Natsis Konstantinos, Piagkou Maria, Skotsimara Georgia, Totlis Trifon, Apostolidis Stylianos, Panagiotopoulos Nikitas-Apollon, Skandalakis Panagiotis
Department of Anatomy (Head: K. Natsis), Medical School, Aristotle University of Thessaloniki, Post Box 300, 54124 Thessaloniki, Greece.
Department of Anatomy (Head: P. Skandalakis), Medical School, National and Kapodistrian University of Athens, M. Asias 75, 11527 Athens, Greece.
J Craniomaxillofac Surg. 2014 Jul;42(5):e266-70. doi: 10.1016/j.jcms.2013.10.003. Epub 2013 Nov 1.
Mandibular nerve entrapment has great significance, as it may be responsible for the appearance of several neurological pathologies, such as chewing disorders, taste loss, facial or tongue paraesthesia and neuralgia. The ossified pterygoalar (Pta) bar is the result of calcification and/or ossification of the ligament extending from the pterygospinous process of the lateral pterygoid lamina to the infratemporal surface of the sphenoid bone. The ossified bar may act as the cause for this entrapment. One hundred and forty-five Greek adult dry skulls were examined for the existence of a complete or incomplete Pta bar and a relative foramen. The Pta bar appeared in 31.7% of the skulls, in total, in 4.1% completely and in 27.6% incompletely ossified. The mean sagittal and transverse diameters of Pta foramen were 3.21 ± 1.70 and 4.79 ± 1.39 mm, respectively. There was no statistical significant difference between the presence of Pta bar and the side or gender. Apart from the neurological interest, this study highlights the importance of the existence of Pta bar in neurosurgery, anaesthesiology, oral and maxillofacial surgery. The passage of the needle through the foramen ovale for the injection of anaesthetics, as a treatment for trigeminal neuralgia may not be achieved due to this anatomical obstacle. In this case, intra- or postoperative radiologic investigation may be helpful.
下颌神经卡压具有重要意义，因为它可能是多种神经病变出现的原因，如咀嚼障碍、味觉丧失、面部或舌部感觉异常以及神经痛。翼突钩骨化条（Pta条）是从翼外侧板翼棘突延伸至蝶骨颞下面的韧带钙化和/或骨化的结果。骨化条可能是导致这种卡压的原因。对145个希腊成人干燥颅骨进行检查，以确定是否存在完整或不完整的Pta条及相关孔道。Pta条在31.7%的颅骨中出现，其中完全骨化的占4.1%，不完全骨化的占27.6%。Pta孔的矢状径和横径平均值分别为3.21±1.70毫米和4.79±1.39毫米。Pta条的存在与侧别或性别之间无统计学显著差异。除了神经学方面的意义外，本研究还强调了Pta条在神经外科、麻醉学、口腔颌面外科中的重要性。由于这一解剖学障碍，通过卵圆孔注射麻醉剂治疗三叉神经痛时，可能无法将针穿过该孔道。在这种情况下，术中和术后的影像学检查可能会有所帮助。
