Endoscopic resection of tumors involving the maxillary. Instant anatomy is a specialised web site for you to learn all about human anatomy of the body with diagrams, podcasts and revision questions. Mr and ct anatomy and the pathology of skull base focusing on. The second patient presented after a sudden onset of complete unilateral vision loss with a complete ipsilateral sphenoid sinus opacification and. The newest version of atlas of human anatomy provides the belowmentioned thrilling new options. Tumors which occur in the infratemporal fossa present symptoms that are distinctly different from those which arise in the pterygopalatine fossa or the sinus of morgagni.
The uncinate process was removed successively, and the anterior ethmoid sinus and posterior ethmoid sinus were opened. Temporal, infratemporal, pterygopalatine fossa anatomy ant 1003 with liuzzi at lake erie college of osteopathic medicine studyblue. We aimed to evaluate on 3d volume renderizations the anatomical variables of the pterygopalatine fossa, as related to the variable pneumatization patterns of the bones surrounding the. Pdf endoscopic anatomy of the pterygopalatine fossa. In this report, we present seven cases of tumors arising from the pterygopalatine fossa region and associated structures, and we discussed the surgical approaches to the pterygopalatine fossa region. The anatomy of the pterygopalatine fossa pertinent to the technique of maxillary nerve block at the foramen rotundum was investigated and the ability of inexperienced surgeons to apply the. Squamous cell carcinoma of the pterygopalatine fossa retroantral space. The pterygopalatine fossa is a bilateral, coneshaped depression extending deep from the infratemporal fossa all the way to the nasal cavity via the sphenopalatine foramen it is located between the maxilla, sphenoid and palatine bones, and communicates with other regions of the skull and facial skeleton via several canals and foramina. Maxillary bone forms its anterior wall the lateral surface of the palatine bone forms the medial wall the sphenoid bone particularly the pterygoid plate forms the. The ppf contains fat, the pterygopalatine ganglion ppg, the maxillary division v2 of the trigeminal nerve and its branches zygomatic nerve. The sphenopalatine ganglion lies in the pterygopalatine fossa, which in the in the rat is only a shallow groove towards the lower, posterior end of the orbitotemporal fossa see chapter 5.
Anatomy of pterygopalatine fossa, infra temporal space. Radiology of the pterygoid plates and pterygopalatine fossa. Extra emphasis on serving to college students perceive medical correlates concerning every anatomical construction. The flow of blood to the nasal mucosa, in particular the venous plexus of the. Study 77 temporal, infratemporal, pterygopalatine fossa flashcards from adrian k. Evolution of transmaxillary approach to tumors in pterygopalatine. Endoscopic transnasal approach to the pterygopalatine fossa. Eight cases of adult skull specimens were selected for the simulated surgery. The maxillary artery, lateral pterygoid muscle, pterygoid venous plexus, foramen rotundum and foramen ovale were identified. Mr and ct anatomy and the pathology of skull base focusing. The pterygopalatine fossa ppf is a coneshaped depression deep to the infratemporal fossa and posterior to the maxilla on both sides of the.
The pterygopalatine fossa ppf is a small, clinically inaccessible, fatfilled space located in the deep face that serves as a major neurovascular crossroad between the oral cavity, nasal cavity, nasopharynx, orbit, masticator space, and the middle cranial fossa. The pterygopalatine fossa is a small, wedgeshaped space posteromedial to the maxilla, anterior to the pterygoid process of the sphenoid bone, and inferior to the apex of the orbit. In order to analyze each pterygopalatine fossa and canal separately, the lateral skull roentgenogram should be obtained with the head rotated 10 away from the true lateral. The pterygopalatine fossa is an inverted pyramidalshaped, fatfilled space located on the lateral side of the skull, between the infratemporal fossa and the nasopharynx. Before the dissection, all the specimens were injected with red and. A human skull contains two pterygopalatine fossaeone on the left. Watch the complete lecture in the members area at the pterygopalatine. The ppf contains the ppg and a busy traffic of arteries, veins, lymphatics and nerves. These branches supply much of the nasal cavity, the roof of the oral cavity, and all upper teeth. Atlas of human anatomy pdf free download 2020 medical study. Although it is closely related to the pterygopalatine ganglion, it is still considered a branch of the maxillary nerve and does not synapse in the ganglion.
