A study of the pterygopalatine fossa and it's ganglion in a South African skeletal and cadaver population

Abstract

It is well known that pain experienced by patients diagnosed with trigeminal neuralgia or facial pain syndrome can be effectively treated by blocking the contents of the pterygopalatine fossa. Such a procedure is not widely used due to the difficulty in locating the pterygopalatine fossa which is obscured by bony and soft tissue structures. Radiography still seems to be the most effective method in locating the pterygopalatine fossa. The aim of this study was to re-look the pterygopalatine fossa and devise a safe and alternative method of locating the fossa including its contents without the aid of radiography. A total of 160 skulls (40 black males, 40 black females, 40 white males and 40 white females) from the Department of Anatomy at the University of Pretoria were used. Standard as well as additional anthropometric techniques were employed to define the bony landmarks that would assist in defining this region more clearly. Regression analysis was carried out which determined the strength of influence each measurement had on the location of the pterygopalatine fossa. Separate formulas were created for the right and left sides to accommodate for asymmetry. These formulas were then tested on 47 cadavers. The results showed an accuracy of 65.2% on the right and 54.4% on the left. It can be concluded that this new technique may be of value in locating the pterygopalatine fossa more precisely.