Anatomy of the pterygopalatine fossa: an innovative metrical assessment based on 3D segmentation on head CT-scan

Surg Radiol Anat. 2019 May;41(5):523-528. doi: 10.1007/s00276-018-2153-7. Epub 2018 Dec 12.

Abstract

Purpose: The pterygopalatine fossa is an important anatomical structure for several surgical and anaesthesiologic procedures; yet, very few data are available about its size. This study aims at providing a metrical assessment of pterygopalatine fossa through an innovative 3D segmentation procedure on head CT-scans.

Methods: CT-scans from 100 patients (50 males and 50 females) aged between 18 and 85 years were chosen for the study. Right and left pterygopalatine fossae were segmented through ITK-SNAP open source software. Height and volume were calculated on the acquired 3D models. In addition, anterior-posterior nasal spine distance, upper facial height (nasion-prosthion) and biorbital breadth (ectoconchion-ectoconchion) were measured as well. Statistically significant differences of height and volume according to sex and side were assessed through two-way ANOVA test: sexually dimorphic measurements were further assessed through one-way ANCOVA test using the three cranial measurements as covariates (p < 0.05).

Results: On average pterygopalatine fossa height was 24.1 ± 3.5 mm in males, and 22.8 ± 3.4 mm in females, whereas volume was 0.930 ± 0.181 cm3 in males and 0.817 ± 0.157 cm3 in females, with statistically significant differences according to sex (p < 0.05), but not to side (p > 0.05); interaction was negligible for both the measurements. ANCOVA test verified that sexual dimorphism of both measurements is independent from general cranial size (p < 0.05).

Conclusions: The present study highlighted the sexual dimorphism of pterygopalatine fossa: results may improve the knowledge of this anatomical structure difficult to explore, but crucial in several fields of clinics and surgery.

Keywords: 3D segmentation; Anatomy; CT-scan; Pterygopalatine fossa.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anatomic Landmarks
  • Female
  • Humans
  • Imaging, Three-Dimensional
  • Male
  • Middle Aged
  • Pterygopalatine Fossa / anatomy & histology*
  • Pterygopalatine Fossa / diagnostic imaging*
  • Sex Characteristics
  • Tomography, X-Ray Computed / methods*