Exploring the pterygopalatine fossa: a comprehensive radiological analysis for advancing maxillofacial therapeutics

Karthikeya Patil, Mahima V Guledgud, Sanjay C J, Sharath Niranjan, Varusha Sharon Christopher, Akash Saha

Abstract


Objectives: The purpose of the study is to analyze whether the volume of the pterygopalatine fossa will have a significant impact on the qualitative effect of local anesthesia or any other therapeutic procedures through this structure.
Materials and Methods: It is a descriptive retrospective study with a single institutional setting. The study included subjects of age above 18 with quality cone beam computed tomography (CBCT) images taken from 2020 to 2023. Descriptive statistics were performed. Volume and sex associations were done through an independent t test, and volume and age associations were done through a Chi-square test. A P value of less than 0.05 was considered significant.
Results: A study of 107 patients, excluding 53 females and 54 males, found a significant difference in the mean volumes of the pterygopalatine fossa (PPF) between males and females. The average capacity was 717±66.7 cc on the right side and 661±61.6 cc on the left, with a p value less than 0.001.
Conclusion: Accurately assessing the volumetric capacity of the PPF is crucial for local anaesthetic and other therapeutic applications. Males have a significantly larger volume of PPF than females, and semiautomatic CBCT picture segmentation offers a practical and independently tested method.



Keywords


Pterygopalatine fossa; Cone Beam Computed Tomography; Morphology; Local anesthesia; Trigeminal neuralgia

Full Text:

PDF

References


Tashi S, Purohit BS, Becker M, Mundada P. The pterygopalatine fossa: imaging anatomy, communications, and pathology revisited. Insights into imaging. 2016;7(4): 589–599.

Wormald PJ, Athanasiadis T, Rees G, Robinson S. An evaluation of effect of pterygopalatine fossa injection with local anesthetic and adrenalin in the control of nasal bleeding during endoscopic sinus surgery. American journal of rhinology. 2005;19(3): 288–292.

Roberti F, Boari N, Mortini P, Caputy AJ. The pterygopalatine fossa: an anatomic report. The Journal of craniofacial surgery. 2007;18(3): 586–590.

Bahşi İ, Orhan M, Kervancıoğlu P, Yalçın ED. Morphometric evaluation and clinical implications of the greater palatine foramen, greater palatine canal and pterygopalatine fossa on CBCT images and review of literature. Surgical and radiologic anatomy: SRA. 2019;41(5): 551–567.

Salgado-Parente A, González-Huete A, Antolinos-Macho E, Michael-Fernández A, Quintana-Pérez JV, Alba-Pérez B, et al. Radiologist’s Guide to the Pterygopalatine Fossa. Radiographics: a review publication of the Radiological Society of North America, Inc. 2023;43(11): e230078.

Behairy EA, Barsem NG, Eldemerdash AA. Evaluation of surgical approaches to infratemporal and pterygopalatine fossae. The Egyptian Journal of Otolaryngology. 2023;39(1): 109.

Bannon R, Parihar S, Skarparis Y, Varsou O, Cezayirli E. 3D printing the pterygopalatine fossa: a negative space model of a complex structure. Surgical and radiologic anatomy: SRA. 2018;40(2): 185–191.

Yin J, Wu Y, Zhang Z, Zhang Y, He J, Yang Z, et al. Operative management of trigeminal schwannomas: based on a modified classification in a study of 93 cases. Acta neurochirurgica. 2023;165(12): 4157–4168.

Nader A, Kendall MC, De Oliveria GS, Chen JQ, Vanderby B, Rosenow JM, et al. Ultrasound-guided trigeminal nerve block via the pterygopalatine fossa: an effective treatment for trigeminal neuralgia and atypical facial pain. Pain physician. 2013;16(5): E537–E545.

Aoun G, Nasseh I, Sokhn S. Radio-anatomical Study of the Greater Palatine Canal and the Pterygopalatine Fossa in a Lebanese Population: A Consideration for Maxillary Nerve Block. Journal of clinical imaging science. 2016;6: 35.

Hafeez NS, Ganapathy S, Sondekoppam R, Johnson M, Merrifield P, Galil KA. ANATOMICAL VARIATIONS OF THE GREATER PALATINE NERVE IN THE GREATER PALATINE CANAL. Journal . 2015;81: f14.

Brand HS, Bekker W, Baart JA. Complications of local anaesthesia. An observational study. International journal of dental hygiene. 2009;7(4): 270–272.

Cummings DR, Yamashita DDR, McAndrews JP. Complications of local anesthesia used in oral and maxillofacial surgery. Oral and maxillofacial surgery clinics of North America. 2011;23(3): 369–377.

Stojčev Stajčić L, Gačić B, Popović N, Stajčić Z. Anatomical study of the pterygopalatine fossa pertinent to the maxillary nerve block at the foramen rotundum. International journal of oral and maxillofacial surgery. 2010;39(5): 493–496.

Hwang SH, Seo JH, Joo YH, Kim BG, Cho JH, Kang JM. An anatomic study using three-dimensional reconstruction for pterygopalatine fossa infiltration via the greater palatine canal. Clinical anatomy . 2011;24(5): 576–582.

Gibelli D, Cellina M, Cappella A. Disclosing the ‘hidden’ anatomical structures of the cranium: morphological and metrical assessment of pterygopalatine fossa and intrapetrous internal carotid artery …. Italian Journal of. 2018; https://oajournals.fupress.net/index.php/ijae/article/view/11410

Icen M, Orhan K. Cone-beam computed tomography evaluation of the pterygomaxillary fissure and pterygopalatine fossa using 3D rendering programs. Surgical and radiologic anatomy: SRA. 2019;41(5): 513–522.

Gallardo CAC, Galdames ICS, López MGC, Matamala DAZ, Coronado G, Suazo G, et al. Relationship between pterygopalatine fossa volume and cephalic and upper facial indexes. International journal of morphology = Revista internacional de morfologia. 2008;26(2): 393–396.

Vinod P. Compare the effectiveness of normal saline to adrenaline (1:100000) in reducing intra operative bleeding following pterygopalatine fossa infiltration prior to performing endoscopic sinus surgery. [masters] Christian Medical College, Vellore; 2015. http://repository-tnmgrmu.ac.in/9730/ [Accessed 7th November 2023].

du Plessis M, Navsa N, Bosman MC. Preliminary results on a study to locate the pterygopalatine fossa using mathematical formulae. Clinical anatomy . 2010;23(8): 931–935.




DOI: http://dx.doi.org/10.36162/hjr.v9i2.604

Refbacks

  • There are currently no refbacks.