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Pterygopalatine fossa

The pterygopalatine fossa (PPF) is a small but complex space of the deep face in the shape of an inverted pyramid located between the maxillary bone anteriorly, the pterygoid process posteriorly and inferior to the orbital apex. It is quite important as it is a neurovascular crossroad of the nasal cavity, masticator space, orbit, oral cavity and middle cranial fossa.

Gross anatomy

Borders

The walls of the PPF are as follows:

medial: perpendicular plate of the palatine bone
lateral: narrowing to the pterygomaxillary fissure
anterior: posterior wall of the maxillary sinus
posterior: medial and lateral pterygoid plates; inferior aspect of lesser wing of sphenoid bone
roof: incompletely formed by the greater wing of the sphenoid bone; inferior orbital fissure
floor: narrowing to palatine canals; pyramidal process of the palatine bone

Communications

The PPF is an important pathway for the spread of neoplastic and infectious processes:

medially: communicates with the nasal cavity via the sphenopalatine foramen, which transmits the sphenopalatine artery, the nasopalatine nerve and the posterior superior nasal nerves

laterally: communicates with the masticator space (or infratemporal fossa) via the pterygomaxillary fissure

anteriorly: communicates with the orbit via the inferior orbital fissure (superiorly)

posteriorly and superiorly: communicates with the Meckel cave and cavernous sinus (of the middle cranial fossa) via the foramen rotundum
posteriorly and inferiorly: communicates with the middle cranial fossa via the vidian canal, which transmits the Vidian nerve
posteriorly and medially: the palatovaginal canal transmits the pharyngeal nerve and the pharyngeal branch of maxillary artery to the nasopharynx

inferiorly: communicates with the palate via the greater and lesser palatine canals ,often these canals arise from the one canal, referred to as either the greater palatine canal or the pterygopalatine canal

Contents

The PPF contains:

pterygopalatine ganglion
descending palatine artery branch of the maxillary artery
maxillary division of trigeminal nerve : enters via foramen rotundum
nerve of the pterygoid canal

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