Pterygopalatine Fossa Anatomy for a Surgical Approach to Sphenopalatine Ganglion

Abstract

The sphenopalatine ganglion is an extracranial neural structure within the pterygopalatine fossa. Modulation of this region via implantation of a neuromodulatory device presents a novel therapy for the treatment of facial and head pain. Yet sex, race, and genetic factors contribute to morphological variations between individuals. This study defines the standards and variations of the bony landmarks surrounding the pterygopalatine fossa. One hundred dry skulls were analyzed from the Hamann-Todd osteological collection. Ten anatomical dimensions were measured on each side of the face for each specimen (vidian foramen, zygomatic buttress, zygomatic maxillary suture, pyriform rim, infraorbital rim, pterygoid maxillary suture, greater palatine foramen, auditory canal, and pterygoid fossa). A statistical analysis was performed for both sides of the face based on sex and race. When stratified by sex, 7 of the 10 measurements revealed a statistically significant difference bilaterally. When stratified by race, 5 of the 10 measurements demonstrated a statistically significant difference bilaterally. Both male and African American skulls showed greater hemifacial values bilaterally when compared with their respective counterparts. The only statistically significant measurement on both the left and right sides of all skulls was the length from the vidian foramen to the infraorbital rim. Defining the anatomical mean distance between skull landmarks and highlighting differences between sex and race not only provides further insight into relative skull anatomy, but also sets the stage for device innovation.

Radiological anatomy assessment of the fissura pterygomaxillaris for a surgical approach to ganglion pterygopalatinum

“…Our results coincide with those of Frautschi et al. () who, like us, found no significant differences between the left and right measurements of different bony landmarks that surround the PPF.…”

“…These results are consistent with a recent work conducted on dried human skulls (Frautschi et al. ), in which the authors emphasized the trend that males had significantly larger dimensions for the size of the PPF and its surrounding bony structures than females.…”

“…; Frautschi et al. ), while others have carried out anatomical non‐morphometric studies of PPF by performing cadaver dissections (Roberti et al. ; Rusu, ; Rusu & Pop, ).…”

“…A more recent study has indicated gender and race as being responsible factors (Frautschi et al. ). It has long since been known that anatomical variations of the PPF also affect the PMF (Osborn, ), which is the critical anatomical structure in predicting the success of a surgical approach to the PPF.…”

Vidian Canal Types and Dehiscence of the Bony Roof of the Canal: An Anatomical Study

“…The Vidian nerve is an important anatomical formation for foramen lacerum, mandibular nerve, foramen ovale, pterygopalatine fossa, and Eustachian tube. The Vidian nerve is located in the posteromedial of the lacerum segment of the internal carotid artery and in the caudal part of the lateral vertical segment in the anterolateral side of the pterygopalatine fossa (16). The Vidian canal ostium is located just below the foramen rotundum.…”