Wang Yunfeng, Sui Jun, Li Xiaojiang, Ma Jing
Department of Otoneurology and Skull Base Surgery, Eye and ENT Hospital of Fudan University, Shanghai.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2007 Oct;21(19):869-72.
To provide morphologic data for the operation of pterygopalatine fossa (PPF) region by measuring the bony landmarks and dissecting vessel and nerve.
The shape, size and adjacent important structures of PPF were observed in 20 dry skulls (forty sides). Ten (twenty sides) skulls were fixed in 4% paraformaldehyde and their arteries were perfused with red lacteprene. The pterygopalatine fossa was exposed from the middle sagittal section dissected to inner wall of maxillary sinus and PPF and observed the course of trigeminal nerve and arteria maxillaris under the operating microscope. To investigate the related surgical anatomy approaches of the maxillary sinus and pterygopalatine fossa.
The pterygopalatine fossa shows a long and narrow cleft. PPF communicate with nasal cavity, oral cavity, pharynx, orbit, infratemporal fossa and middle cranial fossa. The pterygopalatine segment of maxillary artery and accompanying vein, the maxillary nerve and sphenopalatine ganglion are the most important structures. There are two layers of tissue in the pterygopalatine fossa, they are nervous layer and vessel layer.
(1) To deal with lesion, the approach of maxillary sinus can de used, the cross point of the upper wall, the inner wall and the back wall can be thought as important landmark. (2) Safe scope could be acquired in endoscopic transnasal surgery in pterygopalatine fossa, pterygoid canal and foramen rotundum could be thought as an important landmark.
通过测量翼腭窝（PPF）区域的骨性标志并解剖血管和神经，为翼腭窝区域手术提供形态学资料。
观察20个干燥颅骨（40侧）翼腭窝的形态、大小及毗邻重要结构。将10个（20侧）颅骨固定于4%多聚甲醛中，经动脉灌注红色乳胶。从矢状中剖面切开至上颌窦内壁暴露翼腭窝，在手术显微镜下观察三叉神经及上颌动脉走行。探讨上颌窦与翼腭窝相关手术解剖入路。
翼腭窝呈狭长裂隙状。翼腭窝与鼻腔、口腔、咽、眶、颞下窝及中颅窝相通。上颌动脉翼腭段及其伴行静脉、上颌神经及蝶腭神经节为最重要结构。翼腭窝内有两层组织，即神经层和血管层。
（1）处理病变时可采用上颌窦入路，上颌窦上壁、内壁及后壁的交点可作为重要标志。（2）翼腭窝内镜经鼻手术可获得安全范围，翼管及圆孔可作为重要标志。
