places the lesion on the V3 trunk, near the foramen or closer to the brainstem

On imaging

Axial CT with bone windows shows the paired oval holes; widening on one side suggests a schwannoma or perineural spread. Contrast MRI shows a thickened, enhancing V3 and changes in the chewing muscles it supplies (swelling early, fatty wasting later).

Clinical notes

  • Nasopharyngeal carcinoma can invade the skull base here, causing numbness of the lower face and weakness of chewing
  • The emissary vein links the pterygoid plexus with the cavernous sinus, a path for infection from the infratemporal region
  • Electrodes placed through it can record from the medial temporal lobe when planning epilepsy surgery

Anatomical variants

  • Its size and shape differ between sides; it may be split by a bony spur or merge with the foramen spinosum
  • An ossified pterygospinous or pterygoalar ligament can bar the outer opening and make needle access difficult

Memory aid

Contents: «MALE» (Mandibular nerve, Accessory meningeal artery, Lesser petrosal nerve, Emissary vein).

Test yourself

Think of the answer, then tap the question to see it.

Which structures pass through the foramen ovale?

The mandibular nerve (V3), the accessory meningeal artery, the lesser petrosal nerve and an emissary vein.

Why is the foramen ovale targeted in trigeminal neuralgia procedures?

A needle from the cheek passes up through it to the trigeminal ganglion in Meckel's cave for rhizotomy or balloon compression.

Which clue suggests cancer spreading along V3 through the foramen ovale?

Wasting of the chewing muscles on one side, with numbness of the lower face (e.g. nasopharyngeal carcinoma).

What lies just in front of and just behind the foramen ovale in the skull base?

In front and medial, the foramen rotundum (V2); behind and lateral, the foramen spinosum (middle meningeal artery).

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Educational information, not medical advice. For any symptom, see a health professional.

Its names

Official Latin (TA2)
foramen ovale TA2 622
Official Spanish (DeCS)
Agujero oval
English (TA2)
Foramen ovale

Sources: Terminologia Anatomica (TA2); Anatomy, Head and Neck, Skull Foramen; Anatomy, Head and Neck, Mandibular Nerve.

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Representative model, for educational purposes only.