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Pterygopalatine nerve

Xin Zhang, Halima Tabani, Ivan El-Sayed, Matthew Russell, Xuequan Feng, Arnau Benet
BACKGROUND: Surgical access to Meckel's Cave (MC) is challenging due to its deep location and surrounding important neurovascular structures. Currently existing endoscopic endonasal (EE) approaches require dissecting near the internal carotid artery (ICA) or require transposition of the pterygopalatine neurovascular bundle. OBJECTIVE: To describe a novel approach to access the anterolateral aspect of the MC using a minimally invasive EE route. METHODS: The EE transmaxillary transinferior orbital fissure approach was simulated in 10 specimens...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
Kei Ijichi, Masahiro Muto, Ayako Masaki, Shingo Murakami
Plexiform schwannoma (PS) is a rare variety of benign nerve sheath tumor characterized by a multinodular plexiform growth pattern. PS is usually confined to the head and neck or skin. The pre-operative diagnosis of PS is difficult, and this has lead to a common misdiagnosis as a schwannoma. In addition, studies have indicated that an incomplete resection of PS often results in tumor recurrence. Here we describe a rare case of PS presented in the parapharyngeal space. Our case involved a 36-year-old man with swelling of the pharynx, who presented with a soft cervical mass...
May 6, 2017: Auris, Nasus, Larynx
S Carrier, B Castagneyrol, L Beylacq, K Nouette-Gaulain, M Montaudon, M Laurentjoye
INTRODUCTION: The aim of this study was to describe the anatomical landmarks for maxillary nerve block in the pterygopalatine fossa. The risk of injury to the skull base and maxillary artery was assessed. METHODS: This retrospective study was based on the analysis of 61 consecutive computed tomography angiographies obtained from patients suffering from different pathologies. Anatomical relationships between optic canal (OC), foramen rotundum (FR), inferior orbital fissure (IOF) and puncture point (PP) were assessed...
April 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
Shilpee Bhatia Sharma, Trichy Narayanan Janakiram, Hina Baxi, Balamurugan Chinnasamy
Juvenile nasopharyngeal angiofibroma is a locally aggressive benign tumour which has propensity to erode the skull base. The tumour spreads along the pathways of least resistance and is in close proximity to the extracranial part of trigeminal nerve. Advancements in expanded approaches for endoscopic excision of tumours in infratemporal fossa and pterygopalatine fossa increase the vulnerability for the trigeminocardiac reflex. The manipulation of nerve and its branches during tumour dissection can lead to sensory stimulation and thus inciting the reflex...
March 21, 2017: European Archives of Oto-rhino-laryngology
Masataka Uehara, Masaaki Sasaguri, Shunji Shiiba, Kazuhiro Tominaga
Oral cancer, especially that originates in the maxillary tuberosity, buccal mucosa, and maxillary alveolus, is apt to invade the pterygopalatine fossa, where an intraoral approach is nearly impossible. There are 2 main types of extraoral approach to the pterygopalatine fossa; the anterior approach and the lateral approach. Although the lateral approach has an advantage compared with the anterior approach in terms of cosmetics, after the operation numbness of the lower lip occurs due to the sacrifice of the mental nerve...
June 2017: Journal of Craniofacial Surgery
Li Gao, Lei Zhou, Zhengshou Dai, Xinsheng Huang
PURPOSE: The authors studied the anatomic importance of the endoscopic prelacrimal recess approach (PLRA) to the pterygopalatine fossa (PPF) and infratemporal fossa (ITF). METHODS: Ten adult heads (20 sides) from cadavers fixed in formalin were dissected using the PLRA. Anatomic dissections were detailed and several crucial landmarks measured. RESULTS: Identification of the infraorbital neurovascular bundle is the crucial step for the detection of other branches of the maxillary artery...
January 18, 2017: Journal of Craniofacial Surgery
Georges Aoun, Ibrahim Nasseh, Sayde Sokhn
AIM: The aim of this study was to describe the morphology of the component, greater palatine canal-pterygopalatine fossa (GPC-PPF), in a Lebanese population using cone-beam computed tomography (CBCT) technology. MATERIALS AND METHODS: CBCT images of 79 Lebanese adult patients (38 females and 41 males) were included in this study, and a total of 158 cases were evaluated bilaterally. The length and path of the GPCs-PPFs were determined, and the data obtained analyzed statistically...
