Pterygopalatine fossa neuroanatomy this is a teaser video. The pterygopalatine fossa is a major distribution center for the parasympathetic innervation and vascular supply of deep facial structures. At the bottom you can see its communication with the nasal cavity through the sphenopalatine foramen and inside a vascular structure arrow. 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 sphenomaxillary fissure, bounded in front by the maxillary tuber and behind by anterior portions of the pterygoid process, affords lateral access to the pterygopalatine fossa. You may not embed one of our images on your web page without a link back to our site. 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. Neoplastic processes involving the infratemporal fossa may originate from the tissues in the region, but more often are the result of extension from neighboring structures. See results from the pterygopalatine fossa quiz on sporcle, the best trivia site on the internet. N2 the pterygopalatine fossa is a wellprotected region of the skull base, and surgical access for resection of tumors growing in this region can be challenging. It is largely innervated by the greater petrosal nerve a branch of the facial nerve. To open the pterygopalatine fossa widely bone must be broken from around the sphenopalatine foramen. Mnemonics for the nbde part 1 some r rated learn with flashcards, games, and more for free. Clinical functional anatomy of the pterygopalatine. Ct scan shows a soft tissue mass, which is located in the pterygopalatine fossa, causing expansion of the left cavernous sinus.
Patients are monitored for adverse reactions after the procedure is finished. It connects the infratemporal fossa with the pterygopalatine fossa borders. The pterygopalatine fossa belongs to the deep region of the face. Giovanni mazzotti, alessandra ruggeri, in computerguided applications for dental implants, bone grafting, and reconstructive surgery adapted translation, 2016. Pterygopalatine fossa ubc neuroanatomy season 2 ep 5 duration. Radiology of the pterygoid plates and pterygopalatine fossa. Jaradeh the pterygopalatine fossa ppf represents a major pathway of spread of malignancy and infection from the head and neck into the skull base. Which cranial nerves are sensory feeling, motor movement, or both. Dissection of pterygopalatine fossa anatomy of pterygopalatine fossa. A new look at sphenopalatine ganglion blocks for chronic migraine. Film is a presentation of the dissection of pterygopalatine fossa with the special reference to the arterial plexus. Learn vocabulary, terms, and more with flashcards, games, and other study tools. We report a patient who had an inflammatory pseudotumor ipt that invaded to the maxillary sinus and orbital cavity, with the left pterygopalatine fossa as the principal site.
Bhanu prakash usmle, fmge and neet pg 65,157 views. The walls of the pterygopalatine fossa are formed by. It communicates with the nasal and oral cavities, infratemporal fossa, orbit, pharynx, and. It is a region normally explorable only after removal or demolition of many anatomical structures. The flow of blood to the nasal mucosa, in particular the venous plexus of. Pterygomaxillary fissure radiology reference article. 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 inferior to the orbital apex. Infratemporal fossa abscess is a rare condition that is scantly described in the literature. A sphenopalatine ganglion block is a relatively quick procedure that offers patients rapid pain relief. The postsynaptic fibers of the pterygopalatine or sphenopalatine ganglion ppg or spg supply the lacrimal and nasal glands. The pterygopalatine fossa is an inverted pyramidalshaped, fatfilled space located on the lateral side of the skull, between the infratemporal fossa and the nasopharynx.
Medially the vertical plate of the palatine bone, anteriorly is the posterior wall of the maxillary sinus, posteriorly the vertical portion of the common root of the pteygoid plates, and laterally the pterygomaxillary fissure figure 1. It has been cited as an uncommon complication of dental infections and tooth extractions. The cranial nerves number one through twelve dentists deal primarily with cranial nerve number five, the trigeminal nerve. Pterygomaxillary fossa article about pterygomaxillary. Patients usually report pain relief between 15 and 30 minutes after the procedure. The risks associated with a sphenopalatine ganglion block are very low. You notice that it is in the area of the it fossa, which one of the following structures would not be affected. The clinical anatomy of the maxillary artery in the. It should be noted that the lower part of the pterygoid fossa and anterior border of the pterygoid process is formed by the pyramidal process of the palatine bone.
