Anatomy of the Pterygoid Process and Pterygoid Fossa

Abstract

The pterygoid process with its lateral and medial plates and the pterygoid fossa on the under-surface of the skull provide surfaces of attachment for the masticatory muscles and give support to the auditory tube. As Zehm (1966) points out, Conley (1956) and Fluur (1964) were the first to redirect serious attention to the operative exposure of this region, which had previously been considered inaccessible. Tumors can develop silently in this area (which Zehm calls the “retromaxillary space”) because of their concealed location. The medial surface of the medial pterygoid plate grossly demarcates the retromaxillary space from the nasopharynx. A tubal process no longer listed in current anatomic nomenclature projects sometimes backward from the medial plate and gives support to the cartilaginous part of the auditory tube slightly above its midpoint. The cartilage itself usually projects 2–3 mm past the posterior border of the medial pterygoid plate. Perovic (1958) noted that a “tubal impression” could sometimes be identified above the tubal process. Close to the skull base is the scaphoid fossa, which apposes the auditory cartilage and provides a site of origin for the tensor veli palatini. In our material we determined the paramedian distances, lengths, and angulations of the pterygoid plates as well as their distances from the midsagittal plane and the contralateral pterygoid processes (Lang and Hetterich 1983).