Anatomical study of the pterygopalatine fossa using an endoscopic endonasal approach: spatial relations and distances between surgical landmarks.
OBJECTIVE
The pterygopalatine fossa is an area that lies deep within the skull base. The recent extensive use of the endoscopic endonasal approach has provided neurosurgeons with a method to reach various areas of the skull base through a less invasive approach than traditional transcranial or transfacial approaches. This study aims to provide neurosurgeons with new data concerning direct endoscopic measurements and precise anatomical topography features of the pterygopalatine fossa.


METHODS
An anatomical dissection of six fixed cadaver heads (12 pterygopalatine fossae) was performed to analyze spatial relationships and distances between the most important neurovascular structures in this region, and to estimate the size of the endoscopic surgical field for operations in this area. The endoscopic endonasal approach offers direct access to the pterygopalatine fossa through its anteromedial walls.


CONCLUSIONS
Using an endoscopic endonasal approach makes it possible to identify all of the anatomical landmarks of the pterygopalatine fossa and almost all of the contiguous skull base areas.
Solari
Domenico
D
Department of Neurological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, Naples, Italy.
Magro
Francesco
F
Cappabianca
Paolo
P
Cavallo
Luigi M
LM
Samii
Amir
A
Esposito
Felice
F
Paternò
Vincenzo
V
De Divitiis
Enrico
E
Samii
Madjid
M
D000328:Adult; D001837:Body Weights and Measures; D002102:Cadaver; D004210:Dissection; D004724:Endoscopy; D006801:Humans; D008443:Maxillary Sinus / Q000033:anatomy & histology; D009296:Nasal Cavity / Q000601:surgery; D021362:Palate, Hard / Q000098:blood supply* / Q000294:innervation*; D011626:Pterygoid Muscles / Q000033:anatomy & histology; D019291:Skull Base / Q000098:blood supply* / Q000294:innervation*