ОСОБЕННОСТИ ТОПОГРАФО-АНАТОМИЧЕСКОГО СТРОЕНИЯ КРЫЛОВИДНО-НИЖНЕЧЕЛЮСТНОГО ПРОСТРАНСТВА, ВЛИЯЮЩИЕ НА ЭФФЕКТИВНОСТЬ ПРОВЕДЕНИЯ БЛОКАД НЕРВОВ И ДРУГИХ ХИРУРГИЧЕСКИХ ВМЕШАТЕЛЬСТВ

Abstract

Introduction. The region of the pterygo-mandibular space is an anatomical formation that is quite often sub- jected to surgical interventions (blockade of the mandibular nerve and its branches, operations for purulent processes, injuries). Among the complications of these surgical interventions, there are contractures of the lower jaw, neuritis of the lower alveolar and lingual nerves, and failure of anesthesia during blockades of these nerves. The purpose of the study was to analyze literature data and anatomical preparations of the pterygo-mandibular space, to take into account different options for the location of nerves and blood vessels during blockades and operations. Material and methods. The analysis of the literature and our own anatomical studies of 8 preparations of the deep parts of the human head was carried out. Results and discussion. The pterygo-mandibular space has a rather complex topographic and anatomical structure. Its anatomical structures are mobile along with the lower jaw and, accordingly, are adapted to these conditions in the form of a tortuous course of nerves and blood vessels, which prevents their stretching, tension, and injury. These features must be taken into account when performing surgical interventions, blockades of sensory and motor nerves in this area. Spatial perception of the location of the anatomical structures of the pterygo-mandibular space is facilitated by describing them relative to the lateral and medial muscles. Conclusions: The topographic and anatomical structure of the pterygo-mandibular space is variable and complex, which must be taken into account when performing nerve blocks, diagnostics, operations for purulent processes and traumatic injuries. The pterygo-mandibular space, connected directly with the peripharyngeal, should also be considered as part of the oral pharynx communicating with the base of the skull and neck.