Slavin M L, Abramson A L
J Clin Neuroophthalmol. 1986 Dec;6(4):254-7.
A patient developed sensory disturbance and pain in the distribution of the maxillary nerve several months after removal of a statedly benign cutaneous malar lesion. One year later, abducens palsy developed, and computed tomography showed a mass of the pterygopalatine fossa abutting on the superior nasopharynx. Results of examination and multiple biopsies of the nasopharynx were normal. Direct biopsy of the pterygopalatine fossa via a transmaxillary sinus approach revealed squamous cell carcinoma. Extension of malignancy from the adjacent nasopharynx (not detected on biopsy) or sphenoid sinus and perineural spread of an undiagnosed cutaneous squamous cell carcinoma along the maxillary nerve were considered as possibilities. The anatomy of the pterygopalatine fossa and its environs is reviewed with respect to clinical signs of second division trigeminal neuropathy, abducens palsy and diminished ipsilateral tearing.
一名患者在切除一处据称是良性的面部皮肤病变数月后，出现了上颌神经分布区域的感觉障碍和疼痛。一年后，出现展神经麻痹，计算机断层扫描显示翼腭窝有一肿块，紧邻鼻咽上部。鼻咽部的检查结果和多次活检均正常。通过经上颌窦途径对翼腭窝进行直接活检，发现为鳞状细胞癌。考虑到可能是恶性肿瘤从相邻的鼻咽部（活检未检测到）或蝶窦扩展而来，也可能是未被诊断出的皮肤鳞状细胞癌沿上颌神经发生神经周围扩散。本文结合三叉神经第二支神经病变、展神经麻痹及同侧流泪减少的临床体征，对翼腭窝及其周围的解剖结构进行了综述。
