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Head and Neck
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
Other branches of the facial nerve contain special sensory and parasympathetic fibers. The chorda tympani passes between the incus and malleus, near the tympanic membrane (Plate 3.45a and c), that emerges from the temporal bone just posterior to the temporo-mandibular joint, and joins the lingual nerve of the trigeminal nerve complex. The special sensory nerves carry taste sensation from the anterior two-thirds of the tongue. The parasympathetic fibers synapse in the submandibular ganglion. Postganglionic axons innervate the submandibular salivary gland and sublingual salivary gland. Another branch of the facial nerve, the greater petrosal branch, leaves the temporal bone on the petrosal surface, and joins the deep petrosal nerve to form the nerve of the pterygoid canal. The nerve of the pterygoid canal enters the pterygopalatine fossa, where the parasympathetic fibers synapse in the pterygopalatine ganglion. The deep petrosal nerve carries postganglionic sympathetic fibers that will pass through the pterygopalatine ganglion to be distributed with the sensory fibers of the maxillary division of the trigeminal nerve (Plate 3.39b). As will be explained in Section 3.3.1.5, the ganglion stimulates the lacrimal gland and secretions from the mucosa of the nasal cavity, paranasal sinuses, roof of the mouth, soft palate, and nasopharynx.
Clinical Neuroanatomy
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
Several important branches arise from the intrapetrous part of the nerve: The greater petrosal nerve arises from the geniculate ganglion, carrying taste fibres from the palate and conveying preganglionic, parasympathetic fibres to the pterygopalatine ganglion, and thence via the zygomaticotemporal and lacrimal nerves to the lacrimal gland. It is joined by the deep petrosal nerve (derived from the sympathetic plexus on the carotid artery) to form the nerve of the pterygoid canal.A branch from the ganglion joins the lesser petrosal nerve and is then carried to the otic ganglion. This conveys secretomotor fibres via the auriculotemporal nerve to the parotid gland. It also carries sympathetic fibres derived from the carotid artery to supply the blood vessels of the parotid gland.A small twig, the nerve to stapedius, arises 6 mm above the stylomastoid foramen.The chorda tympani arises at the same level and runs forward across the middle ear and enters a canal in the petrotympanic fissure, grooves the spine of the sphenoid and joins the lingual branch of the Vth nerve with which it is distributed to the presulcal part of the tongue.At the stylomastoid, foramen twigs join both the vagus and glossopharyngeal nerve.The posterior auricular nerve supplies the muscles of the ear and occipital belly of occipitofrontalis.The branches to the muscles of facial expression are, from above down, the temporal, zygomatic, buccal, marginal and cervical. They pass through the substance of the parotid gland before emerging in the skin and are vulnerable to disease in the parotid gland and to local surgical procedures.Cutaneous fibres are distributed with the auricular branch of the vagus supplying the skin on both sides of the auricle and part of the external auditory canal and tympanic membrane.
Congenital alacrima
Published in Orbit, 2022
Zhenyang Zhao, Richard C. Allen
The neural regulation of lacrimal gland secretion comprises an afferent sensory arm and a parasympathetic dominant efferent arm. The afferent arm receives input from the nasal mucosa and ocular surface sensory fibers, which are composed of the polymodal nociceptors of the cornea.4 The stimulatory signal is processed in the spinal trigeminal nucleus and relayed to the superior salivary nucleus.5 The efferent arm originates from the superior salivary nucleus projecting to the pterygopalatine ganglion, initially through the greater superficial petrosal nerve, which later joins the deep petrosal nerve to form the vidian nerve before synapsing. The postganglionic fibers from the pterygopalatine ganglion provide parasympathetic innervation for the lacrimal gland.6 The same process regulates both reflex and basal tear secretion despite being different clinical concepts. This is supported by the observation that minimal basal tear secretion occurs without stimuli during sleep and under local or general anesthesia.7 Any interruptions along this pathway can lead to decreased tear production and alacrima.
A Prospective, Randomized Clinical Trial to Evaluate Analgesic Efficacy of Bilateral Pterygopalatine Fossa Injection in Patients Undergoing Maxillofacial Cancer Surgeries Under General Anesthesia
Published in Egyptian Journal of Anaesthesia, 2021
Ekramy M Abdelghafar, Dina Nabil Abbas, Ahmed Othman, Sherif Bahaa Elddin Zayed, Ashraf Hamed Shawki
The sphenopalatine ganglion (SPG) is located within the pterygopalatine fossa (PPF). This ganglion has sympathetic activity in the form of visceral motor functions through its connection to the cervical sympathetic chain via the deep petrosal nerve and parasympathetic activity via the superficial petrosal nerve. The primary sensory distribution is the palate, buccal mucosa, nose, and orbit (Figure 1) [3].