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Right Medial View of Orbit, Lateral Nasal Wall, Pterygopalatine Fossa, and Cavernous Sinus

Surgical Correlation


Right medial view of orbit, lateral nasal wall, pterygopalatine fossa, and cavernous sinus. This paramedian dissection includes the floor of the anterior cranial fossa on which the frontal lobes rest with the anterior cerebral artery coursing forward in the interhemispheric fissure. Just inferior to this anteriorly are the orbital contents enclosed by periorbita. At the floor of the orbit are the infraorbital artery and nerve and just lateral to this, the zygomatic nerve. The floor of the orbit forms the roof of the maxillary sinus, which is in view here following removal of the turbinates. The pterygopalatine fossa and contents are visible. The posterior superior alveolar artery is a branch of the maxillary artery within the infratemporal fossa. The maxillary artery passes through the pterygomaxillary fissure and gives rise to the sphenopalatine artery, which provides branches to the nasal cavity and septum. The descending palatine artery descends within the greater palatine canal toward the palate in company with greater and lesser palatine nerves, branches of the maxillary nerve, to the hard and soft palate, respectively.  Openings at the posterior wall of the pterygopalatine fossa allow entrance for the maxillary nerve and Vidian nerve. Preganglionic parasympathetic fibers in the latter nerve synapse in the pterygopalatine ganglion and postganglionic fibers are then distributed along branches of the maxillary nerve. The maxillary nerve courses within the dura of the lateral wall of the cavernous sinus in nearby relationship with the cavernous segment of the internal carotid artery. Within the sella turcica sits the pituitary gland with its infundibulum connecting the gland to the hypothalamus. Superior to the gland is the optic chiasm to which converge the optic nerves. The ophthalmic artery follows this nerve into the optic canal and orbit. Posterior to the clivus is the basilar artery resting on the anterior surface of the pons. (Image courtesy of AL Rhoton, Jr.)