Pterygoid Canal Research Articles

Size and shape of the pterygopalatine fossa of the skull of a child aged 3–5 years based on the analysis of computed tomography scans

BACKGROUND: Endoscopic microsurgical techniques are used for sparing operations to remove foreign bodies of the pterygopalatine fossa, as well as neoplasms invading into it or growing out of it. These surgeries are performed not only in adults, but also in children as young as one month. For these surgeries, understanding the detailed structure and morphometric characteristics of the pterygopalatine fossa is crucial. However, detailed descriptions specific to children are lacking in the literature. AIM: This study aimed to examine the size and shape of the pterygopalatine fossa and the relative location of nerve foramina in children aged 3 to 5 years (the period of primary dentition) using computed tomography data. MATERIALS AND METHODS: To study the size and shape of pterygopalatine fossa, we analyzed anonymous archival frontal and axial computed tomograms of 12 children (24 pterygopalatine fossae) aged 3 to 5 years, obtained for examination of the underlying disease (brain pathology). All computed tomography scans were obtained using a helical computed tomograph (Somatom Sensation 64; Siemens, Germany) with an effective current of 63, 120 kV, a slice thickness of 0.5 mm, a reconstruction step of 0.7 mm, a collimation of 12×0.6 mm, Kernel U 70, a window width of 450 HU and a window center of 50 HU in University Clinic of Russian University of Medicine. The measurements were performed in the Cdviewer software after the preliminary measurements had determined sufficiently constant points on the contours of the pterygopalatine fossa of scans. On axial sections passing through the pterygoid canal, where the measurements had the greatest values, the following were studied: the largest width of the pterygoid canal (the distance between the anterior opening of the pterygoid canal and the orbital process of the palatine bone), the width of the medial wall and separately the width of the sphenopalatine foramen and the sphenoidal process of palate bone, the angle of deviation the medial wall from the sagittal plane, the width of the anterior wall (the distance between the most posteriorly protruding point of the anterior wall of the pterygopalatine fossa to the orbital process of the palatine bone), the greatest depth of the pterygopalatine fossa (posterior wall width) and the width of the pterygomaxillary fissure. The distance from the level of the orifice of the greater palatine canal to the anterior opening of the pterygoid canal and to the round foramen were measured on the frontal sections. According to axial tomograms, the spatial ratios between the orifice of the greater palatine canal and the round foramen and the anterior opening of the pterygoid canal, between these openings and the sphenopalatine foramen, between the round foramen and the anterior opening of the pterygoid canal were assessed. RESULTS: The study found that the shape of the pterygopalatine fossa differs from the pyramid-like structure, featuring four distinct parts: the main one adjacent to the sphenopalatine foramen, and funnel-shaped constrictions at the vestibule of the pterygoid canal, greater palatine canal, and pterygomaxillary fissure. The data indicated minor individual differences in the size of the pterygopalatine fossa and the uniformity of its shape in children aged 3 to 5 years. The spatial relationships of the orifice of the greater palatine canal, the anterior opening of the pterygoid canal, the round foramen, and the sphenopalatine foramen openings determining the position of the nerves in the pterygopalatine fossa were clarified. CONCLUSIONS: Pterygopalatine fossa in children aged 3 to 5 years (period of formed primary dentition) is characterized by a complex cavity structure, suggesting a different position of the pterygopalatine ganglion in it than is commonly believed. This circumstance, as well as for the first time the sizes of the pterygopalatine fossa determined by us, should be considered when developing surgical access to the pterygopalatine fossa and the pterygopalatine ganglion.

Clinically relevant morphometric analysis of pterygopalatine fossa and its volumetric relationship with adjacent paranasal sinuses: a CT-based study.

