Anatomy of Pterygopalatine Fossa in a Nutshell

Anatomy of Pterygopalatine Fossa

Between the nasal cavity and the infratemporal fossa

PT fossa

• Very small space located at apex of the orbit
• Is pyramidal / triangular in shape
• Is a key area that has access to other cavities, orbit, fossae
• Contains the Maxillary artery
• Borders:
  • Palatine bone
  • Maxilla
  • Pterygoid plate of sphenoid

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1-Sphenopalatine foramen; 2-Inferior orbitalis fissure; 3-frontalis process of zygomatic bone; 4-Supraorbital notch; 5-Nasalis part of frontal bone; 6-Lacrimal bone; 7-Fossa of lacrimal sac; 8-Infraorbital foramen; 9-Canine fossa; 10-Alveolar process; 11-Hamulus of pterygoid process; 12-Pyramidal process of palatine bone; 13 Lateral lamina of pterygoid process; 14-oval foramen; 15-styloid process; 16-external acoustic meatus; 17-zygomatic process of temporal bone; 18-Pterygopalatine fossa; 19-Squamos parr of temporal bone

• Is a junction point:
  • Maxillary artery enters from the infratemporal fossa
  • Maxillary nerve enters from the middle cranial fossa (foramen rotundum)
  • Both structures have terminal branching occurring in the PT fossa.
• Another key structure: Pterygopalatine Ganglion– Is a parasympathetic ganglion associated with CN VII
• Maxillary artery path:
  • From the infratemporal fossa→enters  PT fossa through Pterygomaxillary fissure
  • Terminal branch  sphenopalatine exits PT fossa through sphenopalatine foramen→goes to nasal cavity
• Maxillary nerve path:
  • Enters through pterygopalatine fossa from the middle cranial fossa via the foramen rotundum
  • Gives off numerous branches in the PT fossa

Maxillary artery: 3^rd part Branches within PT fossa

• Posterior superior alveolar
  • Is questionable
  • May come off while in infratemporal fossa or in PT fossa
  • Enters the maxilla and supplies posterior maxillary teeth
• Artery of the Pterygoid Canal Is very small, unable to see
• Pharyngeal branch
  • Supplies part of the mucous membrane in the nasopharynx
  • Is also very small and hard to see
• Infraorbital artery: 2 branches
  • Middle superior alveolar – upper teeth
  • Anterior superior alveolar- upper teeth
  • Then travels through infraorbital canal and exits through infraorbital foramen to supply skin on face / lower eye lid.
• Descending palatine: 2 branches
  • Greater palatine artery- greater palatine canal to hard palate
  • Lesser palatine artery- lesser palatine canal to soft palate
• Sphenopalatine artery: is the terminal branch that goes on to the nasal septum.

Maxillary nerve: V2- all sensory branches

• Meningeal:
  • Very small branches
  • Recurrent back through foramen to supply dura mater
• Zygomatic: 2 branches
  • Zygomaticofacial
  • Zygomaticotemoral
  • End up on skin of face / temple
• Infraorbital:
  • Travels with infraorbital artery
  • anterior / middle/ posterior superior alveolar- all 3 to upper teeth
  • Exits through infraorbital foramen and onto skin of the face (lower eye lid, lateral nose, skin of cheek)
• Nasopalatine: Goes to the nasal septum
• Greater palatine: to hard palate
• Lesser palatine: to soft palate
• Nasal:
  • Posterior and lateral
  • Small branches of V2 that go to lateral and posterior portions of the nasal cavity
• Pharygeal branch: supplies the nasopharynx

Pterygopalatine Ganglion

• Resides in the Pterygopalatine fossa
• Is a parasympathetic ganglion
• Effectors:
  • Lacrimal Gland
  • Mucous Glands of nasal cavity / oral cavity (on palate)
• Pre GN reside in brain with CN VIIà branch off as the Greater Petrosal Nerve→is  joined by sympathetic Post GN (called the Deep Petrosal Nerve) from Superior Cervical Ganglion
• The Greater and Deep Petrosal nerves come together in the Pterygoid canal→are then referred to as The Nerve of the Pterygoid Canal
• Sympathetics go right through the Pterygopalatine Ganglion
• Parasympathetics synapse within the Pterygopalatine Ganglionà Post GN then go off to effectors.
  • Nasopalatine, Greater / Lesser Palatine, Nasal, and Pharyngeal branches all carry both sympathetics and parasympathetics
  • Branches that go to the skin:
• No parasympathetic fibers (never go to skin)
• Sympathetics are in these branches

Important Passages connecting to PT fossa and  their Contents:

1. Foramen Rotundum: connects to Middle Cranial Fossa

• • – contains V2

1. Infraorbital fissure: connects to Orbit

• • – contains infraorbital nerve, artery, vein

1. Pharyngeal canal: connects to Nasopharynx

• • – contains pharyngeal branch of maxillary artery and nerve

1. Pterygoid canal: connects to Middle cranial fossa

• • – connects nerve of the pterygoid canal

1. Sphenopalatine foramen: connects to Nasal Cavity

• • – contains sphenopalatine artery and nasopalatine nerve

1. Greater Palatine canal: connects to Oral Cavity

• • – contains descending palatine artery (branches into greater/ lesser palatine artery) and greater / lesser palatine nerves.

1. Pterygomaxillary fissure: connects to Infratemporal Fossa

• • – contains Maxillary artery

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