Endoscopic endonasal approach to the pterygopalatine fossa. Temporal, infratemporal, pterygopalatine fossa anatomy ant 1003 with liuzzi at lake erie college of osteopathic medicine studyblue. Anterior cranial fossa boundaries contents teachmeanatomy. If you would like a large, unwatermarked image for your web page or. Tumor involvement of the ppf has important treatment and prognostic implications. Surgical access to this anatomical space is difficult, especially for tumor. The pterygopalatine fossa is a pyramidal space located between the maxillary bone anteriorly, the pterygoid process posteriorly and inferior to the. The contents of the pterygopalatine fossa 1 third part pterygopalatine part of the maxillary artery 2 maxillary nerve 3 nerve of the pterygoid canal vidians nerve 4 pterygopalatine ganglion all the upper teeth receive their innervation and blood supply from the maxillary nerve v2 and the terminal part of the maxillary artery. Surgical anatomy of the infratemporal fossa integrates the basic clinical and surgical anatomy of the. Branches from pterygopalatine ganglion supplies sensory from v2, parasympathetic secretomotor from cn vii these fibers originate from greater petrosal n. 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. 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.
The patient was an 83yearold woman who suddenly became aware of impairment in the eyesight and visual field of the left eye. 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. Its importance lies as the neurovascular crossroad of the nasal cavity, masticator space, orbit, oral cavity, and middle. It communicates with the temporal fossa deep to the zygomatic arch and the pterygopalatine fossa through the pterygomaxillary fissure. 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. The fossa is located between the pterygoid process and the maxillary tuberosity. Pterygopalatine definition of pterygopalatine by the. The pterygopalatine fossa is an inverted pyramidshaped space of the viscerocranium, protected by bony structures. Pterygopalatine fossa definition of pterygopalatine. 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. This article describes the anatomy of the pterygopalatine fossa and space, including its contents and gateways. The anterior cranial fossa is the most shallow and superior of the three cranial fossae. The major structures that occupy the infratemporal fossa are the lateral and medial pterygoid muscles, the mandibular division of the trigeminal nerve, the chorda tympani branch of the facial nerve, the otic.
Anterior ethmoidal nerve from v1, sensory innervation to anterior region several smaller branches off this nerve. The maxillary branch of the trigeminal nerve cn v enters the fossa from behind, through the foramen rotundum, and the pterygoid nerve enters the fossa via the pterygoid canal. Its main contents are the maxillary artery and maxillary nerve. In this article, we shall look at the borders, contents and clinical correlations of the anterior cranial fossa. The pterygopalatine fossa contains the pterygopalatine ganglion. 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. The infraorbital nerve is a consistent landmark that delimits the surgical boundaries between the pterygopalatine fossa and the infratemporal fossa. 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 infratemporal fossa is the region deep to the ramus of the mandible. This book is distributed under the terms of the creative commons.
Other articles where pterygopalatine ganglion is discussed. During their early phase, tumors in this area may cause symptoms similar to wellknown neuralgias. 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. J pterygopalatine fossa questions and study guide quizlet. Respiratory system anatomy lecture 4 2 anatomical structure and boundaries the pterygopalatine fossa is an inverted tear drop shaped space. Endoscopic transnasal approach to the pterygopalatine fossa.
Pterygopalatine definition of pterygopalatine by the free. These branches supply much of the nasal cavity, the roof of the oral cavity, and all. Cn vii greater petrosal nerve pterygopalatine ganglia v2 zygomatic branch lacrimal nerve v1 lacrimal gland. Due to its inherent complex location and connections, it can potentially act as a.
Situated between the maxilla, sphenoid, and palatine bones. Head and neck gross anatomy, medical animation duration. Jun 15, 2015 the contents of the pterygopalatine fossa 1 third part pterygopalatine part of the maxillary artery 2 maxillary nerve 3 nerve of the pterygoid canal vidians nerve 4 pterygopalatine ganglion all the upper teeth receive their innervation and blood supply from the maxillary nerve v2 and the terminal part of the maxillary artery. The pterygoid ganglion receives fibers from the maxillary nerve.
The pterygopalatine ganglion is one of four parasympathetic ganglia of the head and neck and largest of the peripheral parasympathetic ganglia. It lies superiorly over the nasal and orbital cavities. The pterygopalatine fossa contents openings teachmeanatomy. 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 close to the apex of the orbit. The infratemporal fossa accommodates the insertion of the temporalis muscle, medial and lateral pterygoid muscles, mandibular nerve cranial nerve cn v3, otic ganglion, chorda tympani nerve, maxillary artery, and the pterygoid plexus of the veins. Surgical anatomy of the pterygopalatine fossa volume 89 issue 1 robert t. Temporal, infratemporal, pterygopalatine fossa anatomy ant. The pterygopalatine fossa ppf is an obscure but important space in the deep face that needs to be evaluated very carefully in the realm of head and neck imaging, since a myriad of infective, inflammatory, and neoplastic conditions can affect it. Anatomy pterygopalatine fossa questions and study guide. Pterygopalatine fossa an overview sciencedirect topics. Tumor involvement of the ppf has important treatment and prognostic implications 46. The pterygopalatine fossa is an important neurovascular crossroad of the head and neck, communicating with numerous foramina, including the inferior orbital fissure, foramen rotundum, and the vidian canal3. This space communicates with both the nasal and oral cavities, the infratemporal fossa, the orbit, the pharynx, and the middle cranial. These branches supply much of the nasal cavity, the roof of the oral cavity, and all upper teeth.