This study aimed to perform morphometric measurements of the pterygopalatine fossa (PPF), the transition zone to critical neurovascular structures. The second aim was to investigate the relationship between the volumes of the PPF and the paranasal sinuses and the effect of nasal septum deviation (NSD) types on all these measurements. We performed PPF's morphometry and all volume measurements on the CT images of 260 patients (130 male and 130 female, age range 18-79). All volumetric measurements and the angle between foramen rotundum (FR) and pterygomaxillary fissure (PMF) were significantly higher in males than females. In contrast, the distance between sphenopalatine foramen (SPF) and PMF was considerably higher in females than in males. The PPF volume, the distance between the pterygoid canal (PC) and maxillary sinus, and the angle between FR and PMF were significantly higher on the right side than on the left. In contrast, the angle between PC and SPF and between greater palatine canal and PPF were considerably higher on the left side than on the right. The angle between PC and SPF decreased markedly with age. Only sphenoidal sinus volume was significantly smaller on the same side as the septal deviation. There was no correlation between PPF volume with maxillary and sphenoid sinus volumes from adjacent paranasal sinuses. Volumetric and morphometric data obtained from PPF and paranasal sinuses can aid clinicians in diagnosing and treating patients by guiding them in selecting the right surgical approach or tools, especially in endoscopic procedures.

Juvenile Nasopharyngeal Angiofibroma

Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign tumour affecting mostly adolescent and can be malignant because it’s aggressive, destructive, spread locally and often extends to the skull. The exact cause of JNA is unknown. JNA originates from the pterygopalatine fossa at the aperture of the pterygoid canal. Clinical symptoms include nasal obtruction, epistaxis and headaches. The diagnosis is based on anamnesia, physical and radiological examination. CT scan and MRI are the main modalities in detecting and determining tumour stage.

The role of palatovaginal canal and sphenopalatine artery in the localization of vidian canal during vidian neurotomy

Objective:To explore the role of palatovaginal canal and sphenopalatine artery in the localization of pterygoid canal during pterygoid neurotomy. Method:55 patients with or without nasal polyps were divided into two groups: group A（twenty-nine cases, anterior wall approach of sphenoid sinus） and group B（twenty-six cases, middle nasal meatus approach）. All patients underwent unilateral vidian neurectomy under nasal endoscope. The vidian canal was located by palatal canal and sphenopalatine artery in group A and B, respectively. Result:The vidian canal was located successfully in all patients, with small wound, fast postoperative recovering. There was no irreversible complication. Conclusion:The relationship between the palatovaginal canal, sphenopalatine artery and the external orifice of vidian canal is constant, which can be used as an anatomical marker of vidian neurotomy.

Study of the pterigidal canal (vidian canal) through images of cone beam computer tomography.

Objective: The aim of this study was to evaluate the pterygoid canal (PC) by Cone Beam Computed Tomography (CBCT), establishing its configuration and proximity with anatomical structures. Material and Methods: We evaluated 398 CBCT exams, all from a public University radiology clinic archive. Four parameters were evaluated: single or double PC, distance between PC and the inferior part of the sphenoid sinus (SS), ratio of PC and SS and the distance between the PC and the foramen rotundum. Results: It was observed that most of the PC of the sample presented simple morphology, the most frequent type of relationship between the PC and the SS on both sides was the close contact with the wall. Among the cases that there were some distances between the PC and the inferior wall of the SS, the mean of this distance did not exceed 3.20 mm, being the left side (3.03 mm) slightly closer than the right (3.20 mm). Finally, the distances between the PC and the corresponding Foramen Rotundum are presented with mean values of 5.87 mm for the right side and 6.31 mm for the left side. Conclusion: CBCT examination is of paramount importance for PC identification; once in the studied sample, the mean values found evidence the close relation between the PC and the SS.KeywordsCone beam computed tomography; Endonasal approach; Vidian canal.

Morphometric assessment of important landmarks on skull intended for Vidian nerve surgery.

The aim of our study was to determine guide parameters for clinicians by morphometric assessment of important landmarks on cranium intended for Vidian nerve surgery. For the study, 23 half-skull bases, 40 skull bases and 40 skulls were obtained from the Department of Anatomy, Ege University Medicine Faculty. The vertical distances were measured using a digital caliper to the nearest 0.01mm. The anterior opening of the Vidian canal (pterygoid canal) was observed as oval shaped on 57 specimens (31.1%), funnel shaped on 58 specimens (31.7%), round shaped on 64 specimens (35%) and septated on 4 specimens (2.2%). Vidian canal was embedded into the body of sphenoid on 55 specimens (52.4%) (embedded type) and protruded to sphenoidal sinus on 50 specimens (47.6%) (protruded type). 21 specimens of 50 were partial and 29 specimens were total. There were dehiscences on 21 specimens of 50 protruded type on the base of sphenoidal sinus (20%). Anterior opening of the Vidian canal was assessed according to medial lamina of pterygoid process. It was located medially in 169 of the specimens (92.3%) and laterally in 14 specimens (7.7%). Vidian canal and Vidian nerve are deeply located structures on skull. Vidian canal and surrounding structures are important landmarks for microsurgery and endoscopic approaches to Vidian nerve. We consider that knowledge of anatomical features of Vidian canal and preoperative imaging by CT (computed tomography) will be supportive when choosing and planning a safe surgical approach.