A wingedshaped feature consisting of laminae called the medial pterygoid plate and the lateral pterygoid plate, the pterygoid process forms the fossas posterior border with its front surface. The pterygopalatine nerves or sphenopalatine branches, two in number, descend to the pterygopalatine ganglion although it is closely related to the pterygopalatine ganglion, it is still considered a branch of the maxillary nerve and does not synapse in the ganglion it is found in the pterygopalatine fossa additional images. May 11, 2020 the pterygopalatine fossa is an inverted pyramidalshaped, fatfilled space located on the lateral side of the skull, between the infratemporal fossa and the nasopharynx. Objective to describe an endoscopic transnasal approach to the pterygopalatine fossa ppf.
Location of the descending palatine artery in relation to the le fort i. Pterygopalatine ganglion radiology reference article. The anatomy of the pterygopalatine fossa keeps a traditional level and is viewed as constant, even though a series of structures neighboring the fossa are known to present individual variations. The pterygopalatine fossa ppf, less commonly known as the sphenopalatine fossa, is a small but complex space of the deep face in the shape of an inverted pyramid located between the maxillary bone anteriorly, the pterygoid process posteriorly, and orbital apex superior. The pterygopalatine fossa is an irregular space where neurovascular structures course through to the nasal cavity, palate, pharynx, orbit and face figure 221a and b. Located in the pterygopalatine fossa, posterior to the middle turbinate, the sphenopalatine i. The full text of this article is available in pdf format. In the pterygopalatine fossa the pterygopalatine ganglion is suspended from the maxillary nerve by 2 roots. Anatomy, pterygopalatine fossa statpearls ncbi bookshelf. May 26, 2016 the pterygopalatine fossa ppf is a small, clinically inaccessible, fatfilled space located in the deep face that serves as a major neurovascular crossroad between the oral cavity, nasal cavity, nasopharynx, orbit, masticator space, and the middle cranial fossa. J pterygopalatine fossa questions and study guide quizlet. Robert lewis maynard, noel downes, in anatomy and histology of the laboratory rat in toxicology and biomedical research, 2019. The pterygopalatine ganglion is one of four parasympathetic ganglia of the head and neck and largest of the peripheral parasympathetic ganglia. Through eight bony canals or foramina, this fossa communicates with the nasal and oral cavities, infratemporal fossa, orbit, pharynx, and middle cranial fossa.
In the pterygopalatine fossa anterior to the pterygopalatine ganglion gives origin to branches that accompany branches of the maxillary nerve v2 and the pterygopalatine ganglion. Respiratory system anatomy lecture 4 2 anatomical structure and boundaries the pterygopalatine fossa is an inverted tear drop shaped space. Although the pterygopalatine fossa is a small compartment hidden between the maxillae and the sphenopalatine bone, it has multiple communications with surrounding structures, such as the oral cavity, the nasal cavity, the infratemporal fossa, the. Jaradeh the pterygopalatine fossa ppf represents a major pathway of spread of malignancy and infection from the head and neck into the skull base. Ppf contains fat, the pterygopalatine ganglion ppg, the maxillary division v2 of the trigeminal nerve and its branches zygomatic nerve. Associated with cranial nerve vii contains the cell bodies of postganglionic parasympathetic neurons, whose axons are secretomotor to the lacrimal gland, nasal glands, and glands of the hard and soft palates branches of v2 pass through or around the ganglion. Its small volume combined with the numerous structures that pass through makes this a complex region for anatomy students. Out of the 7 patients, one had a primary synovial sarcoma occurring in the masticator space, and the others had secondary tumors. Relationship between pterygopalatine fossa volume and.
