Pterygopalatine fossa

Last revised by Reuben Schmidt on 22 Oct 2023

The pterygopalatine fossa (PPF), less commonly known as the sphenopalatine fossa, 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 orbital apex superiorly 8. Its importance lies as the neurovascular crossroad of the nasal cavity, masticator space, orbit, oral cavity, and middle cranial fossa

The walls of the pterygopalatine fossa are as follows:

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

The pterygopalatine fossa contains fat and the following neurovascular structures:

  • thin slice (<1 mm) bone algorithm reconstruction of non-contrast axial sections is the best approach to image the bony walls of the pterygopalatine fossa 4 (see attached diagram)

  • appears as a narrow cleft situated between the posterior wall of the maxillary sinus and the pterygoid plates 5

  • T1W non-contrast axial images are the best approach for imaging the pterygopalatine fossa due to high fat-content 4,5

  • contrast-enhanced images should also be acquired, as these are the best for evaluating the deep face 4

    • mild post-contrast enhancement is normal due to the presence of small emissary veins 5

  • may be obscured by susceptibility artifact in the following situations:

    • "blooming" at the air-tissue interface between the maxillary sinus, which is a direct anterior relation 4

    • dental fillings 4

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