[The study on the microsurgical anatomy of maxillary sinus approach pterygopalatine fossa].

OBJECTIVE: To provide morphologic data for the operation of pterygopalatine fossa (PPF) region by measuring the bony landmarks and dissecting vessel and nerve. METHOD: The shape, size and adjacent important structures of PPF were observed in 20 dry skulls (forty sides). Ten (twenty sides) skulls were fixed in 4% paraformaldehyde and their arteries were perfused with red lacteprene. The pterygopalatine fossa was exposed from the middle sagittal section dissected to inner wall of maxillary sinus and PPF and observed the course of trigeminal nerve and arteria maxillaris under the operating microscope. To investigate the related surgical anatomy approaches of the maxillary sinus and pterygopalatine fossa. RESULT: The pterygopalatine fossa shows a long and narrow cleft. PPF communicate with nasal cavity, oral cavity, pharynx, orbit, infratemporal fossa and middle cranial fossa. The pterygopalatine segment of maxillary artery and accompanying vein, the maxillary nerve and sphenopalatine ganglion are the most important structures. There are two layers of tissue in the pterygopalatine fossa, they are nervous layer and vessel layer. CONCLUSION: (1) To deal with lesion, the approach of maxillary sinus can de used, the cross point of the upper wall, the inner wall and the back wall can be thought as important landmark. (2) Safe scope could be acquired in endoscopic transnasal surgery in pterygopalatine fossa, pterygoid canal and foramen rotundum could be thought as an important landmark.