Visualisation of the vomerovaginal canal during endonasal transpterygoid approaches and CT imaging diagnosis.

The vomerovaginal canal (VVC) and palatovaginal canal (PVC) are two canals that open forward to the posterior wall of the pterygopalatine fossa (PPF). Although the anatomy and computed tomography (CT) appearances of the PVC have been well studied, the VVC has been rarely reported, especially in endoscopic examinations. Some studies have even failed to distinguish the PVC from the VVC on CT images. The purpose of this study was to demonstrate the anatomy of the VVC on endoscopy and reveal its differences from the PVC, and to analyse the relative positions of the VVC, PVC, and pterygoid canal on CT images. Ten dry skull bases were studied to observe the structures involved in the formation of the VVC. Dissection of four cadaveric heads was performed to demonstrate the anatomy of the VVC on endoscopy. Coronal CT image analysis in 70 patients was conducted to evaluate the distances and relative positions between the VVC, PVC, and pterygoid canal. The PVC and VVC were also compared on axial CT images. The osteological study showed the top wall of the VVC was the antero-inferior wall of the sphenoid sinus. The VVC may be a helpful landmark in endoscopic endonasal transpterygoid approaches. Steps and discrimination in the dissections of the VVC and PVC were described. The interval between the PVC and VVC could be observed on both coronal and axial CT images. The coronal CT images of patients showed differences in the positions and distances among the three canals at both the anterior and posterior apertures of the PVC. The VVC can be easily mistaken for the PVC if its existence is not suspected. The anatomical morphologies and trajectories of the VVC and PVC differed on both nasal endoscopy and CT. The existence of the VVC should be considered during surgery and CT diagnosis within this area.

The pterygopalatine fossa: morphometric CT study with clinical implications.

The pterygopalatine fossa is a deep viscerocranial space containing the maxillary artery and nerve, the pterygopalatine ganglion, and the nerve of the pterygoid canal (vidian nerve). The endoscopic approach to this area relies on adequate preoperative imaging, such as computed tomography (CT). The aim was to determine the morphometric characteristics of the pterygopalatine fossa and its communications, including several previously unpublished measurements. 100 CT scans (56 male and 44 female patients) were analyzed. The axial, coronal, and sagittal slices, together with the three-dimensional reconstructions, were used in the study. The central diameter and the length of the foramen rotundum, the vertical diameter and the length of the pterygoid (vidian) canal, and the diameter of the sphenopalatine foramen were significantly larger in men. The central diameters of the foramen rotundum and the vidian canal were significantly smaller than their anterior and posterior transverse diameters. The vidian canal length of 12.1mm indicates the presence of the type 3 VC with a sensitivity of 83% and a specificity of 85%. Several new descriptions of the pterygopalatine fossa are presented here (such as the angle between the sphenopalatine foramen and the vidian canal, a new aspect in the understanding of the FR, and the distance between the posterior wall of the maxillary sinus to the vidian canal and the foramen rotundum), which might prove useful in the comprehension of the anatomy of the pterygopalatine fossa.

The risk factors for residual juvenile nasopharyngeal angiofibroma and the usual residual sites.

