Revision 31 for 'Pterygopalatine fossa'

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Pterygopalatine fossa

The pterygopalatine fossa (PPF) is a small space of the deep face the shape of an inverted pyramid between the maxillary bone anteriorly, the pterygoid process posteriorly and lies 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 crania fossa

Gross anatomy


The walls of the PPF are as follows:

  • medial - perpendicular plate palatine bone
  • lateral - narrowing to pterygomaxillary fissure
  • anterior - posterior wall of maxillary sinus
  • posterior - medial and lateral pterygoid plates; inferior aspect of lesser wing of sphenoid bone
  • roof - inferior orbital fissure
  • floor - narrowing to palatine canals

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


The PPF contains:

  • pterygopalatine ganglion
  • descending palatine artery (branch of the maxillary artery)
  • maxillary division of trigeminal nerve (V2) - enters via foramen rotundum
  • nerve of the pterygoid canal

Radiological appearance

  • thin slice (<1mm) bone algorithm reconstruction of non-contrast axial sections is best approach to image the bony walls of the PPF 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 PPF 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
  • PPF may be obscured by "blooming" at the air-tissue interface between the maxillary sinus, which is a direct anterior relation 4
  • dental fillings may also obscure the PPF 4

Related pathology

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