Applied anatomy for management of pterygopalatine fossa lesions via endoscopic transnasal approach

Objective:To provide anatomic data for management of pterygopalatine fossa lesions via endoscopic transnasal approach.Methods: Fifteen(30 sides) formalin-preserved human skulls were subjected to microsurgical dissection to evaluate the exposure scopes of 3 different endoscopic surgery approaches: endonasal middle meatal transpalatine approach,endonasal middle meatal transantral approach,and endonasal inferior turbinectomy transantral approach.Meanwhile,20(40 sides) dry skulls were dissected and the related measurements were obtained.Results: The 3 approaches allowed for different exposure of the pterygopalatine fossa structure.The mean distances from foramen rotundum to anterior nasal spur,superior orbital fissure,and optic canal were(61.86±3.67)mm,(3.56±0.75) mm,and(11.23±1.24) mm,respectively.Conclusion: The 3 endoscopic approaches are safe and effective for resection of different pterygopalatine fossa lesions and foramen rotundum serves as a landmark for safe management of the pterygopalatine fossa.