The Infratemporal and Pterygopalatine Fossae

Earlier chapters of this book have covered both the autonomic nervous system of the head and neck and the osteology of the skull as it pertains to the temporal fossa. This naturally leads into the infratemporal and pterygopalatine fossae. The infratemporal fossa is a complicated region at the skull base deep to the masseter muscle acting as a relay station for vascular entry and exit to the deep face and for sensory and autonomic distribution to the V2 region with infraorbital, nasal, palatal and pharyngeal innervation and secretion. The fossa is wedge-shaped deep to the zygomatic arch that directly communicates with the temporal fossa antero-superiorly and deeply with the pterygopalatine fossa (PPF). The lateral connection of the infratemporal and pterygopalatine fossae is via the pterygomaxillary fissure. The boundaries are bony and muscular. It is wise here to examine an intact skull from the side if available (after removing the mandible).This area dissected in the cadaver or in prosected specimens is bets seen with the majority of the zygomatic arch resected and by removal of the head of the mandible along with removal of the coronoid process and its attaching temporalis tendon. The mandible may be split length ways where the inferior alveolar nerve is displayed with its mylohyoid branch just before the mandibular foramen.