Juvenile nasopharyngeal angiofibroma (JNA) is non-metastasizing but potentially locally destructive tumor of the nasopharynx. It can destroy the skull base and invade into the cerebrum. Surgical management is the primary standard but residual disease is always a risk factor. We aimed to determine the risk factors for residual disease and usual sites for these residual tumors. The medical records of 131 patients (mean age 17.6 ± 6.8, range 9-71 years) with histologically proven JNA were retrospectively analyzed. The surgeries were all nasal endoscopic approaches, with or without assistant incision. The prevalence of residual disease was 16.8%. Risk factors associated with JNA recurrence included tumor stage, intraoperative bleeding, and the year in which the operation was performed. The pterygoid canal, pterygoid process, and pterygopalatine foramen were the most frequent locations for residual tumor. Surgical management should take particular care for the pterygoid canal, petrygoid process, and pterygopalatine foramen. Contrast-enhanced CT and MRI are effective tools to evaluate complete JNA excision in the first two days after primary surgery. Careful exploration of these areas may be the key to avoid residual JNA.

Effect of artemisinin and neurectomy of pterygoid canal in ovalbumin-induced allergic rhinitis mouse model

BackgroundAllergic rhinitis (AR), characterized by sneezing, nasal itching and rhinorrhea, affects a large number of population. This study aimed to explore the effects of artemisinin alone or combined with neurectomy of pterygoid canal in ovalbumin-induced AR mouse model and illustrate the underlying mechanisms.MethodsAllergic symptoms were evaluated to verify inhibitory effect of artemisinin alone or combined with neurectomy of pterygoid canal on AR. Serum levels of histamine, immunoglobulin E (IgE) and inflammatory factors TNF, INF-γ, IL-1β IL-10, IL-4 and IL-5 were measured by ELISA. The mRNA levels of TNF, INF-γ, IL-1β and IL-10 in local lymph nodes were measured by RT-qPCR. The total and phosphorylated levels of ERK and JNK were assessed by Western blot. CD4+CD25+Foxp3+ T (Treg) cells were analyzed by flow cytometry.ResultsArtemisinin significantly relieved the behavior symptoms of AR mice. The administration of artemisinin strikingly suppressed the expression of histamine, IgE and inflammatory factors. An increased Treg cell proportion and inhibited ERK phosphorylation were observed in artemisinin-treated groups as compared to those in the AR group. Moreover, artemisinin plus neurectomy of pterygoid almost abolished the behavioral score increase in AR mice.ConclusionsThese results indicated that artemisinin exhibited anti-allergic effect by inhibiting ERK activation and increasing Treg cell proportion, which subsequently decreased the expressions of allergic mediators. In addition, artemisinin combined with neurectomy of pterygoid showed better efficacy than artemisinin alone.

Computed Tomography Research: Relative Anatomy of Caldwell-Luc Approach in Pterygopalatine Fossa Surgery.

With the development of endoscopic technique, Caldwell-Luc approach has more wide applications and becomes a common method of pterygopalatine fossa (PPF) surgery. Few data can be used in this approach to avoid injuring the vessels and nerves within this area. In this study, the authors used computed tomography to get the coordinates of inferior orbital fissure, foramen rotundum, sphenopalatine foramen, internal opening of pterygoid canal, the strangulation of PPF, and the greater palatine foramen with canine fossa as the origin. Parameters of 60 patients (120 observations) between 35 and 55 years who have no experience of trauma or surgery before were involved in this study. The data were analyzed by SPSS, statistical software with the comparison between sexes and sides. After calculating the relative distances and angles between these points and canine fossa, the authors get the proportions of the upper part of PPF, and the pterygopalatine canal to PPF, respectively. The authors finally got the safety surgical range. The results are meaningful to safety in surgery and complication avoidance, which can be great references in clinical applications.

Perineural spread-susceptible structures: a non-pathological evaluation of the skull base.

Perineural spread adenoid cystic carcinoma can alter the dimension of foramina and canals of the skull base. The objective of this study was to determine the range of normal variation of the foramina and canals of both hemicranium. We analyzed 200 individuals with no alterations of the skull base in a retrospective manner using high-resolution computed tomography. We measured the short and long axis diameters of the foramen rotundum (FR), foramen ovale (FO), stylomastoid foramen (SMF), pterygoid canal (PTC), internal auditory canal (IAC), and the facial nerve canal in its labyrinthine portion (LPFC) to calculate the area in each hemicranium, compare them and obtain the normal range of asymmetry. Parametric and non-parametric comparison tests were realized. The structures that had the lowest range of asymmetry were the LPFC (0.00-0.79 mm2) and the FR (0.00-2.12 mm2). The one that had the highest asymmetry range was the FO (0.00-9.16 mm2). Significant differences were found in the FO (p = 0.01) and the IAC (p = 0.00) in the gender comparison. We determined a normal asymmetry range of the susceptible foramina and canals of the skull base. This study reports a useful and objective measure to differentiate anatomical from pathological variations of the foramina and canals of the skull base by age and gender. Our results establish a basis for future studies that evaluate this range as a diagnostic tool of metastasis in the skull base as a complement of other imaging techniques.

