The anatomy of the foramina and efferent nerve fibers from the pterygopalatine ganglion in posterolateral nasal wall

Laryngoscope Investigative Otolaryngology

article

Kazuhiro Ogi MD, PhD¹  Rowan Valentine MBBS, PhD, FRACS¹  Masanobu Suzuki MD, PhD¹  Shigeharu Fujieda MD, PhD²  Alkis James Psaltis MBBS, PhD, FRACS¹  Peter-John Wormald MD, PhD, FRACS¹ 

[1] Department of Surgery—Otolaryngology, Head and Neck Surgery, University of Adelaide;Division of Otorhinolaryngology Head and Neck Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Sciences, University of Fukui

关键词: posterior nasal neurectomy;    pterygopalatine ganglion;    vidian neurectomy;   

DOI  :  10.1002/lio2.808

学科分类：环境科学（综合）

来源: Wiley

【 摘 要 】

Background The advance of endoscopic surgery has enabled selective section of the postganglionic nerve branches from pterygopalatine ganglion (PPG) as a modification of the vidian neurectomy. Recent microanatomic studies have suggested that the nasal mucosa is also innervated by multiple efferent rami associated with the sphenopalatine artery (SPA) in the procedure “posterior nasal neurectomy.” This anatomic cadaveric study aims to identify all postganglionic nerve fibers in the lateral nasal wall which should inform future surgical procedures aimed at interrupting these nerve fibers. Methods Two cadaver heads, with a total of three individual sides, were dissected. All neurovascular structures penetrating the vertical plate of palatine bone were carefully identified following meticulous removal of the overlying mucosa layers. The efferent nerve fibers were identified and dissected back to their origin—the PPG or greater palatine nerve. Results Several foramina with efferent PPG nerves were identified on the vertical plate of the palatine bone and medial pterygoid plate. The superior, middle, and inferior turbinates (IT) were innervated by efferent nerves from the PPG via the anterior region of the SPA. The IT was innervated from nerves originating from behind the SPA through bony foramina. The lateral wall of inferior meatus was innervated by efferent nerves that originated from greater palatine nerve and pharyngeal nerve. Conclusion This study demonstrated the anatomical positions of the postganglionic nerves that innervate the lateral nasal wall. These nerves are located anterior to the SPA as well as posterior to the SPA, where they penetrate the palatine bone. Level of evidence: NA.

【 授权许可】

CC BY|CC BY-NC-ND