Lesser palatine nerves

The lesser palatine nerves are branches of the maxillary nerve (V2), specifically derived from the pterygopalatine ganglion, which itself is associated with the maxillary division of the trigeminal nerve (cranial nerve V). These nerves provide sensory and parasympathetic innervation to the soft palate, tonsils, and uvula.

Location

The lesser palatine nerves originate in the pterygopalatine ganglion in the pterygopalatine fossa. They descend through the lesser palatine canal, which is located in the palatine bone, alongside the greater palatine nerve. The nerves exit the canal via the lesser palatine foramina, which are located near the posterior portion of the hard palate, before extending to the soft palate, uvula, and tonsils.

Structure and Anatomy

Origin

The lesser palatine nerves are branches of the maxillary nerve (V2) via the pterygopalatine ganglion. The pterygopalatine ganglion is located in the pterygopalatine fossa, a small space between the pterygoid process of the sphenoid bone and the maxilla. These nerves carry both sensory and parasympathetic fibers, with the sensory fibers originating from the maxillary division of the trigeminal nerve (V2).

Course through the Pterygopalatine Fossa

After originating in the pterygopalatine ganglion, the lesser palatine nerves descend toward the oral cavity. They pass through the pterygopalatine fossa, a region containing several neurovascular structures. The pterygopalatine fossa communicates with multiple foramina and canals that provide passage for important nerves and vessels, including the lesser palatine nerves.

Path through the Palatine Canal

The lesser palatine nerves travel downward through the lesser palatine canal, which is a small bony canal located in the posterior part of the palatine bone. The lesser palatine canal runs parallel to the greater palatine canal, and both canals descend from the pterygopalatine fossa toward the hard and soft palate. The greater palatine nerve travels through the larger greater palatine canal, while the lesser palatine nerves follow a smaller adjacent canal.

Exit through the Lesser Palatine Foramina

The lesser palatine nerves exit the palatine canal through the lesser palatine foramina, which are openings located posterior to the greater palatine foramen. These foramina are situated near the junction between the hard and soft palate, allowing the nerves to emerge onto the posterior aspect of the oral cavity. There are usually two or three lesser palatine foramina, which provide passage for multiple branches of the lesser palatine nerves.

Branching and Distribution

After exiting the lesser palatine foramina, the lesser palatine nerves divide into smaller branches that spread across the soft palate and surrounding structures. The main areas of distribution for the lesser palatine nerves include:

• Soft Palate: The nerves provide innervation to the mucosa of the soft palate, particularly the posterior region. The soft palate is involved in swallowing and speech production.
• Uvula: The lesser palatine nerves innervate the mucosal lining of the uvula, a small fleshy projection at the back of the soft palate.
• Tonsils: These nerves also provide sensory input to the palatine tonsils, located between the anterior and posterior pillars of the throat.
• Palatine Glands: The parasympathetic fibers in the lesser palatine nerves supply the mucous glands of the soft palate, contributing to glandular secretion.

Relationship with Greater Palatine Nerve

The lesser palatine nerves are closely related to the greater palatine nerve, which travels through the greater palatine canal and supplies the hard palate. While the greater palatine nerve supplies the anterior palate and hard palate mucosa, the lesser palatine nerves are responsible for innervating the posterior soft palate and associated structures.

Communication with Other Nerves

The lesser palatine nerves have connections with other nerves in the pterygopalatine fossa, including:

• Facial Nerve (Cranial Nerve VII): Parasympathetic fibers from the facial nerve, via the greater petrosal nerve, travel through the pterygopalatine ganglion and join the lesser palatine nerves to supply the mucosal glands of the soft palate.
• Glossopharyngeal Nerve (Cranial Nerve IX): Some sensory fibers from the glossopharyngeal nerve may contribute to the sensory innervation of the soft palate and tonsils.

Function

The lesser palatine nerves have important sensory and parasympathetic functions, primarily related to the posterior part of the oral cavity, including the soft palate, uvula, tonsils, and palatine glands. Below is a detailed breakdown of these functions.

Sensory Innervation of the Soft Palate

The lesser palatine nerves provide sensory innervation to the mucosa of the soft palate, which is critical for detecting touch, temperature, pain, and pressure. These sensory inputs are essential for several processes:

• Swallowing: The soft palate rises to close off the nasopharynx during swallowing, preventing food or liquid from entering the nasal cavity. Sensory input from the lesser palatine nerves helps coordinate this movement and detect any irritation or foreign bodies.
• Speech Production: The sensation provided by the lesser palatine nerves is important for speech articulation, especially in the modulation of air passing through the oral cavity, contributing to sounds like “k” and “g.”

Sensory Innervation of the Uvula

The uvula, a small projection hanging from the soft palate, is also innervated by the lesser palatine nerves. This innervation is important for:

• Gag Reflex: Sensory input from the uvula, provided by the lesser palatine nerves, is involved in triggering the gag reflex. This reflex helps protect the airway by preventing large objects or food from entering the throat.
• Speech and Swallowing: The sensation of the uvula aids in proper function during speech and swallowing, contributing to the soft palate’s elevation and closure during these activities.

Sensory Innervation of the Tonsils

The lesser palatine nerves provide sensory fibers to the palatine tonsils, located between the anterior and posterior tonsillar pillars. This function includes:

• Pain Sensation: The nerves transmit pain sensations from the tonsils, which can become inflamed or infected in conditions such as tonsillitis.
• Monitoring Foreign Bodies: Sensory input from the tonsils helps detect foreign particles or food that might get lodged in the throat, triggering a protective response like coughing or swallowing.

Parasympathetic Innervation of the Palatine Glands

The lesser palatine nerves carry parasympathetic fibers that innervate the palatine glands, which are mucous glands located in the soft palate. These parasympathetic fibers originate from the facial nerve (cranial nerve VII) via the greater petrosal nerve and travel through the pterygopalatine ganglion to join the lesser palatine nerves. The parasympathetic functions include:

• Secretion of Mucus: The parasympathetic fibers stimulate the palatine glands to secrete mucus, which lubricates the soft palate and keeps it moist. This is important for maintaining the health of the mucosal surface and aiding in swallowing.
• Response to Salivary Reflexes: During eating or drinking, parasympathetic activation increases mucus production, which helps with the passage of food and drink through the oral cavity.

Supporting Reflex Actions

The sensory input from the lesser palatine nerves is also involved in certain reflexes, including:

• Swallowing Reflex: Sensory fibers from the soft palate and uvula play a key role in triggering the swallowing reflex. When food or liquid touches the back of the soft palate, it sends signals to the brainstem to initiate a coordinated swallowing response.
• Gag Reflex: The sensory innervation of the soft palate, particularly the uvula and tonsils, is crucial in triggering the gag reflex. This reflex protects the airway by initiating a defensive contraction of the throat muscles when the posterior oral cavity is stimulated by a foreign object or irritation.

Clinical Significance

The lesser palatine nerves are clinically significant due to their role in innervating the soft palate, uvula, tonsils, and palatine glands. Damage or irritation to these nerves can lead to sensory disturbances such as numbness, loss of sensation, or pain in the soft palate and uvula. This may occur due to trauma, surgical procedures like tonsillectomies or palatal surgeries, or infections like tonsillitis.

In some cases, damage to the parasympathetic fibers in these nerves can result in reduced mucus production from the palatine glands, causing dryness of the soft palate and discomfort, particularly during swallowing or speaking. These nerves are also involved in reflex actions such as the gag reflex and swallowing reflex, making them critical in maintaining normal oropharyngeal functions.