The mucoperiosteum was then elevated, and the maxillary bone was exposed from the pyriform aperture anteriorly to the
pterygomaxillary fissure posteriorly.
From various studies, Ricketts found that the center of least growth is near the
pterygomaxillary fissure because growth changes occur in a radial manner from this area while the area itself remains constant.
The lesion involved the orbital apex and extended into the pterygopalatine fossa and then through the
pterygomaxillary fissure into the infra-temporal space where it was noted subdermally at the level of the zygoma.
Surgical access to the maxilla was performed buccally and subperiosteal nonkeratinized mucosa detachment, extending from the floor of the nasal fossa to the
pterygomaxillary region.
The computed tomography (CT) and magnetic resonance imaging (MRI) showed soft tissue density lesion in the right nasal fossa, ethmoid cells, and maxillary sinus with extension into the inferior portion of the orbit through the lamina papyracea and posteriorly to the
pterygomaxillary fissure (Figures 1 and 2).
The horizontal osteotomies were made at the anterolateral maxillary wall, from the piriform aperture to the
pterygomaxillary suture.
The CTV70 is copied to form the CTV66 which is expanded and includes the whole nasopharynx, adjacent retropharyngeal lymph nodal regions, parapharyngeal space, pterygoid plates,
pterygomaxillary fissures, floor of the sphenoid sinus, foramen lacerum and the posterior part of the nasal cavity (5 mm anterior to the GTV).
PM plane is the connection between sphenethmoid (SE) and
pterygomaxillary fissure (Ptm), and the extremely important plane to understand the basic structure of craniofacial complex and its development.
After destroying the pterygoid plates, the tumour extend to pterygopalatine fossa winding round the posterior surface of maxilla through
pterygomaxillary fissure, thus entering the cheek.
Ehrlich, "Mixed tumors of the
pterygomaxillary space: Operative removal: oral approach," Oral Surgery, Oral Medicine, Oral Pathology, vol.
In few cases it isindicated for removal of foreign bodies from maxillary sinus and provides an access to
pterygomaxillary fissure and pterygo-palatine fossa.This approach is also required for evaluation and stabilization of orbital floor fracture and removal of orbital floor in decompression2.
Radiographs of the hamulus and
pterygomaxillary region should be obtained to determine whether the hamulus is fractured, whether an osteophyte is present on the hamular process producing inflammation of the bursa, or for any other abnormal findings.