Cluster of nests of squamous epithelial cells found microscopically in tissue taken from approximate site used by dentist for injection of Inferior alveolar nerve: (A) Juxtra oral organ of Chievitz, (B) Max Joseph organ, (C) Both, (D) None
Answer is A. The juxtaoral organ is a small structure located within the soft tissue overlying the angle of the mandible in the buccotemporal space. It is composed of an epithelial parenchyma embedded in a highly organized connective tissue stroma rich in nerves and sensory receptors innervated by the buccal nerve. This metabolically active structure presumably serves as a mechanosensor in the lateral wall of the oral cavity. Needless surgical removal of this juxtaoral structure is therefore best avoided. In children, the normal organ may be discovered as a small mass in the cheeks, which may lead to extensive and unnecessary investigations. Hyperplasia of the parenchyma may occur, but carcinoma originating from this organ has not been reported.
Conclusion: Awareness of this normal anatomic structure is important, because the finding of epithelial islands intimately admixed with nerves could be misinterpreted as perineural invasion by carcinoma.