Big Picture

The pterygopalatine fossa is the region between the pterygomaxillary fissure and the nasal cavity. The fossa accommodates branches of the maxillary nerve [cranial nerve (CN) V-2], the pterygopalatine ganglion, and the terminal branches of the maxillary artery.

Boundaries of the Pterygopalatine Fossa

The pterygopalatine fossa is an irregular space where neurovascular structures course through to the nasal cavity, palate, pharynx, orbit and face (Figure 22-1A and B). The neurovascular structures enter and exit the fossa through the following boundaries:

• Anterior boundary. Posterior surface of the maxilla.
  
• Posterior boundary. Pterygoid processes and the greater wing of the sphenoid bone, with openings for the following structures:
  
  
  
  • Foramen rotundum for CN V-2.
    
  • Pterygoid canal for the nerve of the pterygoid canal (Vidian nerve).
    
  • Pharyngeal (palatovaginal) canal for the pharyngeal branch of CN V-2.
  
  
• Medial boundary. Perpendicular plate of the palatine bone containing the sphenopalatine foramen, which transmits the nasopalatine nerve (CN V-2 branch) and the sphenopalatine artery.
  
• Lateral boundary. Pterygomaxillary fissure, which communicates with the infratemporal fossa.
  
• Superior boundary. Greater wing and body of the sphenoid bone, with the infraorbital fissure transmitting the infraorbital nerve and the vessels in the orbit.
  
• Inferior boundary. Palatine process of the maxilla and the pterygoid process of the sphenoid bone with the greater and lesser palatine canals and foramina, which transmit the greater and lesser palatine nerves and vessels.