What provides the sensory supply of the face?

Sensory Supply of the Face

The sensory supply of the face is primarily provided by the three divisions of the trigeminal nerve (CN V): the ophthalmic (V1), maxillary (V2), and mandibular (V3) divisions, which innervate the upper face, midface, and lower face, respectively. 1

Trigeminal Nerve Divisions and Their Distribution

Ophthalmic Division (V1)

• Supplies sensation to:
  • Forehead and anterior scalp
  • Upper eyelid
  • Cornea and conjunctiva
  • Lacrimal gland
  • Nasal cavity (portions)
  • Frontal and sphenoidal sinuses
  • Dura mater, tentorium cerebelli, and posterior falx cerebri 2, 3

Maxillary Division (V2)

• Supplies sensation to:
  • Midface region
  • Cheeks
  • Upper lip
  • Lateral nose
  • Lower eyelid
  • Mucosa of the nasal cavity
  • Upper teeth and gums 1, 4

Mandibular Division (V3)

• Supplies sensation to:
  • Lower face
  • Lower jaw
  • Temple region
  • Part of the external ear
  • Tongue (general sensation)
  • Oral mucosa
  • Lower teeth and gums 1, 4
• Also contains motor fibers that innervate the muscles of mastication 2

Additional Facial Sensory Innervation

• The facial nerve (CN VII) contributes to facial sensation through:

  • Special sensory fibers for taste to the anterior two-thirds of the tongue
  • General sensory fibers to a small portion of the external ear and tympanic membrane 2

• The lower and lateral portions of the face receive additional sensory innervation from cutaneous branches of the cervical plexus 5

Clinical Significance

• Trigeminal neuralgia can cause severe facial pain along the distribution of one or more divisions of the trigeminal nerve, most commonly affecting the maxillary and mandibular divisions 2, 1

• MRI is the preferred imaging modality for evaluating the trigeminal nerve and its branches, while CT is valuable for assessing bony anatomy, skull base, and neural foramina 2, 1

• High-resolution imaging techniques are essential for visualizing the nerve branches adequately, especially in cases of trigeminal neuralgia, skull base tumors, trauma, and vascular compression 1

• Facial nerve disorders like Bell's palsy primarily affect motor function (facial expression) but can also impact special sensory function (taste) and parasympathetic functions to glands of the head 2

Anatomical Relationships

• The trigeminal nerve is the largest cranial nerve and exits the brain on the lateral surface of the pons 4, 6

• The facial nerve has the longest extracranial course of any cranial nerve and works in close functional relationship with the trigeminal nerve 7, 6

• Understanding the detailed neuroanatomy of these nerves is crucial for proper diagnosis and management of facial sensory disorders 6

By recognizing the specific distribution patterns of the trigeminal nerve divisions, clinicians can better localize lesions affecting facial sensation and develop appropriate diagnostic and treatment strategies.