Abstract
This retrospective, observational, longitudinal study performed a morphometric analysis of the pterygopalatine fossa (PPF) in patients undergoing surgically assisted rapid maxillary expansion (SARME) using cone beam CT (CBCT). CBCT scans of 41 consecutive patients were assessed and the following measurements were performed: PPF volume (PPFV), height (PPFH), length (PPFL) and angle (PPFA). The sample was divided into groups D (patients undergoing SARME; n=26) and control (n=15). Group D was subdivided into D+ (with pterygomaxillary disjunction – PMD) and D- (without PMD). The differences between the pre and postoperative periods were tested using the U Mann-Whitney or the t-test. Groups D+ and D- were compared using the one-way ANOVA or Kruskal-Wallis tests (level of significance set at 5%). In general, there were morphometric variations in PPF, with lower values after SARME. Differences for PPFH, PPFL and PPFA were not significant (p>0.05). On the right side, there were differences in PPFV, with lower values in patients from group D+ (p<0.05). These findings indicate a morphometric reduction of PPF after SARME, with differences when the disjunction is performed or not. The maxillofacial surgeon must be aware of these changes when performing SARME with or without disjunction.
Highlights
The pterygopalatine fossa (PPF) is an anatomical structure with pyramidal shape and an inverted base (Tashi et al., 2016), located between the viscerocranium and the neurocranium
Greater variability in PPF volume (PPFV) was observed in group D+, while on the right side, variability in PPFV was greater in the control group
PPF height (PPFH) showed results opposite to those found in PPFV
Summary
The pterygopalatine fossa (PPF) is an anatomical structure with pyramidal shape and an inverted base (Tashi et al., 2016), located between the viscerocranium and the neurocranium It communicates with the orbit through the inferior orbital fissure; with the middle cranial fossa through the foramen rotundum and the pterygoid canal; with the nasopharynx through the pharyngeal canal; with the infratemporal fossa through the pterygomaxillary fissure; with the nasal cavity through the sphenopalatine foramen; and with the oral cavity through the greater palatine foramen and lesser palatine foramina (Derinkuyu et al, 2017). PPF has been studied by several medical specialties (Liu et al, 2017; Gibelli et al, 2019) since the region represents the access for endoscopic surgeries on the skull. The cone beam CT (CBCT) has been considered for the study of this region, as it allows accurate measurements with lower radiation doses compared to helical CT (Icen & Orhan, 2019)
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