Temporal, infratemporal, pterygopalatine fossa anatomy ant. The maxilary nerve can be block in the pterygopalatine fossa, entering. Pdf squamous cell carcinoma of the pterygopalatine fossa. Ten anatomical dimensions were measured on each side of the face for each specimen vidian foramen, zygomatic buttress, zygomatic maxillary suture, pyriform rim. Each fossa is a coneshaped paired depression deep to the infratemporal fossa and posterior to the maxilla on each side of the skull, located between the pterygoid process and the maxillary tuberosity. As endoscopic sinus surgery ess has progressed over the last 10 years, new techniques have been introduced to aid with the resection of tumors in regions which traditionally have been difficult to access. Anatomy pterygopalatine fossa questions and study guide. It is largely innervated by the greater petrosal nerve a branch of the facial nerve. Imaging anatomy, communications and pathology rsna. Mar 24, 2018 pterygopalatine fossa neuroanatomy this is a teaser video. Thieme atlas of anatomy, general anatomy and musculoskeletal. Anatomy of pterygopalatine fossa, infra temporal space 1. Primary tumors of the infratemporal and pterygopalatine fossae. This study defines the standards and variations of the bony landmarks surrounding the pterygopalatine fossa.
Given its inherent complex location and connections, the. Pterygopalatine fossa definition of pterygopalatine fossa. Its surgical anatomy is discussed, with particular emphasis on the relationship between the medical plate of the pterygoid process of the sphenoid bone and the vertical plate of. Largest of the 4 parasympathetic ganglia in the head, contains the largest aggregation of neurons in the head outside the brain. Jan 27, 2020 download netters atlas of human anatomy 7th edition pdf free 2020. Original article morphological study of the pterygoid canal with highresolution ct junrong chen1,2, jiahe xiao2 1department of radiology, sichuan orthopedic hospital, sichuan, china. Pterygopalatine fossa neuroanatomy this is a teaser video. The ganglion, a triangular structure 5 mm in diameter, is covered by a layer of connective tissue and. Situated between the maxilla, sphenoid, and palatine bones.
It resides in the pterygopalatine fossa, which is located in the superior pterygomaxillary fissure, in the anterosuperior part of the infratemporal fossa medial to the zygomatic arch and the coronoid process of the mandible although it is described as being a parasympathetic. The messerklinger surgical approach was used under the endoscope. Tumors in the pterygopalatine fossa ppf and infratemporal fossa itf. Dentists who wish to completely block v2 often use the intraoral approach of injecting an anesthetic agent into the pterygopalatine fossa via the greater palatine foramen and canal. Anatomical and clinical appraisal of the pterygopalatine. Each fossa is a coneshaped paired depression deep to the infratemporal fossa and posterior to the maxilla on each side of the skull, located. Body head and neck areasorgans pterygopalatine fossa pterygopalatine ganglion and vb in fossa. A human skull contains two pterygopalatine fossaeone on the left side, and another on the right side. Atlas of human anatomy pdf free download 2020 medical. The pterygopalatine fossa communicates with the middle space and meckels cavum via the round.
The pterygopalatine nerves or sphenopalatine branches, two in number, descend to the pterygopalatine ganglion. The neurovascular structures enter and exit the fossa through the following boundaries. Watch the complete lecture in the members area at the pterygopalatine fossa is a pyramidal space. Surgical anatomy of the infratemporal fossa using the. Written and edited by expert surgeons in collaboration with a worldrenowned anatomist, this exquisitely illustrated reference consolidates surgical, anatomical and technical knowledge for the entire human body in a single volume. The pterygopalatine fossa is a depression or hollow in the human skull that is named for its location at the pterygoid process of the sphenoid bone.
The pterygopalatine ganglion and its role in various pain syndromes. Temporal, infratemporal, pterygopalatine fossa anatomy. The maxillary nerve produces the following branches. The walls of the pterygopalatine fossa are formed by. Endoscopic study for the pterygopalatine fossa anatomy. Its small volume combined with the numerous structures.
