Anatomical study of the pterygopalatine fossa pertinent to the maxillary nerve block at the foramen rotundum

Stajčić, L. Stojčev; Gačić, Bojan; Popović, Nataša; Stajčić, Zoran

doi:10.1016/j.ijom.2009.11.002

Cited by 33 publications

(8 citation statements)

References 6 publications

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“…In spite of the variability found, our results also agree with those previously published by Stojcev Stajcić et al. (), with no differences between the right and left sides for any analysed parameters, including PMF width (seven narrow left PMFs of 81, and six narrow right PMFs of 78).…”

Section: Discussionsupporting

confidence: 93%

“…These results are in line with those offered by the only published work that has also measured PMF width (Stojcev Stajcić et al. ). Among other parameters, these authors measured PMF width in 85 dry human skulls.…”

Section: Discussionsupporting

confidence: 92%

“…By considering these data and limitations in comparison (their study was done in dry skulls and did not indicate the exact place where widths were measured), Stojcev Stajcić et al. () found 8.18% of narrow PMFs, 13 PMF of 159 intact PPFs with a width less than or equal to 2 mm. This result comes very close to 6.61% of our PMF Types III and IV, narrow (width less than or equal to 2 mm) in its lower two‐thirds or any of its thirds, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Some have conducted a study on dry human skulls (Stojcev Stajcić et al. ; Frautschi et al. ), while others have carried out anatomical non‐morphometric studies of PPF by performing cadaver dissections (Roberti et al.…”

Section: Discussionmentioning

confidence: 99%

“…Measurements of 159 PPF in 85 dry human skulls gave inconsistent results, and the widest variations occurred in the volume, width and depth of the PPF (Stojcev Stajcić et al. ). A more recent study has indicated gender and race as being responsible factors (Frautschi et al.…”

Section: Introductionmentioning

confidence: 99%

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Radiological anatomy assessment of the fissura pterygomaxillaris for a surgical approach to ganglion pterygopalatinum

et al. 2017

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The ganglion pterygopalatinum has become a therapeutic target to treat various pain syndromes in recent years. It is located in the fossa pterygopalatina, and the fissura pterygomaxillaris is the main access to surgically approach this structure. Recently, the neuromodulation of the ganglion pterygopalatinum by microstimulator implantation has become the first therapeutic line in refractory cluster headache treatment. This invasive technique is performed transorally through the fissura pterygomaxillaris, and is limited by the size of the implantation device, which requires an opening of at least 2 mm. Therefore, extensive knowledge about the anatomy of the fissura pterygomaxillaris prior to surgery is necessary to predict the success of both the approach and intervention. Likewise, establishing a morphological typology of the different fissura pterygomaxillaris variations would be a valuable predictive tool in the clinical practice. In this work, an anatomical analysis was performed of the morphological characteristics of the 242 fissurae pterygomaxillares, which corresponded to 121 adult patients, 58 males and 63 females, aged between 18 and 87 years. For each subject, right and left fissures were studied with radiological computed tomography images. Aperture fissura pterygomaxillaris measurements were taken in an upper (Measure A), middle (Measure B) and lower craneo-caudal third (Measure C). Intra-subject differences were studied between the measurements taken of each patient's right and left fissures, and the inter-subject measures in which fissures were compared according to patients' age and gender. The obtained results showed no significant differences between each patient's right and left fissures in any three measurements taken. Intra-subject differences were not significant for gender or age. No statistically significant differences were found for the inter-subject measures between the measures of fissures according to patients' age. However, our data revealed that males' fissurae pterygomaxillares were significantly larger than those of females in all three measures. Having analysed fissures, a typological classification was made according to the morphological patterns found. A 2-mm limiting measure was considered, and Measures A, B and C of each fissure were classified depending on whether they had a value above or equal to 2 mm, or below 2 mm. With this classification criterion, four fissurae pterygomaxillares types were obtained. Type I and II fissure values (with a higher prevalence) were equal to or were greater than 2 mm in all three measures, or in two measures. Type III fissure values were only greater than or equal to 2 mm in Measure A, whereas all the Type IV fissure values were below 2 mm. Future studies are necessary to correlate the fissure types successfully proposed in the surgical ganglion pterygopalatinum approach.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Radiological anatomy assessment of the fissura pterygomaxillaris for a surgical approach to ganglion pterygopalatinum

et al. 2017

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An anatomic study using three‐dimensional reconstruction for pterygopalatine fossa infiltration via the greater palatine canal

et al. 2011

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The pterygopalatine fossa (PPF) is accessed via the greater palatine canal (GPC) in an attempt to reduce bleeding during paranasal sinus surgery. This study aims to investigate the anatomy of the greater palatine foramen (GPF), GPC, and the PPF, with reference to PPF infiltration using three-dimensional reconstruction of computer tomographic (CT) scan measurements. The CT scans of 50 patients were retrospectively evaluated. The morphology of the GPF, GPC, and the PPF was assessed in a three-dimensional model. The thickness of the mucosa over the GPF was evaluated in the parasagittal plane. The mean length of the GPC was 13.8 ± 2.0 mm, and the mean height of the PPF was 21.0 ± 3.4 mm. The mean angles of the GPC in relation to the hard palate and the PPF were 67.4° ± 6.9° and 159.8° ± 7.1°, respectively. The GPF was 16.2 ± 1.3 mm lateral to the sagittal plane of the posterior nasal spine (PNS) and 6.1 ± 1.7 mm anterior to the coronal plane of the PNS. The mean volume of the PPF was 1039.9 ± 280.0 mm(3) . The mean thickness of the mucosa overlying the GPF was 10.7 ± 1.8 mm. We recommend that the PNS may be used as the bony landmark to locate the position of the GPF during PPF infiltration. The needle delivering the anesthetic should be bent 25 mm from the tip at a 45° angle, and a 1-ml injection of anesthetic should be administered in adults.

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Automatic pterygopalatine fossa segmentation and localisation based on DenseASPP

Wang,

Shi

2024

Robotics Computer Surgery

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BackgroundAllergic rhinitis constitutes a widespread health concern, with traditional treatments often proving to be painful and ineffective. Acupuncture targeting the pterygopalatine fossa proves effective but is complicated due to the intricate nearby anatomy.MethodsTo enhance the safety and precision in targeting the pterygopalatine fossa, we introduce a deep learning‐based model to refine the segmentation of the pterygopalatine fossa. Our model expands the U‐Net framework with DenseASPP and integrates an attention mechanism for enhanced precision in the localisation and segmentation of the pterygopalatine fossa.ResultsThe model achieves Dice Similarity Coefficient of 93.89% and 95% Hausdorff Distance of 2.53 mm with significant precision. Remarkably, it only uses 1.98 M parameters.ConclusionsOur deep learning approach yields significant advancements in localising and segmenting the pterygopalatine fossa, providing a reliable basis for guiding pterygopalatine fossa‐assisted punctures.

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Anatomical study of the pterygopalatine fossa pertinent to the maxillary nerve block at the foramen rotundum

Cited by 33 publications

References 6 publications

Radiological anatomy assessment of the fissura pterygomaxillaris for a surgical approach to ganglion pterygopalatinum

Radiological anatomy assessment of the fissura pterygomaxillaris for a surgical approach to ganglion pterygopalatinum

An anatomic study using three‐dimensional reconstruction for pterygopalatine fossa infiltration via the greater palatine canal

Automatic pterygopalatine fossa segmentation and localisation based on DenseASPP

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