The pterygopalatine fossa is a slit-like space located in the lateral sectors of the human skull. This part of the body has an irregular shape, which is limited by a tubercle in front of the upper jaw, and behind it is framed by the pterygoid process.
Detailed anatomy
The pterygopalatine fossa is partially framed by a significant wing of the bone in the form of a wedge. Delving into the anatomy of this space, you can also notice that from the inside it is surrounded by an outer surface from the plate of the palatine bone, located perpendicularly.
Outside, this space is in contact with the infratemporal structure directly through the gap, which is called the pterygomaxillary. Where are the borders of the pterygopalatine fossa?
At the top, the fossa is connected in front to the orbit through the inferior orbital fissure, and inside there is contact with the nasal cavity passing through the wedge-shaped palatine opening. Behind the anatomy of this space is arranged in such a way that it is clearly seen how it connects to the cranial cavity through the foramen ovale. Below is its transition to a thin large palatine canal, which opens through large and smallpalatine spaces into the oral cavity. The average dimensions of the pterygopalatine fossa are considered to be six millimeters in the anterior direction, and nine in the transverse direction, while the height reaches eighteen units.
During childhood, the fossa is a tiny formation in the form of a gap, which begins to increase from the age of three. In the fossa filled with fiber, there is the second branch of the triple nerve, which is referred to as the maxillary nerve with the zygomatic and pterygopalatine nerves branching from it, as well as the posterior superior alveolar junction. These weaves go through the openings of the tubercles of the upper jaw. In addition, in the pterygopalatine fossa lies a node consonant with its name.
What are the messages of the pterygopalatine fossa with?
Artery branches
Branches of the so-called maxillary arteries go through the fossa, namely:
- infraorbital artery;
- descending palatal;
- sphenoid palatine artery.
Pterygoid venous plexuses are selectively located in the pit space and in the adjacent infratemporal depression.
The fossa seems to be projected onto the surface of the face as an isosceles triangle, its upper part runs along the line that connects the ear point with the outer edges of the eye sockets in the direction of the zygomatic arch. The front, like the back, is at a sixty-degree angle.
Anatomy of the pterygopalatine fossa on x-ray
X-ray imaging of the pit spacemanifests itself in the pictures of the skull as a result of lateral projections. During such operations, a total imposition of both dimples on each other can occur. Such measures may make it somewhat difficult to assess the studied palatal space located closer to the cassette during X-ray. To achieve a separate image, the head of the patient being examined is turned from the lateral position slightly facing into the cassette area, this should be done within ten degrees. Isolated images of the analyzed fossa are achieved using tomography. You can see the openings of the pterygopalatine fossa.
Separate area of enlightenment
In hard-to-distinguish images of the skull, it is isolated in the form of an area of enlightenment, which stretches vertically for a distance of approximately two centimeters. Such a site originates as an angular enlightenment, starting from the point of the alveolar process of the jaw, and then it expands upward. Then this area passes into the upper region of the orbit. In such an area, its transverse size reaches approximately nine millimeters, 9 mm, and the boundaries that diverge and create an angle reaching fifteen degrees. From above, the fossa is framed by a part of the base of the skull in the form of some arcs that are created by large parts of the sphenoid bone.
Possible damage to the pterygopalatine fossa
When the upper jaw or the base of the skull is damaged, then during the implementation of anesthesia and the removal of molars, ruptures and injuries of blood vessels may occur, as well asnerves that are located in the region of the pterygopalatine space. Hematomas that occur in this case may not resolve for quite a long time. Situations when vascular aneurysms occur are also not excluded. Gunshot wounds of the bone structures of the skeleton, which are accompanied by an incorrect ratio of bones and form a pterygopalatine fossa, can also lead to injury to nerve endings and blood vessels. After suffering shrapnel wounds, foreign bodies may remain in the fossa, for example, metal fragments, pieces of teeth, etc. This is likely to provoke prolonged inflammatory processes. Methods for restoring its damage are based on the treatment of defects in the jaw and other bones that form its plates. Removal of foreign bodies, as well as fragments, is most often carried out by opening the maxillary sinus, or through an external wound.
Diseases
Purulent inflammation of this space usually occurs as a result of an increase in pain processes from the area around the temples, or develop after the acquisition of damage. The most dangerous are the so-called phlegmon of the pterygopalatine fossa, which can rapidly spread into the orbit, oral cavity, or into the region of the maxillary sinus of the skull. In such cases, surgical treatment should be undertaken. For this purpose, incisions are made from the side of the vestibule of the oral cavity in the posterior upper section along the mucous membrane, and then carefully try to get deep with, for example, closed scissors,Kocher probe and the like. A rubber turunda or drainage is introduced into the space, which must be fixed with a ligature from the edge of the wound. The wound is usually irrigated with antibiotics or an antiseptic. In diseases such as neuralgia and neuritis, the necessary drugs can be injected into the pterygopalatine fossa to affect the nerves and blood vessels.
