The pterygopalatine fossa in three dimensions: A digital anatomical model derived from radiographic imaging, refined with peer-reviewed literature, and optimized with medical illustration

Abstract

The pterygopalatine fossa (PPF) is a small fat-filled space deep within the head on the lateral skull base. It serves as a site of communication between the infratemporal fossa, nasal cavity, nasopharynx, middle cranial fossa and the orbit, creating a pathway for infection and malignant spread. Its complex anatomy often makes diagnosis and treatment of pathologies in this region difficult. Moreso, the vital structures within this region makes comprehension of this region key for safe surgical resections. Here we develop an anatomically accurate 3D model for the PPF and the integral structures contained within. Neurovasculature, musculature, and openings of the PPF were segmented and measured from the Computerized Tomography (CT) angiogram of a healthy 29-year-old woman. Data related to variations, relationships, and dimensions of structures from anatomical studies were also used to deduce accurate relationships and identify known common anatomical variants of structures within the PPF. Finally, a medical illustrator used these data to develop a 3D anatomical model. The PPF is a clinically important area that transmits structures necessary for many functions in the head, including tear production, sensation over the maxilla, and supply of inner facial and nasopharyngeal structures. The final 3D model created in this project may serve to improve education and training for clinical applications. This includes identifying pathways of disease transmission and learning best surgical practices, such as approaches, nerve blocks, endoscopic techniques, and surgical landmark identification.