Although the pterygopalatine fossa is a small compartment hidden between the maxillae and the sphenopalatine bone, it has multiple communications with surrounding structures, such as the oral cavity, the nasal cavity, the infratemporal fossa, the middle cranial fossa, the orbit and the nasopharynx. Review of osteology infratemporal space pterygopalatine fossa radiology 3. Illustrated veterinary anatomical nomenclature 3rd edittion gheorghe m. Original article morphological study of the pterygoid. The pterygopalatine fossa contents openings teachmeanatomy.
Aug 15, 2016 pterygopalatine fossa 1overview and topographic anatomy general information pyramidshaped fossa on the lateral aspect of the skull between the maxillas infratemporal surface and the pterygoid process of the sphenoid contains major nerves and blood vessels that supply the nasal cavity, upper jaw, hard palate, and soft palate. Pterygopalatine fossa 1overview and topographic anatomy general information pyramidshaped fossa on the lateral aspect of the skull between the maxillas infratemporal surface and the pterygoid process of the sphenoid contains major nerves and blood vessels that supply the nasal cavity, upper jaw, hard palate, and soft palate. The anterior wall is formed by the posterior surface of the maxilla the medial wall is formed by the lateral surface of the palatine bone the posterior wall and roof are formed by parts of the sphenoid bone. Sensory branches of the maxillary nerve are joined by preganglionic ps facial nerve fibres and. The maxillary branch of the trigeminal nerve served as a superior landmark to progress into the retroantral space and pterygopalatine fossa. Pterygopalatine fossa an overview sciencedirect topics.
Following facial trauma, angulation or interruption of the pterygopalatine fossa and canal indicates fractures through the maxilla going as far posteriorly as the. Pterygopalatine fossa definition of pterygopalatine. It receives parasympathetic fibers from the facial nerve. It is known as a major neurovascular crossroad between the orbit, the nasal cavity, the nasopharynx, the oral cavity, the infratemporal fossa, and the cranial fossa. Our study showed average ct scan measurements of 5. This thrilling and revolutionary new characteristic provides extra help to college students whore curious and crave for a extra indepth understanding. Pterygopalatine fossa fossa pterygopalatina imaios. Jun 15, 2015 anatomy of pterygopalatine fossa, infra temporal space 1. Pterygopalatine fossa anatomy for a surgical approach to. Patients one patient presented with an asymptomatic ppf schwannoma.
The pterygopalatine fossa is the space between the pterygoid process of the basisphenoid bone and the maxilla. Angled needle is advanced 2530 mm up the greater palatine canal and an anesthetic solution is injected, flooding the pterygopalatine fossa sounds about as fun. The pterygopalatine fossa is the distribution centre for the main vessels and nerves of the middle third of the face. One hundred dry skulls were analyzed from the hamanntodd osteological collection. Pdf the pterygopalatine ganglion and its role in various. Its surgical anatomy is discussed, with particular emphasis on the relationship between the medical plate of the pterygoid process of the sphenoid bone and the vertical.
Squamous cell carcinoma of the pterygopalatine fossa a case report. The pterygopalatine ganglion aka meckels ganglion, nasal ganglion, spg or sphenopalatine ganglion is a parasympathetic ganglion found in the pterygopalatine fossa. Its formation enables the pterygopalatine fossa to. Axial magnetic resonance image shows a wellcircumscribed mass in the right pterygopalatine fossa causing anterior displacement of the posterior wall. Other articles where pterygopalatine ganglion is discussed. Both axial hrct and mpr images of the pterygopalatine fossa were obtained. Grays surgical anatomy 1st edition pdf free pdf epub. The pterygopalatine fossa ppf is an important anatomic location of the deep portion of the face. Objective to describe an endoscopic transnasal approach to the pterygopalatine fossa ppf design case series of 3 patients setting an academic medical center patients one patient presented with an asymptomatic ppf schwannoma. The pterygopalatine fossa is a major distribution center for the parasympathetic innervation and vascular supply of deep facial structures. The opening of the maxillary sinus was identified and was expanded forward and backward.
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