Anatomical study of pterygoid canal (PC) and palatovaginal canal (PVC) in endoscopic trans-sphenoidal approach.

The primary purpose of our work was to make anatomical measurements of pterygoid canal (PC) and palatovaginal canal (PVC). The secondary goal was to locate the two structures based on the landmarks in the trans-sphenoidal surgery and draw a safe corridor of fenestration in the bottom of sphenoid sinus during surgical procedure to sphenopalatine region. Computed tomographic angiography (CTA) images of PC, PVC and sphenoid sinus in 200 adults were reviewed. Multiplanar reconstruction of the CT images was performed, and the anatomical features of the PC and PVC were studied in the coronal, sagittal, and axial planes. The length, diameter and direction of PC and PVC were measured in the plane through or perpendicular to them. The anterior and posterior opening of PC and PVC were identified by the surgical landmarks such as the middle lowest point of sellar floor, the sagittal midline and the bottom of the sphenoid sinus. Both PC and PVC can be found and identified easily on CTA image, the shape and size of the PC and PVC were in agreement with those retrieved from previous literatures, the position of them can be located by the anatomical landmarks in sphenoid sinus. Knowing the anatomical features of PC and PVC and their location based on the anatomical landmarks are helpful to the endoscopic trans-sphenoidal surgery. These data in our study will provide surgeons a better understanding of PC and PVC and their relationship to sphenoid sinus. Notably, it will not help the surgeons to avoid injuring neurovascular structures as well as provided supportive information for the choice of the appropriate endoscopic equipment.

Location of Pterygopalatine Fossa and its Relationships to the Structures in Sellar Region.

The aim of this study is to locate pterygopalatine fossa (PPF) and the opening of its communicating canals by accessing the relationship between PFF and the endoscopic landmarks such as the tubercular recess (TR) and middle lowest point of sellar floor (SF) as well as analyze the relation between PPF and important structures such as internal carotid artery (ICA) and optic canal (OC). Computer topographic angiography (CTA) images of 118 PPF regions were reviewed. The measurement was on coronal, sagittal, and axial planes after multiplanar reconstruction (MPR). The location of PPF and its relationship to the sphenoid sinus, ICA, and OC were studied. The communicating canals of PPF, which were related to the transsphenoid approach, were three-dimensionally measured by the stationary structures, such as the middle lowest point of SF, the sagittal midline, and the top and bottom wall of sphenoid sinus. The posterior part of PPF was located by the middle lowest point of SF. The anterior opening of sphenopalatine foramen (SPF), pterygoid canal (PC), palatovaginal canal (PVC), and foramina rotundum (FR) have relative stationary position, which can be located by the landmarks of sellar region during the endoscopic surgery. Pterygopalatine fossa is related to numerous neurovascular structures. Accurate understanding of the radiologic anatomy of PPF is beneficial for the PPF disease diagnosis, the selection of treatment plan and the prognosis evaluation.

Anatomical Study on Meckel Cave with Endoscopic Endonasal, Endo-Maxillary Sinus, and Endo-Pterygoid Process Approaches

