Vol 69, No 2 (2010)
Original article
Submitted: 2012-02-06
Published online: 2010-05-27
Microanatomy of the neural scaffold of the pterygopalatine fossa in humans: trigeminovascular projections and trigeminal-autonomic plexuses
M.C. Rusu
Folia Morphol 2010;69(2):84-91.
Vol 69, No 2 (2010)
ORIGINAL ARTICLES
Submitted: 2012-02-06
Published online: 2010-05-27
Abstract
The pterygopalatine fossa (PPF) is an anatomically-hidden deep extracranial space.
The neural scaffold of the PPF remains anatomically understudied in humans.
Moreover, there are no anatomical data in humans pointing out the extracranial
trigeminovascular distributions, in contrast to the trigeminal supratentorial ones.
By anatomical microdissections, the neural scaffold of the PPF and the presence
of trigeminovascular projections were evaluated. The anterior and superior approaches
of the pterygopalatine fossae in nine dissected blocks of human middle
skull base and the frontal cuts of two different specimens, led to several
results: (1) the neurovascular contents of the PPF, embedded in the pterygopalatine
adipose body, have a layered disposition; (2) the posterior neural layer is
represented by a pterygopalatine cross, centred by the pterygopalatine ganglion
(PPG) that sends off ascending, descending, and medial branches and has
a lateral connection with the maxillary nerve - 4 quadrants could have been
defined as referring to this cross; (3) at the level of the upper lateral quadrant
there are two superposed layers (i) a superficial plexus contributed by the maxillary
nerve, the maxillary artery plexus and the PPG and its orbital branches
(OBs) and (ii) a deep layer, consisting of the OBs proper of the PPG; (4) within
the PPF and on the posterior wall of the maxillary sinus distinctive trigeminovascular
projections were evidenced. The anastomoses involving autonomic and
trigeminal fibres, located in the PPF passage to the orbital apex, support the
complicate and polymorphous neural input to the orbit, while the evidence of
a pterygopalatine trigeminovascular scaffold offers a substrate for a better understanding
of various facial algias.
(Folia Morphol 2010; 69, 2: 84-91)
Abstract
The pterygopalatine fossa (PPF) is an anatomically-hidden deep extracranial space.
The neural scaffold of the PPF remains anatomically understudied in humans.
Moreover, there are no anatomical data in humans pointing out the extracranial
trigeminovascular distributions, in contrast to the trigeminal supratentorial ones.
By anatomical microdissections, the neural scaffold of the PPF and the presence
of trigeminovascular projections were evaluated. The anterior and superior approaches
of the pterygopalatine fossae in nine dissected blocks of human middle
skull base and the frontal cuts of two different specimens, led to several
results: (1) the neurovascular contents of the PPF, embedded in the pterygopalatine
adipose body, have a layered disposition; (2) the posterior neural layer is
represented by a pterygopalatine cross, centred by the pterygopalatine ganglion
(PPG) that sends off ascending, descending, and medial branches and has
a lateral connection with the maxillary nerve - 4 quadrants could have been
defined as referring to this cross; (3) at the level of the upper lateral quadrant
there are two superposed layers (i) a superficial plexus contributed by the maxillary
nerve, the maxillary artery plexus and the PPG and its orbital branches
(OBs) and (ii) a deep layer, consisting of the OBs proper of the PPG; (4) within
the PPF and on the posterior wall of the maxillary sinus distinctive trigeminovascular
projections were evidenced. The anastomoses involving autonomic and
trigeminal fibres, located in the PPF passage to the orbital apex, support the
complicate and polymorphous neural input to the orbit, while the evidence of
a pterygopalatine trigeminovascular scaffold offers a substrate for a better understanding
of various facial algias.
(Folia Morphol 2010; 69, 2: 84-91)
Keywords
sphenopalatine ganglion; trigeminal nerve; maxillary artery; periarterial sympathetic plexus
Title
Microanatomy of the neural scaffold of the pterygopalatine fossa in humans: trigeminovascular projections and trigeminal-autonomic plexuses
Journal
Folia Morphologica
Issue
Vol 69, No 2 (2010)
Article type
Original article
Pages
84-91
Published online
2010-05-27
Page views
559
Article views/downloads
1293
Bibliographic record
Folia Morphol 2010;69(2):84-91.
Keywords
sphenopalatine ganglion
trigeminal nerve
maxillary artery
periarterial sympathetic plexus