Revision 47 for 'Pterygopalatine fossa'

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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:

Communications

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

Contents

The PPF contains:

Radiological appearance

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