Microanatomic study of access to the pterygopalatine fossa via a combined frontotemporaland infratemporal fossa approach

Objective To provide an anatomic basis for surgical treatment of the lesions involving the pterygopalatine fossa and middle skull base via a lateral infratemporal fossa approach. Methods Osseous structures in the pterygopalatine fossa of 15 dry skull specimens were studied, and the microsurgical dissection was performed for observing the structures of vessels and nerves and their syntopy in 12 adult cadaveric heads via a combined frontotemporal and infratemporal fossa approach. Results The pterygopalatine portion of the maxillary artery was anterior to the neural component, and the external diameter of terminal segment of the maxillary artery was (2.46 ± 0.58) mm. The average distance from the foramen of the infraorbital fissure to the foramen rotundum and the vidian canal was (13.34 ± 3.03) mm and (17.33 ± 4.05) mm, respectively. The vidian canal runs anteriorly from the foramen lacerum to reach the pterygopalatine fossa parallel to the groove of the carotid artery. The average length of the vidian canal was (14.65 ± 1.76) mm. Conclusion The foramen of the infraorbital fissure served as a reliable landmark for identifying the deep structures of the pterygopalatine fossa in the lateral infratemporal fossa surgery.