2016: Journal of Clinical Imaging Science
Pierre R Bourque, Gabrielle Bourque, William Miller, John Woulfe, Jodi Warman Chardon
Perineural invasion is a targeted cellular proliferation guided by neurotrophins, rather than a simple diffusion of tumor in a path of least resistance. Invasion of cranial nerves by squamous cell carcinoma can represent an important diagnostic dilemma. It commonly presents as a distinct clinical neurological syndrome of combined isolated trigeminal and facial neuropathies. The focal cancer source may have been overlooked or remain occult. This case series illustrates diverse clinical presentations and neuroimaging challenges in four patients with squamous cell carcinoma of the cranial nerves...
January 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
A Zoghlami, N Bon Mardion, F Callonnec, D Dehesdin, F Proust, J-P Marie
INTRODUCTION: Skull base meningoencephaloceles are rare congenital malformations. The two cases of transalar transsphenoidal malformation reported here differ from the classical transsphenoidal meningoencephalocele. CASE REPORTS: Case 1 was a three-and-a-half-year-old boy and case 2 was a 36-year-old man. Both cases presented with clinical features of recurrent meningitis. Surgical management of case 1 was performed via an intradural infratemporal fossa craniotomy with reoperation 2years later...
December 2016: European Annals of Otorhinolaryngology, Head and Neck Diseases
Taro Takanami, Yasushi Ota, Mitsuya Suzuki
A 57-year-old woman presented to our department with a 2-month history of pain and paresthesia on the left side of the face 12 years after having undergone surgery for breast cancer. We performed an endoscopic biopsy and diagnosed metastatic breast cancer to the pterygopalatine fossa. There has been no recurrence for two years since the metastatic tumor was treated by radiation therapy. A literature search shows only one case of metastatic breast cancer with severe trigeminal neuralgia located in the V2 division of the trigeminal nerve area...
February 2017: Auris, Nasus, Larynx
Li Gao, Xinsheng Huang
As an important landmark, the posterolateral wall of maxillary sinus can help to locate numbers of significant signs such as maxillary artery and its branches, maxillary nerve and infraorbital nerve, infratemporal fossa and pterygopalatine fossa etc. in the endoscopic surgery for paranasal sinuses and lateral skull base. This article reviewed related researches about the anatomy and endoscopic surgery of posterolateral wall of maxillary sinus.
December 2015: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Malgorzata Radzimirska, Krystyna Bogus-Nowakowska, Tadeusz Kuder, Anna Robak
INTRODUCTION: Cocaine- and amphetamine-regulated transcript (CART), neuropeptide Y (NPY) and galanin (GAL) act as neurotransmitters and neuromodulators in both the central and peripheral nervous systems. Their presence has been found in different taxonomic groups, in particular in mammals. However, only few investigators have studied these neuropeptides in the class Aves (birds). The aim of the present study was to describe the distribution of CART, NPY and GAL in the pterygopalatine ganglion (PPG) of the domestic duck (Anas platyrhynchos f...
2016: Folia Histochemica et Cytobiologica
Ali M Elhadi, Hasan A Zaidi, Kaan Yagmurlu, Shah Ahmed, Albert L Rhoton, Peter Nakaji, Mark C Preul, Andrew S Little
OBJECTIVE Endoscopic transmaxillary approaches (ETMAs) address pathology of the anterolateral skull base, including the cavernous sinus, pterygopalatine fossa, and infratemporal fossa. This anatomically complex region contains branches of the trigeminal nerve and external carotid artery and is in proximity to the internal carotid artery. The authors postulated, on the basis of intraoperative observations, that the infraorbital nerve (ION) is a useful surgical landmark for navigating this region; therefore, they studied the anatomy of the ION and its relationships to critical neurovascular structures and the maxillary nerve (V2) encountered in ETMAs...
December 2016: Journal of Neurosurgery
Jianfeng Liu, Jun Han, Dazhang Yang, Dandan Liu, Rui Li, Yanbing Yu, Qiuhang Zhang, Juan C Fernandez Miranda, Paul A Gardner, Carl H Snyderman
OBJECTIVE: To identify the landmarks of transpterygoid approach and to report its application in a series of cases. METHODS: Two silicon-injected adult cadaveric heads(4 sides) were dissected by performing an endoscopic endonasal transpterygoid approach after CT scanning for imaging guidance. High-quality pictures were obtained. This approach was used to treat twelve patients with skull base lesions including 3 spontaneous cerebrospinal fluid (CSF) leaks in the lateral recess of the sphenoid sinus, 2 neurofibromas and 2 Schwannomas involving the pterygopalatine fossa and infratemporal fossa, 1 dermoid cyst involving the middle fossa and infratemporal fossa, 1 invasive fungal sinusitis invading the middle fossa base, 1 basal cell adenoma in the upper parapharyngeal space, 1 chondrosarcoma in the parasellar region and 1 adenoid cystic carcinoma...
