| Objective To investigate microsurgical anatomy, sheet sectional anatomy and three-dimensional reconstructed images, and to provide anatomic data for oral maxillary surgery, nasal and skull base surgery, image dignose and medical teaching. Methods (1)Microanatomic structures of pterygopalatine fossa region were observed and measured in 30 skulls (60 sides) and in 15 adult cadaveric heads (30 sides).(2) Clinical anatomy was studied by simulating transnasal endoscopic surgery in 10 adult cadaveric heads(20 sides).(3)Seriate sheet sections were observed and studied in 6 pterygopalatine fossa regions(12 sides).(4)Scan images and 3D images of HRCT including MPR and SSD were observed in 20 pterygopalatine fossa regions of volunteers.(5)Transverse, coronal, and sagittal images of high resolution MRI were observed in 10 pterygopalatine fossa regions of volunteers.Results (1)The configurations of pterygopalatine fossa include pyramid shape, intermediate shape and strait shape. The distance was 48.66 2.29mm from the middle point of zygoma arch to medial wall of pterygopalatine fossa. Foramen rotundum was unconspicuous in 33.33% and notably in 5.00% in the lateral wall of sphenoid sinus. The pterygoid canal situated within sphenoid sinus in 30.00% and lack of superior roof in 5.00%.(2)The Pterygopalatine portion of maxillary artery branch into posterior superior alveolar artery, infraorbital artery, descending palatine artery, sphenopalatine artery, artery of pterygoid canal. Its patterns were classified into M type, T type, Y type, intermediate type, and other type. The maxillary nerve travels in anterior and lateral direction in pterygopalatine fossa. The distance was 4.98 1.35mm from foramen rotundum to posterior wall of maxillary sinus.(3)Sphenopalatine artery divided into two branches in pterygopalatine fossa in 75% and in sphenopalatine foramen in 25%.The distances from internal carotid artery to sphenopalatine foramen, from internal carotid artery to anterior nasal spur, and from foramen rotundum to anterior nasal spur were 16.66 2.65mm, 66.94 5.35mm, and 62.90 3.81 mm respectively.(4)Seriae sheet section could originaly and accurately demonstrate figure changes and relationships among maxillary artery, maxillary nerve, pterygopalatine ganglion. (5)HRCT images could clearly demonstrate osseous anatomy of pterygopalatine fossa and its communications. The configuration of pterygopalatine fossa is various in transverse plane and is changless in coronal and sagittal plane. Foramen rotundum and pterygoid canal could be best showed in transverse plane. And inferior orbit fissure, sphenopalatine foramen and the relationships between Foramen rotundum and sphenoid sinus and between pterygoid canal and sphenoid sinus in coranal plane. And pterygopalatine canal, great palatine canal and little palatine canal in sagittle plane.(6) SSD images could satisfactorily demonstrate osseous structures of pterygopalatine fossa region, such as pterygopalatine fossa, foramen rotundum and pterygoid canal. Three-dimension shape and spatial relationship could be well showed in various directions. (7) MRI could well demonstrate the fat and important structures in pterygopalatine fossa, such as maxillary artery, maxillary nerve and sphenpalatine artery.Conclusions (1)The osseous structures of pterygopalatine fossa region were observed in order to provide anatomic parameters for block anesthesia and endoscopic surgery and enrich Chinese morphology data.(2)To be familiar with microsurgical anatomy of passing structures is helpful for clinical operation and improving operational success.(3) To conform landmark of encoscopic pterygopalatine fossa surgery and establish safe scope of operation.(4)The technique of celloidin embedding was firstly applied to sheet sectional anatomic study of pterygopalatine fossa, which provide valuable basic research data for sectional anatomy of image.(5) Transverse plane combined with reconstructed coronal plane and sagittal plane could entirely and systemly demonstratethe configuration of pterygopalatine fossa a... |
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