title: The pterygopalatine fossa: imaging anatomy, communications, and pathology revisited.
abstract: The pterygopalatine fossa (PPF) is a small, clinically inaccessible, fat-filled space located in the deep face that serves as a major neurovascular crossroad between the oral cavity, nasal cavity, nasopharynx, orbit, masticator space, and the middle cranial fossa. Due to its inherent complex location and connections, it can potentially act as a natural conduit for the spread of inflammatory and neoplastic diseases across the various deep spaces in the head and neck. This review aims to acquaint the reader with the imaging anatomy of the PPF, its important communications, and to identify some major pathological conditions that can involve the PPF, especially in conditions where its involvement can have serious diagnostic and therapeutic implications, such as in perineural tumour spread.
  
  
  CONCLUSIONS
  • The PPF is a small neurovascular junction in the deep face with important to-and-fro connections. • Awareness of anatomy of the PPF and its communications helps to simplify imaging of its pathology. • Perineural tumour spread is clinically the most important pathology in this region.
authors.affiliation: Department of Diagnostic Radiology, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore.
authors.forename: Sonam
authors.initials: S
authors.lastname: Tashi
authors.affiliation: Department of Neuroradiology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore. purohitbela@yahoo.co.in.
authors.forename: Bela S
authors.initials: BS
authors.lastname: Purohit
authors.affiliation: Department of Imaging, Division of Radiology, Geneva University Hospital, Rue Gabrielle Perret Gentil 4, 1211, Geneva 14, Switzerland.
authors.forename: Minerva
authors.initials: M
authors.lastname: Becker
authors.affiliation: Department of Diagnostic Radiology, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore.
authors.forename: Pravin
authors.initials: P
authors.lastname: Mundada
keywords: CT; MRI; Perineural tumour spread; Pterygopalatine fossa