Pterygomaxillary

Pterygomaxillary refers to the anatomical region that involves the pterygoid process of the sphenoid bone and the maxilla. This area is significant in both dentistry and maxillofacial surgery due to its relevance in procedures such as maxillary expansion, orthognathic surgery, and the administration of local anesthesia for dental procedures. The pterygomaxillary region encompasses important anatomical structures including the pterygomaxillary fissure, which is a gap between the pterygoid process and the maxilla. This fissure is a critical area for the passage of nerves and vessels.

Anatomy

The pterygomaxillary region is bounded anteriorly by the posterior wall of the maxilla and posteriorly by the pterygoid process of the sphenoid bone. It forms a part of the infratemporal fossa, a deep space located inferior to the temporal fossa and deep to the ramus of the mandible. The pterygomaxillary fissure allows communication between the infratemporal fossa and the pterygopalatine fossa, facilitating the passage of the maxillary nerve, a branch of the trigeminal nerve (CN V2), and various blood vessels including branches of the maxillary artery.

Clinical Significance

The pterygomaxillary region holds significant clinical importance due to its contents and location. In dentistry and maxillofacial surgery, understanding the anatomy of this region is crucial for several procedures:

• Maxillary Expansion: Procedures aimed at widening the maxilla, such as palatal expansion, often require careful consideration of the pterygomaxillary suture to avoid damaging surrounding structures.
• Orthognathic Surgery: Surgeries designed to correct conditions related to the structure of the jaw and face may involve the pterygomaxillary region, especially when manipulating the maxilla.
• Local Anesthesia: The administration of local anesthesia for procedures involving the upper teeth often targets nerves passing through the pterygomaxillary fissure, requiring precise knowledge of the area's anatomy.

Surgical Access

Access to the pterygomaxillary region can be challenging due to its deep location and the presence of vital structures. Surgical approaches to this area must carefully navigate around the maxillary artery and the branches of the trigeminal nerve to minimize the risk of complications.

Conclusion

The pterygomaxillary region is a complex anatomical area of significant interest in dentistry and maxillofacial surgery. Its understanding is essential for the successful execution of various surgical and non-surgical procedures involving the maxilla and surrounding structures.