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. 2013 Nov 20;4(Suppl 6):S422-8.
doi: 10.4103/2152-7806.121628. eCollection 2013.

Clinical functional anatomy of the pterygopalatine ganglion, cephalgia and related dysautonomias: A review

Seyed Ali Khonsary  1 , Quanfeng Ma  1 , Pablo Villablanca  2 , Josh Emerson  1 , Dennis Malkasian  1
Affiliations

Clinical functional anatomy of the pterygopalatine ganglion, cephalgia and related dysautonomias: A review

Seyed Ali Khonsary et al. Surg Neurol Int. .

Abstract

The purpose of this article is to explain the anatomy of the pterygopalatine ganglion (PPG), its location in the pterygopalatine fossa (PPF) in the skull, and the relationship it has to the Vidian nerve terminal branches and the fifth cranial nerve. An overview of the neuro-anatomical/clinical correlations, a spectrum of pathologies affecting the seventh cranial nerve and some therapies both medical and surgical are noted. The focus is the pterygopalatine region with discussion of the proximal courses of the seventh and fifth cranial nerves and their pathological processes. The ganglion is used as an example of neuro-anatomical model for explaining cluster headaches (CH). Radiological correlation is included to clarify the location of the PPF and its clinical importance.

Keywords: Cluster headaches; facial paresis; greater superficial petrosal nerve; pterygopalatine fossa; pterygopalatine ganglion; radiosurgery; seventh cranial nerve; treatment of cluster headaches.

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Figures

Figure 1
Figure 1
Schematic drawing of left sided view (lateral to medial) of the pterygopalatine fossa
Figure 2
Figure 2
Left sided view of pterygopalatine fossa through pterygomaxillary fissure
Figure 3
Figure 3
Left sided view of pterygopalatine fossa and its neural components through pterygomaxillary fissure (the vascular elements are not illustrated)
Figure 4
Figure 4
Detailed neuronal network of pterygopalatine ganglion and the relationship to the skull base and internal carotid artery
Figure 5
Figure 5
CT scan (bone window) axial section through the lower portion of the pterygopalatine fossa
Figure 6
Figure 6
CT scan (bone window) axial section through the medial portion of the pterygopalatine fossa
Figure 7
Figure 7
CT scan (bone window) axial section through the uppermost portion of the pterygopalatine fossa
See this image and copyright information in PMC

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