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Transfacial View of Infratemporal and Pterygopalatine Fossae and Area Relationships

Surgical Correlation


Transfacial view of infratemporal and pterygopalatine fossae and area relationships. In this coronal plane dissection, the infratemporal fossae are located on both right and left borders of the image. They are shown to contain the lateral pterygoid muscle, the pterygoid venous plexus, branches of the mandibular nerve, and the maxillary artery. The maxillary bones have been removed to show the continuity (via the pterygomaxillary fissure) of the infratemporal fossae with the next medial space, the pterygopalatine fossae. Having traversed this fissure, the maxillary artery gives rise to the descending palatine artery that courses within the greater palatine canal to the hard palate. It does so in company with the greater palatine nerve. The maxillary arteries also give rise to the sphenopalatine arteries, which enter the nasal cavity through the sphenopalatine foramen. This foramen is located immediately posterior to the middle turbinate bone. The pterygopalatine fossa on its posterior wall receives the openings and contents of the foramen rotundum and pterygoid (Vidian) canal, namely, the maxillary and Vidian nerves, respectively. The pterygopalatine ganglion is visible, which receives preganglionic parasympathetic fibers within Vidian nerve. Postganglionic fibers then follow to target tissues along branches of the maxillary nerve. Superior to each pterygopalatine fossa is the apex of the orbit, which transmits the optic nerve and ophthalmic artery through the optic canal, and the oculomotor, trochlear, abducens, and ophthalmic nerves, and the superior ophthalmic vein through the superior orbital fissure. Here, also, are the origins of most of the extraocular muscles. Medial to the orbital apexes is the sphenoid sinus within the body of the sphenoid bone. Much of this bone has been removed to reveal the pituitary gland within the sella turcica. The dorsum sellae, likewise, and much of the clivus have been drilled to expose the basilar sinus. A segment of the anterior arch of the atlas was removed to show the odontoid process or dens. (Image courtesy of AL Rhoton, Jr.)