Joe Iwanaga1, William Clifton2, Robert F Dallapiazza3, Yusuke Miyamoto4, Noritaka Komune4, Henry A Gremillion5, Aaron S Dumont3, R Shane Tubbs6. 1. Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA; Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan. Electronic address: iwanagajoeca@gmail.com. 2. Department of Neurological Surgery, MayoClinic Florida, Jacksonville, FL, USA. 3. Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA. 4. Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyusyu University, Fukuoka, Japan. 5. Louisiana State University School of Dentistry, New Orleans, LA, USA. 6. Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA; Department of Anatomical Sciences, St. George's University, St. George's, Grenada; Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA; Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA.
Abstract
INTRODUCTION: Ossification of the pterygospinous and pterygoalar ligaments has been well documented forming pterygospinous and pterygoalar bars. However, the actual ligaments have been rarely shown in the existing literature. Therefore, this study aimed to reveal the anatomy of the pterygoalar ligament/bar and pterygospinous ligament/bar, and its relationship with the branches of the mandibular nerve. METHODS: Thirty sides from fifteen Caucasian fresh frozen cadaveric heads were used in this study. The branches of the mandibular nerve and any ligaments or bony bridges between the lateral plate of the pterygoid process and spine of the sphenoid were observed. RESULTS: A pterygospinous ligament/bar and pterygoalar ligament/bar were defined based on the relationship with the branches of the mandibular nerve. The pterygoalar ligament/bar was further classified into two types. Twenty-seven sides (90%) had at least one pterygoalar ligament/bar or pterygospinous ligament/bar. A pterygospinous ligament/bar was found on 15 sides (50.0%). A pterygoalar ligament/bar was found on 16 sides (53.3%), and a type I on 11 sides and type II on 5 sides. CONCLUSIONS: This finding and classification are simple to understand and easy to apply for future studies, and have important implications regarding the clinical anatomy of trigeminal neuralgia and facial pain.
INTRODUCTION: Ossification of the pterygospinous and pterygoalar ligaments has been well documented forming pterygospinous and pterygoalar bars. However, the actual ligaments have been rarely shown in the existing literature. Therefore, this study aimed to reveal the anatomy of the pterygoalar ligament/bar and pterygospinous ligament/bar, and its relationship with the branches of the mandibular nerve. METHODS: Thirty sides from fifteen Caucasian fresh frozen cadaveric heads were used in this study. The branches of the mandibular nerve and any ligaments or bony bridges between the lateral plate of the pterygoid process and spine of the sphenoid were observed. RESULTS: A pterygospinous ligament/bar and pterygoalar ligament/bar were defined based on the relationship with the branches of the mandibular nerve. The pterygoalar ligament/bar was further classified into two types. Twenty-seven sides (90%) had at least one pterygoalar ligament/bar or pterygospinous ligament/bar. A pterygospinous ligament/bar was found on 15 sides (50.0%). A pterygoalar ligament/bar was found on 16 sides (53.3%), and a type I on 11 sides and type II on 5 sides. CONCLUSIONS: This finding and classification are simple to understand and easy to apply for future studies, and have important implications regarding the clinical anatomy of trigeminal neuralgia and facial pain.