[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) › Foramen ovale [Skeletal system](https://durgical.com/en/anatomy/system/skeletal-system/) · [Head and neck](https://durgical.com/en/anatomy/region/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. [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=head_neck&select=foramen_ovale&side=r) Opens in the Durgical app, no sign-up needed. ## What it is An oval opening in the skull base. ## What it does Carries the mandibular nerve (V3). ## Key points - The classic needle route to the trigeminal ganglion: from the cheek beside the corner of the mouth, up through the opening to Meckel's cave, for trigeminal neuralgia procedures (rhizotomy, balloon compression) - Perineural spread: nasopharyngeal, parotid and masticator space cancers can climb along V3 through it into the skull; wasting of the chewing muscles on one side is a clue - In the skull base, front to back: foramen rotundum, foramen ovale, then foramen spinosum just behind and lateral; the foramen lacerum lies medial - Not the foramen ovale of the heart, the fetal opening between the atria: this one is in the greater wing of the sphenoid ## 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](https://durgical.com/en/anatomy/cavernous-sinus/) to the pterygoid plexus **Above** [Trigeminal ganglion](https://durgical.com/en/anatomy/trigeminal-ganglion/) in Meckel's cave, above and behind; the [temporal lobe](https://durgical.com/en/anatomy/middle-temporal-gyrus/) on the floor of the middle cranial fossa **Below** Infratemporal fossa: V3 divides deep to the [lateral pterygoid](https://durgical.com/en/anatomy/superior-head-of-lateral-pterygoid-muscle/), with the otic ganglion on its medial side **Behind** [Foramen spinosum](https://durgical.com/en/anatomy/foramen-spinosum/), behind and lateral, with the [middle meningeal artery](https://durgical.com/en/anatomy/middle-meningeal-artery/) **In front** [Foramen rotundum](https://durgical.com/en/anatomy/foramen-rotundum/), in front and medial, with V2 **Medial** [Foramen lacerum](https://durgical.com/en/anatomy/foramen-lacerum/) and the [internal carotid artery](https://durgical.com/en/anatomy/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](https://durgical.com/en/anatomy/superficial-part-of-masseter/) and [temporalis](https://durgical.com/en/anatomy/temporalis-muscle/) 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). ## Related conditions - [Trigeminal neuralgia](https://durgical.com/en/conditions/trigeminal-neuralgia/) ## 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). [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/anatomy/foramen-ovale/) 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 ## Related - [V3 mandibular](https://durgical.com/en/anatomy/anterior-division-of-mandibular-nerve/) Sources: Terminologia Anatomica (TA2); [Anatomy, Head and Neck, Skull Foramen](https://www.ncbi.nlm.nih.gov/books/NBK546621/); [Anatomy, Head and Neck, Mandibular Nerve](https://www.ncbi.nlm.nih.gov/books/NBK507820/). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/foramen-ovale/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/foramen-ovale/