The pterygopalatine fossa contains maxillary nerve second branch of the trigeminal nerve, vidian nerve, the pterygopalatine ganglion, and the third part of the maxillary artery. Temporal, infratemporal, pterygopalatine fossa anatomy ant 1003 with liuzzi at lake erie college of osteopathic medicine studyblue. How to draw a jovicagram of the pterygopalatine fossa for rapid recall of its contents and pathways. Pterygopalatine ganglion definition of pterygopalatine. Pterygopalatine ganglion an overview sciencedirect topics. The pterygopalatine fossa ppf 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. Osseous anatomy of the pterygopalatine fossa david l. The pterygopalatine ganglion is a parasympathetic ganglion located in the pterygopalatine fossa just beneath the maxillary nerve. The infratemporal fossa is an area on the skull localized below the temporal fossa and medial to the ramus. It is quite important as it is a neurovascular crossroad of the nasal cavity, masticator space, orbit. 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. A human skull contains two pterygopalatine fossaeone on the left side, and another on the right side.
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. The pterygopalatine fossa is a pyramidal space located between the maxillary bone anteriorly, the pterygoid process posteriorly and inferior to. Pterygopalatine fossa an overview sciencedirect topics. Watch the complete lecture in the members area at the pterygopalatine fossa is a pyramidal space. Study 77 temporal, infratemporal, pterygopalatine fossa flashcards from adrian k. Gross anatomy of pterygopalatine fossa part 1 youtube. Then we classified the branching patterns of the maxillary artery in the pterygopalatine fossa. It is the indented area medial to the pterygomaxillary fissure leading into the sphenopalatine foramen. Clavipectoral fascia gross anatomy extension, attachments, structures piercing medical animation duration. This simple, inexpensive procedure may provide a relatively lowrisk option for the treatment of chronic migraines. Preganglionic fibers reach the ganglion from the facial nerve through the greater superficial petrosal nerve and the nerve of the pterygoid canal. Temporal, infratemporal, pterygopalatine fossa anatomy. T1 minimally invasive transnasal and transmaxillary approaches to the pterygopalatine fossa.
Pterygopalatinefossaspheno palatinefossa definition inverted pyramid shaped paired spaces on both sides of skull posterior to maxilla, deep to infratemporalfossa,belowtheapexoforbit. In human anatomy, the pterygopalatine fossa is a fossa in the skull. The patient was an 83yearold woman who suddenly became aware of impairment in the eyesight and visual field of the left eye. Sphenopalatine ganglion block treatments pain doctor. If you would like a large, unwatermarked image for your web page or blog, please purchase the appropriate license. The pterygomaxillary fissure is a triangular shaped lateral opening of pterygopalatine fossa gross anatomy. A new look at sphenopalatine ganglion blocks for chronic. It is in or close to the foramen that connects the pterygopalatine fossa to the nasal cavity. 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.
Pdf squamous cell carcinoma of the pterygopalatine fossa. Removal of part of the floor of the sphenoid sinus will reveal the nerve of the pterygoid canal n39 bringing parasympathetic motor fibers of the. The pterygopalatine fossa ppf is a critical neurovascular crossroad of the deep portion of the face and a common site for direct invasion and perineural spread of disease. The ppg is located in the pterygopalatine fossa ppf. Charlie steps up to take on a very detailed explanation of the pterygopalatine fossa and its associated structures. In human anatomy, the pterygopalatine fossa sphenopalatine fossa is a fossa in the skull. An inflammatory pseudotumor arising from pterygopalatine. It adjoins ahead with the rear face of the maxilla and behind with the plate of the pterygoid apophysis. It is located lateral to the nasal cavity, anteriorinferior to the middle cranial fossa, inferior to the apex of the orbit, and medial to the infratemporal fossa. Each fossa is a coneshaped paired depression deep to the infratemporal fossa and posterior to the maxilla on each side of the skull, located.
Pdf the pterygopalatine ganglion and its role in various. In this investigation, we observed branching patterns of the third portion of the maxillary artery, a relationship of the terminal branches of the maxillary artery to the pterygomaxillary junction, and the course of descending palatine artery. It is located in the medial aspect of the temporal fossa and is formed by the divergence of the maxilla from the pterygoid process of the sphenoid bone. Pterygopalatine fossa medical definition merriamwebster. Through eight bony canals or foramina, this fossa communicates with the nasal and oral cavities, infratemporal. 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. The third part of the maxillary artery n36 which has come into the fossa through the pterygomaxillary fissure n4 will be evident.
Although rare, it is important to recognize the possibility of this. In this paper the authors present a rare case of squamous cell carcinoma of the pterygopalatine fossa, which was excised in an endoscopic transnasal approach after preoperative selective embolization. A patient comes to your er with a deep laceration on the side of his face. Ct images showed a neoplastic lesion that invaded to. The pterygopalatine ganglion aka meckels ganglion, nasal ganglion or sphenopalatine ganglion is a parasympathetic ganglion found in the pterygopalatine fossa. Tumor involvement of the ppf has important treatment and prognostic implications.
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