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Neck Space Infections
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
The masticator space, (Figures 40.7 and 40.8), lies inferior to the skull base (greater wing of sphenoid and squamous temporal bone) and is bounded by the pharyngeal mucosa medially and the medial surface of the ramus of the mandible laterally. The lateral pterygoid plate, superior constrictor, tensor and levator palatini muscles constitute the posteromedial border and can be subdivided into superficial temporal space superolaterally, deep temporal space superomedially, pterygoid space inferomedially and masseteric space inferolaterally. Communication with the pterygopalatine fossa exists via the pterygomaxillary fissure; the muscles of mastication and the mandibular division of the trigeminal nerve are contained within it.
Head, neck and vertebral column
Published in David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings, McMinn’s Concise Human Anatomy, 2017
David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings
Maxillary artery - runs through or between the pterygoid muscles to pass through the pterygomaxillary fissure and enter the nose, where it is known as the sphenopalatine artery forming the main vessel of the nasal cavity (p. 70). Among the many branches are the middle meningeal artery (p. 36), which passes vertically upwards through the foramen spinosum, and the inferior alveolar artery, which runs downwards behind its companion nerve to enter the mandibular foramen.
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
The temporal region (Plates 3.8 and 3.28 through 3.30) includes the temporal fossa and the infratemporal fossa, which lie superiorly and inferiorly to the zygomatic arch, respectively. The bony features of this region are shown in Plate 3.8 and described in detail in Section 3.2. Briefly, the parietal bone and frontal bone include the superior and inferior temporal lines for attachment of the temporalis muscle. The zygomatic arch is formed by the zygomatic process of the temporal bone and the temporal process of the zygomatic bone. The temporal fossa is formed by the parietal, frontal, squamous part of the temporal, and greater wing of the sphenoid, and contains the temporalis muscle. The infratemporal fossa contains the medial pterygoid muscle, lateral pterygoid muscle, branches of the mandibular nerve (CN V3) and the maxillary artery, and the venous pterygoid plexus converging into the maxillary veins (Plate 3.29). These two fossae communicate with each other through the interval between the zygomatic arch and the lateral surface of the skull. The pterygomaxillary fissure lies between the lateral plate of the pterygoid process of the sphenoid bone and the infratemporal surface of the maxilla. The pterygopalatine fossa lies at the superior end of the pterygomaxillary fissure, and the sphenopalatine foramen (which opens into the nasal cavity) is medial to the fossa (Plate 3.8c; see Box 3.9 for an easy way to remember these structures). The inferior orbital fissure lies between the maxilla and the greater wing of the sphenoid bone, which contains the foramen ovale and foramen spinosum.
Evaluating the perioperative analgesic effect of ultrasound-guided trigeminal nerve block in adult patients undergoing maxillofacial surgery under general anesthesia: A randomized controlled study
Published in Egyptian Journal of Anaesthesia, 2023
Maha Misk, Abdelrhman Alshawadfy, Medhat Lamei, Fatma Khames, Mohamed Abd Elgawad, Hamdy A. Hendawy
Following intubation, the blocks were performed in an aseptic setting with the patients being observed with a fitted oxygen face mask. The block was performed on the same side of the surgery. The side of the patient’s face that needed to be blocked was on the upper side while they lay supine. The high-frequency, linear array transducer (Sonosite M-Turbo ® US machine, 7–12 MHz) was positioned longitudinally on the side of the face slightly below the zygomatic bone, above the mandibular notch, and in front of the mandibular condyle. The probe’s angle was cephalad, pointing in the direction of the pterygopalatine fossa. To reach the foramen rotundum, the local anesthetic could be injected deeply into the superior head of the lateral pterygoid muscle along the pterygomaxillary fissure. The zygomatic bone, lateral pterygoid muscle, lateral pterygoid plate, maxillary bone, and maxillary artery were identified in the pterygopalatine fossa using US and color power Doppler US. A 22-G, 5 cm insulated echogenic needle was inserted out of plane above the zygomatic bone (suprazygomatic approach) and introduced in a lateral to medial and posterior to anterior direction in the pterygopalatine fossa. The patient’s mouth was kept open with an oral airway to prevent the coronoid process from creating an auditory shadow. The probe was slightly elevated in a superior direction. A negative aspiration was followed by the administration of 5 mL of 0.25% bupivacaine.
Bayesian model selection in linear mixed models for longitudinal data
Published in Journal of Applied Statistics, 2020
Oludare Ariyo, Adrian Quintero, Johanna Muñoz, Geert Verbeke, Emmanuel Lesaffre
In the dental study analyzed by Potthoff and Roy [41], the distance in (mm) from the pituitary to the pterygomaxillary fissure was measured at years 8, 10, 12 and 14 on 11 girls and 16 boys. We fitted the following linear mixed model as a function of age and sex (0= Female, 1=Male): i at time j and 34], we obtained the following maximum likelihood estimates: age and sex (0 = Girls, 1 = Boys) of the child, and age of the mother at delivery (agem). The details of the original analysis can be found in [28,30] where a sample of 495 children was selected to fit the model. This subset will also be the basis for this simulation study. The weight evolves in a non-linear way. To make use of an LMM, the time variable age was transformed into 30]. Initially, our population model is based on the following random intercept and slope model:
Transcervical endoscopic approach for parapharyngeal space: a cadaver study and clinical practice
Published in Acta Oto-Laryngologica, 2020
Yi Fang, Haitao Wu, Andrew D. Tan, Lei Cheng
In some cases of tumors that protrude into oropharynx, complete resection of the tumor can be achieved by transcervical endoscopic surgery. Compared with the transoral endoscopic operation, it has the advantage of good arterial control and external negative pressure drainage to prevent postoperative hemorrhage and airway compression. After transoral approach, if the pharyngeal cavity is sutured, it is difficult to retain the drainage tube. If the wound is opened, it is easy to get infected and affect feeding. In the case of tumor breaking into the pharyngeal cavity, combined transoral approach is required. Through transcervical endoscopic surgery, parapharyngeal tumors with smooth capsules can be resected more safely and completely under direct vision whenever they reach up to the skull base, internally exceeding the middle line of oropharynx. The middle fossa approach should be combined when the tumor invades the skull base. When the tumor is located in the inferior temporal fossa, pterygopalatine fossa, and the masticatory muscle space, that is to say the lower boundary of the tumor is above the level of pterygomaxillary fissure, it needs to be completed by endonasal endoscopic approach. The transparotid approach can be combined to remove the lesions derived from the deep leaf of parotid gland.