The location study on nerves and blood vessels in the pterygopalatine fossa and its clinical implication

Objective: To provide anatomical basis for operations on the pterygopalatine fossa by observing the location and the interrelationship of anatomic structures in this area. Methods: Fifteen(thirty sides) skulls were fixed and their arteries were perfused with red lacteprene. The pterygopalatine fossa was exposed through the middle sagittal section, then dissected and observed under the operating microscope(×10). Results: (1) The maxillary nerve separated into two branches immediately after leaving the foramen rotundum. One of the branches entered into the infraorbital canal at the middle point of the border between the superior and posterior wall of the maxillary sinus, and the other descent along the border between the medial and posterior wall. Their direction was vertical each other. (2) The maxillary artery bent in the pterygopalatine fossa with its branches being in the plane parallelling the posterior wall of the maxillary sinus. The artery was under the trunk of the maxillary nerve in the lateral part of the pterygopalatine fossa, and in the superior part, the artery was anterior to the pterygopalatine ganglion. The artery always situated the lateral of the descending palatine nerve in the medial part of the fossa. Conclusions: (1) The location of nerves and the interrelationship of nerves and blood vessels in the pterygopalatine fossa can provide correlative anatomical basis for the operative procedure in the area. (2) The infraorbital nerve and the descending palatine nerve should be abscised separately in the neurotomy of nervus trigeminus.