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Inferior View of Cranial Base

Surgical Correlation


A, Inferior view of cranial base. The right pterygoid process has been sectioned and removed at its junction with the greater wing and body of the sphenoid bone to expose the pterygopalatine fossa and the vidian canal. The vidian nerve, formed by the union of the superficial and deep petrosal nerves, courses in the vidian canal, which passes through the root of the pterygoid process. It opens posteriorly at the anterolateral margin of the foramen lacerum and anteriorly into the medial portion of the pterygopalatine fossa. The sulcus tubae, which is the attachment site of the cartilaginous part of the eustachian tube to the cranial base, is located on the extracranial surface of the sphenopetrosal fissure, anterolateral to the foramen lacerum and the carotid canal, and posteromedial to the foramina ovale and spinosum. The lateral part of the inferior orbital fissure opens into the infratemporal fossa located below the greater sphenoid wing, and the medial part opens into the pterygopalatine fossa located below the orbital apex between the maxilla and pterygoid process. The right zygomatic arch has been removed. B, Inferior view of an axial section of a cranium at the level of the maxillary sinus. The pterygopalatine fossa is located between the posterior wall of the maxillary sinus and the pterygoid process. The roof of the maxillary sinus forms the floor of the orbit. The infratemporal fossa is located below the greater wing of the sphenoid and opens medially into the pterygopalatine fossa. The medial wall of the pterygopalatine fossa is formed by the perpendicular plate of the palatine bone, which has an opening, the sphenopalatine foramen, through which branches of the maxillary artery and nerve reach the nasal cavity. The ethmoid air cells are located medial to the orbit. C, Inferior views of an axial section of the cranial base. The infratemporal fossa is surrounded by the maxillary sinus anteriorly, the mandible laterally, the pterygoid process anteromedially, and the parapharyngeal space posteromedially. It contains the mandibular nerve and maxillary artery and their branches, the medial and lateral pterygoid muscles, and the pterygoid venous plexus. The posterior nasopharyngeal wall is separated from the lower clivus by the longus capitis, and the nasopharyngeal roof rests against the upper clivus and floor of the sphenoid sinus. D, Enlarged view with highlighting of the pre- (red) and poststyloid (yellow) compartments of the parapharyngeal space. The styloid diaphragm, formed by the anterior part of the carotid sheath, separates the parapharyngeal space into pre- and poststyloid parts. The prestyloid compartment, a narrow fat-containing space between the medial pterygoid and tensor veli palatini muscle, separates the infratemporal fossa from the medially located lateral nasopharyngeal region containing the tensor and levator veli palatini and the eustachian tube. The poststyloid compartment, located behind the prestyloid part, contains the internal carotid artery, internal jugular vein, and the cranial nerves IX through XII. (Images courtesy of AL Rhoton, Jr.)