ObjectiveTo study anatomical structures related to Meckel cave with endonasal endoscopic approach and to provide an anatomical basis for endoscopic surgery in Meckel cave.MethodsMeckel cave of 5 adult skulls (10 sides) were fixed with 10% formalin. The anatomical structures of Meckel cave and the related zones adjacent to Meckel cave were observed and measured with endoscopic endonasal approach.ResultsEndoscopic endonasal, endo-maxillary sinus, and endo-pterygoid process approaches were successfully applied in observation of the anatomical structures of meckel cave and the rerated zones adjacent to Meckel cave and in measurement of distances between related anatomical structures for each case of samples. The relevant data were obtained. The distance between the front mouth of palatovaginal canal and vidian canal was 21.4±7 mm, the distance between opening of sphenoid sinus to the upper margin of the choana was 22.3±2.8 mm, the distance between the opening of vidian and foramen rotundum was 7.57±0.7 mm and the length of the pterygoid canal was 13.3±1.2 mm. Based on these data, the positions of the related important structures can be roughly located during surgical operation and various important structures in Meckel cave and its adjacent zones can be found out in a convenient and safe way.Conclusion1) It is feasible to use endonasal endoscopic approach to perform surgical operation in Meckel cave; 2) Use of endonasal endoscopic approach can protect and fully take the advantage of the vidian nerve to locate the position of foramina lacerum of the internal carotid artery during surgical operation; and 3) the observational and experimental data obtained with this approach can provide the rational basis for clinical operation procedures.

Endoscopic and Three-Dimensional Radiographic Imaging of the Pterygopalatine and Infratemporal Fossae

We sought to define the surgical endoscopic anatomy of the pterygopalatine fossa (PPF) and infratemporal fossa (ITF) through endoscopic cadaver dissections and radiographic imaging analysis. Eleven fresh cadavers were submitted to computed tomography (CT) and endoscopic dissection. We used 3-dimensional (3-D) CT reconstruction and endoscopic video imaging for analysis of the bony and soft tissue landmarks. One fixed cadaver head was grossly dissected to confirm the endoscopic anatomic findings. The CT and 3-D CT reconstruction measurements between the pterygoid canal and the foramen rotundum averaged 4.36 mm and 5.09 mm, respectively. An osseous ridge (pterygoid ridge) was identified on the anterior face of the pterygoid process as a novel identifiable anatomic landmark in all of the specimens. The average length of the pterygoid ridge on 3-D CT reconstruction was 7.84 mm. The internal maxillary artery entered the PPF posteromedial to the temporalis tendon and anterolateral to the lateral pterygoid muscle. The average distance from the anterior edge of the lateral pterygoid plate to the foramen ovale was 17.1 mm. The pterygoid ridge is a novel and reliable osseous landmark that could assist surgeons during endoscopic surgery on the PPF and ITF. The neurovascular and muscular anatomic relationships were characterized for both the PPF and the ITF.

The anatomical and clinical details of the pterygoid canal: a three-dimensional reconstructive virtual anatomic evaluation based on CT

To delineate the pterygoid canal (PC) configuration and its position in relation to surrounding important anatomical landmarks using three-dimensional reconstructive technology based on CT for the Chinese. The computerized tomography arteriography (CTA) data of 137 patients were retrospectively evaluated using neuroimaging three-dimensional reconstructive software. The morphological parameters of the PC as well as the spatial relationship and distance between the PC relative to internal carotid artery (ICA) and the foramen rotundum were evaluated. 83.9% of the PC can be identified by our neuroimaging three-dimensional reconstructive software. The mean distance from the PC to the ICA was 2.6 ± 1.2 mm. The mean distance between medial aspects of bilateral ICA was 19.6 ± 2.7 mm. The distal vertical and horizontal distances between the PC and foramen rotundum were 5.2 ± 3.2 and 6.1 ± 2.8 mm, respectively. All the proximal end of the PC were inferior-lateral to the ICA. The PC mainly (92.9%) ran posteriorly with a medial to lateral direction. The distance from the PC to ICA was positively correlated with the distance between bilateral ICA and the distal diameter of the PC. The vertical distance between the PC and foramen rotundum was positively correlated with the length of the PC and the horizontal distance between the PC and foramen rotundum. Understanding the configuration and spatial relationship of the PC may be helpful to improve the accuracy and safety of operation during the expanded transnasal endoscopic approaches to skull base. The three-dimensional reconstructive virtual anatomic technology may be a useful tool to delineate the PC configuration and its position to surrounding important anatomical landmarks.

