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Pterygopalatine nerve

Alexander P Marston, Glenn Merritt, Jonathan M Morris, Shelagh A Cofer
OBJECTIVES: The suprazygomatic maxillary nerve block is associated with improved post-operative pain management after select craniofacial surgical procedures. This study's objective is to better define the impact of pediatric facial skeletal growth on techniques for accessing the pterygopalatine fossa (PPF). METHODS: Pediatric patients with prior thin-slice maxillofacial computed tomography imaging were identified in an institutional radiology database. Aquarius image-processing software (Ver...
February 2018: International Journal of Pediatric Otorhinolaryngology
Olivier Mauvais, Cécile Badet, Laetitia Lestrade, Laurent Tavernier
Primitive tumors of pterygopalatine fossa (PPF) are often benign tumors or extension of a malignant sinonasal tract. Primitive tumors may rarely occur in PPF.The authors present a 71-year-old woman with a 6-month history of left cranial nerve palsy. Magnetic resonance imaging and positron emission tomography-computed tomography showed an enhancing isolated lesion at the PPF. A transmaxillary biopsy was performed, leading to diagnosis of primitive squamous cell carcinoma. The patient underwent radiotherapy treatment...
February 7, 2018: Journal of Craniofacial Surgery
Xinjie Bao, Xiangyi Kong, Chengxian Yang, Huanwen Wu, Wenbin Ma, Renzhi Wang
Malignant peripheral nerve sheath tumor (MPNST) is an uncommon neoplasm that rarely involves the head and neck region. Intracranial MPNSTs unrelated to cranial nerves are highly malignant tumors with poor overall survival, probably because of infiltrating growth into surrounding brain tissue. The pathogenesis of MPNST remains unclear. There are no conclusive explanations for the mechanisms underlying the initiation, progression, and metastasis of MPNST. In this paper, we describe a case of MPNST in the pterygopalatine fossa with intracranial metastatic recurrence and review related literatures...
January 2018: Medicine (Baltimore)
Lu Yang, Li Hu, Weidong Zhao, Huankang Zhang, Quan Liu, Dehui Wang
BACKGROUND: The anatomical locations involved in trigeminal schwannomas (TSs) are quite complex. The endoscopic endonasal approach provides a minimal damage access corridor to both anterior and middle skull base for surgery. Given the nerve function recovery and postoperative neurological deterioration varied in different reports, the author demonstrates his surgery tips and the functional outcomes under endoscopic surgery in one single institution. METHODS: A retrospective review of patients with TSs was undertaken to assess the outcome of endoscopic surgery from 2006 to 2016...
March 2018: European Archives of Oto-rhino-laryngology
Usama Hagag, Mohamed G Tawfiek
OBJECTIVES: To describe the 'blind' and ultrasound-guided approaches to block the maxillary nerve in donkeys. To compare the success and complication rates between the 'blind' and ultrasound-guided techniques based on staining of nerves and other structures in cadavers and assessing level of analgesia in live animals. STUDY DESIGN: Prospective anatomical and experimental study. ANIMALS: Eighteen cadaver heads and nine adult live donkeys. METHODS: Phase 1: the anatomical characteristics of the maxillary nerve and its related structures were investigated within the pterygopalatine fossa in five cadavers...
January 2018: Veterinary Anaesthesia and Analgesia
Jan Plzák, Vít Kratochvil, Adam Kešner, Pavol Šurda, Aleš Vlasák, Eduard Zvěřina
OBJECTIVES: Access to the pterygopalatine fossa is very difficult due to its complex anatomy. Therefore, an open approach is traditionally used, but morbidity is unavoidable. To overcome this problem, an endoscopic endonasal approach was developed as a minimally invasive procedure. The surgical aim of the present study was to evaluate the utility of the endoscopic endonasal approach for the management of both benign and malignant tumors of the pterygopalatine fossa. METHOD: We report our experience with the endoscopic endonasal approach for the management of both benign and malignant tumors and summarize recent recommendations...
October 2017: Clinics
Edyta Dzięciołowska-Baran, Aleksandra Gawlikowska-Sroka
A 60-year-old woman, otherwise in a good health condition, was first admitted to the hospital with a year-long tingling sensations of the right half of the face, which gradually turned into severe neuralgia corresponding to maxillary (V2) and mandibular (V3) branches of the right trigeminal nerve. MRI scans of the head revealed an unusual hyperplastic or inflammatory changes along the brain base, cavernous sinus extending toward the pterygopalatine fossa, and lateral pterygoid on the right side. Meningioma was suspected and neuralgia was treated conservatively...
September 10, 2017: Advances in Experimental Medicine and Biology
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...
September 2017: Journal of Craniofacial Surgery
Kumar Abhinav, David Panczykowski, Wei-Hsin Wang, Carl H Synderman, Paul A Gardner, Eric W Wang, Juan C Fernandez-Miranda
BACKGROUND: The maxillary nerve (V2) can be approached via the open middle fossa approach. OBJECTIVE: To delineate the anatomy of V2 and its specific segments with respect to the endonasal landmarks. We present the endoscopic endonasal interdural middle fossa approach to V2 and its potential application for the treatment of perineural spread in sinonasal/skull base tumors. METHODS: Five human head silicon-injected specimens underwent bilateral endoscopic endonasal transpterygoid approaches...
August 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
Kristen M Fizzano, Andrew K Claude, Lan-Hsin Kuo, Jeffrey B Eells, Simone B Hinz, Brittany E Thames, Matthew K Ross, Robert L Linford, Robert W Wills, Alicia K Olivier, Todd M Archer
OBJECTIVE To determine whether a maxillary nerve block via a modified infraorbital approach, applied before rhinoscopy and nasal biopsy of dogs, would decrease procedural nociception, minimize cardiorespiratory anesthetic effects, and improve recovery quality. ANIMALS 8 healthy adult hound-type dogs PROCEDURES In a crossover study, dogs received 0.5% bupivacaine (0.1 mL/kg) or an equivalent volume of saline (0.9% NaCl) solution as a maxillary nerve block via a modified infraorbital approach. A 5-cm, 20-gauge over-the-needle catheter was placed retrograde within each infraorbital canal, and bupivacaine or saline solution was administered into each pterygopalatine region...
September 2017: American Journal of Veterinary Research
Mei Chen Liu, Xiao Rui Yin, Yi Shui Zhang, Wen Yang, Han Wen Zhang, Hao Bo Duan, Jian Ming Liu, Kai Liang Cheng, You Qiong Li
With the development of endoscopic technique, Caldwell-Luc approach has more wide applications and becomes a common method of pterygopalatine fossa (PPF) surgery. Few data can be used in this approach to avoid injuring the vessels and nerves within this area. In this study, the authors used computed tomography to get the coordinates of inferior orbital fissure, foramen rotundum, sphenopalatine foramen, internal opening of pterygoid canal, the strangulation of PPF, and the greater palatine foramen with canine fossa as the origin...
September 2017: Journal of Craniofacial Surgery
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...
July 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
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