Maxillary nerve (V2): the middle division of the trigeminal
Quick facts
- Origin
- Second division of the trigeminal nerve (V2), leaves the skull through the foramen rotundum.
- Type
- Purely sensory.
- Territory
- Lower eyelid, cheekbone, side of the nose, upper lip, upper teeth and nasal mucosa.
- Cutaneous branches
- Infraorbital, zygomaticofacial and zygomaticotemporal.
The maxillary nerve, or V2, is the middle division of the trigeminal nerve. It is purely sensory and supplies the skin and mucous membranes of the middle third of the face: lower eyelid, cheekbone region, side of the nose, upper lip, upper teeth and gum, and nasal mucosa.
How does it reach the face?
V2 leaves the skull through the foramen rotundum, crosses the pterygopalatine fossa and enters the orbit through the inferior orbital fissure, running along the orbital floor. It emerges on the face as the infraorbital nerve, through the infraorbital canal of the maxilla. Before that, it gives off the zygomatic branch, which divides into the zygomaticofacial and the zygomaticotemporal.
| Cutaneous branch | Territory |
|---|---|
| Infraorbital | Lower eyelid, side of the nose, anterior cheek, upper lip |
| Zygomaticofacial | Skin of the malar prominence |
| Zygomaticotemporal | Anterior temple region |
Why does V2 matter in facial harmonization?
Most filler areas of the middle third lie within the V2 territory: cheekbone, zygomatic region, tear trough, nasolabial fold and upper lip. This has practical consequences:
- Anesthesia: the infraorbital block is a well-known technique for anesthetizing the upper lip and the paranasal region. Numbness in that area is expected.
- Sensory complaints: tingling in the upper lip, nostril wing or lower eyelid after a procedure should be told apart from ordinary swelling. Swelling and bruising can temporarily compress the nerve, and recovery is usually slow.
- Anatomical landmark: the infraorbital foramen is a palpation landmark familiar to the professional. Knowing where it is counts as review anatomy, not an injection formula.
What sets V1, V2 and V3 apart?
Also called: maxillary division of the trigeminal, V2, nervus maxillaris.
Frequently asked questions
Does the maxillary nerve control any muscle?
No. V2 is purely sensory. The muscles of facial expression are controlled by the facial nerve, and those of mastication by V3.