It receives parasympathetic fibers from the facial nerve. Given its inherent complex location and connections, the. The pterygopalatine fossa ppf is a small, clinically inaccessible, fatfilled space located in the deep face that serves as a major neurovascular. 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. The limbus is a bony ridge that forms the anterior border of the prechiasmatic sulcus a groove. The walls of the pterygopalatine fossa are as follows.
Anatomy of pterygopalatine fossa, infra temporal space. In fact, the pterygopalatine fossa is located medially to it, whereas the infratemporal fossa is located laterally and inferiorly to it. In addition, it is partly formed by three other roots that unite in a nerve called the vidian 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. Temporal, infratemporal, pterygopalatine fossa anatomy.
In the pterygopalatine fossa the pterygopalatine ganglion is suspended from the maxillary nerve by 2 roots. Its formation enables the pterygopalatine fossa to. The pterygopalatine fossa ppf is a coneshaped depression deep to the. The ganglion, a triangular structure 5 mm in diameter, is covered by a layer of connective tissue and. The anterior cranial fossa consists of three bones. 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. Bhanu prakash usmle, fmge and neet pg 70,480 views. Surgical anatomy of the pterygopalatine fossa the journal of. The pterygopalatine fossa ppf is an important anatomic location of the deep portion of the face. Its small volume combined with the numerous structures. Due to its inherent complex location and connections, it can potentially act as a natural conduit for the spread of inflammatory. 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.
Request pdf pterygopalatine fossa although the pterygopalatine fossa is a small compartment hidden. The pterygopalatine nerves or sphenopalatine branches, two in number, descend to the pterygopalatine ganglion. Pterygopalatine fossa definition of pterygopalatine fossa. The pterygopalatine fossa is an inverted pyramidalshaped, fatfilled space located on the lateral side of the skull, between the infratemporal fossa and the nasopharynx. Pdf squamous cell carcinoma of the pterygopalatine fossa. Neoplastic diseases which occur in the infratemporal and the pterygopalatine fossae are rare and unusual in their manifestations.
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. The walls of the pterygopalatine fossa are formed by. However, axial ct studies define a larger fossa, which incorporates the pyramidalshaped fossa and has its posterolateral margin at the lateral edges of the base of the pterygoid process and the fused pterygoid plates fig 1c and d. 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. Contents the major structures of the fossa are the maxillary artery, accompanying veins pterygopalatine ganglion, and maxillary. The fossa is located between the pterygoid process and the maxillary tuberosity, close to the orbital apex. You may not embed one of our images on your web page without a link back to our site. 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 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 maxillary nerve produces the following branches. 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. It communicates via canals, fissures, and foramina with various regions of the skull.
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. 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. 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. A human skull contains two pterygopalatine fossaeone on the left side, and another on the right side. Pterygopalatine fossa and nasal cavity at geisel school of. The neurovascular structures enter and exit the fossa through the following boundaries. 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. In human anatomy, the pterygopalatine fossa sphenopalatine fossa is a fossa in the skull.
Jennifer bruecknercollins discusses carlos machado, mds painting of the pterygopalatine fossa, one of several editor discussion videos included with the new 6th edition of dr. Pterygopalatine fossa synonyms, pterygopalatine fossa pronunciation, pterygopalatine fossa translation, english dictionary definition of pterygopalatine fossa. 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 pterygopalatine fossa is an irregular space where neurovascular structures course through to the nasal cavity, palate, pharynx, orbit and face figure 221a and b. 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. Located in the pterygopalatine fossa, posterior to the middle turbinate, the sphenopalatine i. The second patient presented after a sudden onset of complete unilateral vision loss with a complete ipsilateral sphenoid sinus opacification and. Pterygopalatine ganglion radiology reference article. The pterygopalatine fossa is an important space because it communicates with the middle cranial fossa, orbit, nasal cavity, oral cavity, pharynx, foramen lacerum, and the infratemporal fossa via. A patient presents to you with a lesion in the greater petrosal nerves. Largest of the 4 parasympathetic ganglia in the head, contains the largest aggregation of neurons in the head outside the brain. Anatomy, pterygopalatine fossa statpearls ncbi bookshelf. Nasal cavity and pterygopalatine fossa questions and study. 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.
Study 77 temporal, infratemporal, pterygopalatine fossa flashcards from adrian k. Located in the pterygopalatine fossa, posterior to the middle. Primary tumors of the infratemporal and pterygopalatine fossae. An inflammatory pseudotumor arising from pterygopalatine. The fossa accommodates the anteroinferior portions of the frontal lobes of the brain. Formerly known as the sphenopalatine ganglion, the pterygopalatine ganglion is the size of a lentil. Ct images showed a neoplastic lesion that invaded to the maxillary. 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. May 26, 2016 the pterygopalatine fossa ppf is an obscure but important space in the deep face that needs to be evaluated very carefully in the realm of head and neck imaging, since a myriad of infective, inflammatory, and neoplastic conditions can affect it. 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 an important neurovascular crossroad of the head and neck, communicating with. Pterygopalatine foramen definition of pterygopalatine. 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.
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