Head and Neck Imaging

pterygopalatine fossa, pathology

Pathology primarily arising within the pterygopalatine fossa is rare; a neurogenic tumour, head and neck is the entity most likely to be encountered.
The pterygopalatine fossa is more commonly involved by pathology arising in its immediate locality. Posterior spread of a maxillary cancer, or lateral spread of an angiofibroma are typical examples; from here, such lesions gain access to the other spaces communicating with the pterygopalatine fossa (see also sinonasal cavities, cancer ).
Being a crossroads of nerves, the pterygopalatine fossa is commonly involved by perineural tumour spread, head and neck . From here, continued retrograde or anterograde perineural spread can occur; one possibility is spread along the maxillary nerve to the cavernous sinus and Meckel's cave, but also spread along the palatine nerves, posterior and superior alveolar nerves, or into the vidian canal, eventually reaching the facial nerve, is sometimes seen (see adenoid cystic carcinoma ).

RH