3D CBCT anatomy of the pterygopalatine fossa

The anatomy of the pterygopalatine fossa keeps a traditional level and is viewed as constant, even though a series of structures neighboring the fossa are known to present individual variations. We aimed to evaluate on 3D volume renderizations the anatomical variables of the pterygopalatine fossa, as related to the variable pneumatization patterns of the bones surrounding the fossa. The study was performed retrospectively on cone beam computed tomography (CBCT) scans of 100 patients. The pterygopalatine fossa was divided into an upper (orbital) and a lower (pterygomaxillary) floor; the medial compartment of the orbital floor lodges the pterygopalatine ganglion. The pneumatization patterns of the pterygopalatine fossa orbital floor walls were variable: (a) the posterior wall pneumatization pattern was determined in 89.5 % by recesses of the sphenoidal sinus related to the maxillary nerve and pterygoid canals; (b) the upper continuation of the pterygopalatine fossa with the orbital apex was narrowed in 79.5 % by ethmoid air cells and/or a maxillary recess of the sphenoidal sinus; (c) according to its pneumatization pattern, the anterior wall of the pterygopalatine fossa was a maxillary (40.5 %), maxillo-ethmoidal (46.5 %), or maxillo-sphenoidal (13 %) wall. The logistic regression models showed that the maxillo-ethmoidal type of pterygopalatine fossa anterior wall was significantly associated with a sphenoidal sinus only expanded above the pterygoid canal and a spheno-ethmoidal upper wall. The pterygopalatine fossa viewed as an intersinus space is related to variable pneumatization patterns which can be accurately identified by CBCT and 3DVR studies, for anatomic and preoperatory purposes.

Skull base CT: normative values for size and symmetry of the facial nerve canal, foramen ovale, pterygoid canal, and foramen rotundum

Contrast-enhanced MRI is the mainstay for detecting pathology in the skull base foramina and nerve canals, through demonstration of abnormal enhancement. When MRI is contraindicated, or unable to differentiate tumor from non-neoplastic pathology, high-resolution skull base CT is indicated to assess for nerve canal or foramen widening, which is currently determined subjectively. The purpose of this study is to provide objective CT criteria that may help distinguish between normal asymmetry and pathologic nerve canal or foramen widening. Temporal bone CTs of 50 consecutive adults without facial or trigeminal nerve pathology were retrospectively reviewed. Short axis measurements were obtained in the axial plane for three segments of the facial nerve canal (labyrinthine, tympanic, and mastoid), foramen ovale, pterygoid canal and foramen rotundum on both sides in each subject. Descriptive statistics were obtained, and left-right asymmetry was calculated. Nerve canal/foramen size was normally distributed across subjects, with a minimal amount of left-right asymmetry. The upper limits of the 95% confidence interval for absolute left-right asymmetry were: 0.25, 0.21, and 0.15mm for the labyrinthine, tympanic, and mastoid segments of the facial nerve canal, respectively; 0.62mm for foramen ovale; 0.36mm for pterygoid canal; 0.38mm for foramen rotundum. Relative asymmetry is more important than absolute size for determining nerve canal/foramen abnormality. These normative data may be useful adjuncts to subjective assessments of nerve canal/foramen size when using skull base CT to identify tumor.

The Level of Major Proteins and Minerals in the Blood Serum of Chickens Fed Diets with Pure Cellulose

The aim of the research was to determine the concentration of total protein and its fractions as well as the concentration of selected mineral components in the blood serum of male broiler chickens Cobb 500 fed diets with different cellulose content. Blood samples were collected for examination from the birds' pterygoid canal veins on their 42 day of age. There was no influence of cellulose preparation on the content of total protein and its fractions: albumins, alfa1-, alfa2-, beta-, gamma-globulins, albumin to globulin ratio, inorganic phosphorus, sodium, potassium, chloride and iron concentrations in blood serum. The highest calcium concentration (P < 0.05) was detected in the blood serum of males fed a diet with the highest cellulose content (0.75-0.95%). Simultaneously, a tendency of increased calcium content was observed along with an increased amount of pure cellulose in diets. The lowest magnesium level (P < 0.05) was observed in the blood of birds fed diets with the lowest amount of cellulose (0.25-0.45%). The magnesium level in the blood of birds fed a diet with higher amounts of cellulose did not considerably differ from the control group. Results from the current study suggest that introduction of a limited amount of pure cellulose into the diet of broiler chickens does not affect total protein concentration and protein fractions but can influence the mineral content in the blood serum.