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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
The maxillary nerve (CN V2) also has many sensory branches. The nasopalatine nerve is a branch of CN V2 that lies in the mucosa of the nasal septum and runs with the sphenopalatine artery from the spheno-palatine foramen to the incisive canal and supplies the nasal septum and the mucosa that covers the anterior hard palate (Plate 3.39). In the lateral wall of the nasal cavity, the lesser and greater palatine nerves descend from the maxillary nerve, running through the pterygopalatine ganglion into the greater palatine canal, and pass through the lesser and greater palatine foramina, respectively. Parasympathetic fibers run with the maxillary nerve, having originated as branches of the facial nerve. These facial branches run first as the greater petrosal branch of the facial nerve, then as the nerve of the pterygoid canal (Vidian nerve), and then synapse in the pterygopalatine ganglion (see Section 3.3.1.7). Postganglionic axons that arise in this ganglion are distributed with branches of the maxillary nerve (Plate 3.16). The nerves of the pterygopalatine ganglion stimulate the lacrimal gland (crying) and also secretions from the mucosa of the nasal cavity, paranasal sinuses, roof of the mouth, soft palate, and nasopharynx.
Anatomy of the Skull Base and Infratemporal Fossa
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
A cone-shaped depression deep to the infratemporal fossa, posterior to the maxilla near the orbital apex, the small pterygopalatine fossa contains the terminal third of the maxillary artery, the maxillary nerve (V2), the pterygopalatine ganglion just in front of the pterygoid canal (itself containing the Vivian nerve, a union of the greater and deep petrosal nerves, which then runs anteriorly to the sphenopalatine ganglion) and fat. Its roof is the body of the sphenoid and medially it abuts the perpendicular plate of the palatine bone in the lateral nasal wall. It has several communications to other parts of the skull base, principally laterally via the pterygomaxillary fissure to the infratemporal fossa, medially via the sphenopalatine foramen to the nasal cavity and anteriorly via the inferior orbital fissure to the orbit; posteriorly, the pterygoid (Vidian) canal has been described, with the foramens rotundum and lacerum communicating to the middle cranial fossa.
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Published in Anton Sebastian, A Dictionary of the History of Medicine, 2018
Pterygopalatine Syndrome Neuralgia of the lower half of the face, nasal congestion and rhinorrhoea secondary to a lesion in the pterygopalatine ganglion. Described by Greenfield Sleuder (1865–1925) of NewYork in 1908.
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.
Post-concussion Syndrome Light Sensitivity: A Case Report and Review of the Literature
Published in Neuro-Ophthalmology, 2022
Mohammad Abusamak, Hamzeh Mohammad Alrawashdeh
Trigeminal ganglion neurons are both autonomic and sensory. The trigeminovascular reflex regulates the dilatation of innervated vessels by mediators, such as calcitonin gene-related peptide (CGRP) and nitric oxide, which are released after being activated by nociceptive sensory stimuli. The activation of superior salivatory and Edinger-Westphal nuclei by collaterals from the caudal trigeminal nucleus is known as the trigeminal-autonomic reflex, which is considered a multi-synaptic reflex. Parasympathetic activity in the pterygopalatine ganglion is activated by superior salivatory signals that dilate blood vessels and mediate lacrimation via the ciliary ganglion, in contrast to pupillary constriction, which is mediated by Edinger-Westphal output. These two reflexes explain the injection of conjunctival vessels and excessive tearing along with peri-orbital pain in patients with migraine or cluster headaches, which mostly occur with photophobia.1
Efficacy of five-flash intense pulsed light therapy technique in patients with meibomian gland dysfunction
Published in Clinical and Experimental Optometry, 2022
Siamak Zarei-Ghanavati, Samira Hassanzadeh, Abbas Azimi Khorasani, Asieh Ehsaei, Elham Bakhtiari
In the present study, a fifth temporal canthal IPL flash was applied during treatment. Although the mechanism of action of the canthal flash is not fully understood, it may enhance the IPL’s thermal energy transfer to the eyelids.31,32 Karaca et al. suggested a possible neurological effect of the lower lid and canthal flashes on parasympathetic innervation of meibomian glands the branches of which originate from the pterygopalatine ganglion. They hypothesised that this stimulation can encourage the meibomian glands to return to normal activity.17 In addition, the effect of parasympathetic neurotransmitters on human MG epithelial cells has been reported, but the exact mechanism and the possible MG functional changes are not fully understood.33