Pterygopalatine

Pterygopalatine refers to the pterygopalatine region of the face, most notably the pterygopalatine fossa (also called the sphenopalatine fossa) and the neural and vascular structures associated with it. The fossa is a small, cone-shaped space located in the deep face, posterior to the maxillary sinus, bounded medially by the perpendicular plate of the palatine bone and laterally by the maxilla, with the sphenoid bone and pterygoid plates forming its posterior relations. It communicates with the orbit through the inferior orbital fissure, with the nasal cavity through the sphenopalatine foramen, with the oral cavity via the greater and lesser palatine canals, and with the nasopharynx via the pharyngeal canal; it also has connections with the middle cranial fossa via the foramen rotundum.

Contents of the pterygopalatine fossa include the pterygopalatine ganglion (sphenopalatine ganglion), suspended from the maxillary nerve (V2). The fossa houses the maxillary nerve and its branches, such as the zygomatic nerve, and arterial elements from the maxillary artery, notably the sphenopalatine artery and branches to the palate and nasal cavity. The nerve of the pterygoid canal (carrying preganglionic parasympathetic and postganglionic sympathetic fibers) enters the ganglion from the middle cranial fossa.

Branches arising in this region supply the nasal cavity (posterior superior nasal nerves, including the nasopalatine nerve), the palate (greater and lesser palatine nerves), and the pharyngeal region. Functionally, the pterygopalatine ganglion provides parasympathetic secretomotor innervation to the lacrimal gland and to nasal mucosa, via hitchhiking fibers through the zygomatic nerve to the lacrimal nerve. Clinically, the area is relevant for maxillary nerve anesthesia, spreading infections, or neoplasms affecting adjacent structures.