Objective: In the infratemporal region, the ossified inter, pterygoid muscle, fascia becomes the foremost bony cause of a lancinating pain (trigeminal neuralgia), due to the entrapment or compression of the mandibular nerve or its branches. Main bony offenders have to be diagnosed radiologically in day to day practice.
Materials and Methods:One hundred and fifty eight dry macerated skulls of north Indian origin were studied to identify the presence of these ossified components named "the pterygospinous and pterygoalar bars and the enclosed foramina". The skulls showing these bars were subjected to different radiographic views to find out which one exhibited them clearly.
Results:The infratemporal region showed additional bony bars and foramina as incomplete pterygospinous bars in 12 cases (7.69%), unilaterally in 7 cases 4.48% (3 right-sided -1.92%, 4 left-sided -2.56%) and bilaterally in 5 cases 3.20% , complete in 2 cases (1.28%); the pterygoalar bars partial in 2 skulls (1.28%) but a complete bar was not seen. Radiologically these bars were found to be best visualized in the Hirtz axial view with 10-20 0 headward tube tilt. Whether these bars in a given patient of trigeminal neuralgia are the causative factor or not, can best be demonstrated in radiograph of the skull in this view.
Conclusion:Proper treatment for neuralgia can be well planned after assigning the cause and then tackling it by percutaneous trigeminal ganglion neurolysis under proper radiographic visualization.