November 2015: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
Arsani William, Tej Deepak Azad, Eliezer Brecher, Taissa Cherry, Ivan Bernstein, Diana M Bruce, Stacey Rohrer, Zachary Smith, Mary William, Eric Sabelman, Gary Heit, Patrick Pezeshkian, Mark Sedrak
INTRODUCTION: Facial pain is often debilitating and can be characterized by a sharp, stabbing, burning, aching, and dysesthetic sensation. Specifically, trigeminal neuropathic pain (TNP), anesthesia dolorosa, and persistent idiopathic facial pain (PIFP) are difficult diseases to treat, can be quite debilitating and an effective, enduring treatment remains elusive. METHODS: We retrospectively reviewed our early experience with stimulation involving the trigeminal and sphenopalatine ganglion stimulation for TNP, anesthesia dolorosa, and PIFP between 2010-2014 to assess the feasibility of implanting at these ganglionic sites...
March 2016: Acta Neurochirurgica
Jie Gao, Tao Pan, Qianyan He, Yuhao Zhao, Li Li, Mushui Qiu, Hao Qu, Jingyi Shi, Sirui Wang, Kailiang Cheng, Youqiong Li
OBJECTIVE: This study aimed to ascertain the safe range from foramen rotundum to the siphon of internal carotid artery using three-dimensional reconstruction technique. METHODS: We scanned skulls of 121 volunteers to get the final results with thin-section computed tomographic image. RESULTS: The distance of AC was measured as 13.22 (3.79) mm (range, 8.33-105.67 mm; 95% CI [confidence interval], 8.55-21.39 mm). The angle to the sagittal plane was measured as 33...
October 2015: Journal of Craniofacial Surgery
Y Brand, E Lim, V Waran, N Prepageran
BACKGROUND: Endoscopic endonasal techniques have recently become the method of choice in dealing with cerebrospinal fluid leak involving the anterior cranial fossa. However, most surgeons prefer an intracranial approach when leaks involve the middle cranial fossa. This case report illustrates the possibilities of using endoscopic techniques for cerebrospinal fluid leaks involving the middle fossa. CASE REPORT: A 37-year-old male patient presented with multiple areas of cranial defect with cerebrospinal fluid leak due to osteoradionecrosis following radiation for nasopharyngeal carcinoma 4 years earlier...
December 2015: Journal of Laryngology and Otology
Alistair R M Cobb, Michael Vourvachis, Jahangir Ahmed, Michelle Wyatt, David Dunaway, Richard Hayward
BACKGROUND: Patients with syndromic forms of craniosynostosis may experience functional problems such as raised intracranial pressure, proptosis, obstructive sleep apnoea and failure to thrive. The monobloc fronto-facial advancement with osteogenic distraction is increasingly used to correct these functional problems in one procedure as well as improve appearance. The authors report the phenomenon of post operative aberrant facial flushing - an unusual and previously unreported complication of the procedure...
October 2015: Journal of Cranio-maxillo-facial Surgery
Shaan M Raza, Muhamad A Amine, Vijay Anand, Theodore H Schwartz
The surgical management of trigeminal schwannomas (TNs) entails the use of a variety of cranial base approaches for their effective surgical management. Although an extended middle fossa or posterior petrosal approach may be more appropriate for disease with primarily posterior fossa involvement, the expanded endoscopic approaches are suited for tumors with predominately middle fossa and/or extracranial involvement along the V2 and V3 divisions and limited posterior fossa extension. The endoscopic endonasal resection of TNs within the middle fossa, pterygopalatine fossa, and infratemporal fossa is reviewed in this article with a brief discussion of reported outcomes...
July 2015: Neurosurgery Clinics of North America
R Claire Aland, Vivien Shaw
We describe an anatomical variation of the right maxillary artery. The variation loops deep, giving off a middle meningeal artery with an extremely short extracranial segment, then bifurcates into unequal branches. The smaller branch passes superficial to the lateral pterygoid head and distributes primarily to the masticatory muscles. The larger partially pierces the lateral pterygoid lower head, re-emerges superficially, branches again and passes into the pterygopalatine fossa. The larger lies superficial to the lingual and inferior alveolar nerves and deep to the buccal nerve...
March 2016: Anatomical Science International
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