Anatomical and clinical significance of Pterygospinous and Pterygoalar ligaments and bony bars in dentistry.
Abstract
The Pterygospinous Ligament (PSL) extends from the Pterygospinous process of the lateral Pterygoid plate to the spine of the sphenoid bone. Sometimes, it may be ossified forming a bar of bone bounding the pterygospinous foramen to which mandibular nerve and its branches are variably related. Mandibular and chorda tympani nerves may get compressed depicting various clinical symptoms, which in turn depend upon dimensions of the foramen and grades of compression. Therefore, knowledge of the position and extent of ossification of PSL and its relation to the important structures in the deep infratemporal fossa is important for radiologists, neurologists, maxillofacial surgeons, dental surgeons and anesthesiologists during various anesthetic and surgical procedures.
References
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28. Suazo GI, Zavando MD, Smith RL. Anatomical Study of the Pterygospinous and Pterygoalar Bony Bridges and Foramens in Dried Crania and its Clinical Relevance. Int J Morphol. 2010;28(2):405–8.
29. Oetteking B. Memoirs of the American Museum of Natural History. New York, USA: American Museum of Natural History; 1930.
30. Akabori E. Crania nipponicarecentia I. Analytical inquiries into the non-metric variations in Japanese skull according to age and sex. Jpn J Med Sci I Anatomy. 1934;4:61–315.
31. Lepp FH, Sandner 0. Anatomic-radiographic study of ossified pterygospinous and "innominate" ligaments. Oral Surg Oral Med Oral Pathol. 1968;26(2):244–60.
32. Wurzburg JL. Skull Base and Related Structures Atlas of Clinical Anatomy. 2nd Ed. New York, USA: Schattauer; 1995.33. Nayak SR, Rai R, Krishnamurthy A, Prabhu LV, Ranade AV, Mansur DI, Kumar S. An unusual course and entrapment of the lingual nerve in the infratemporal fossa. Bratisl Lek Listy. 2008;109(11):525–7.
34. Shinde VS, Mallikarjun M, Patil R. A Study on an Ossified Pterygospinous Ligamen. J Clin Diagn Res. 2011;5(5 ):9 78 – 9.
35. Newton TH, Gordon D. Radiology of the skull and brain. 1st Ed. Saint Louis: Mosby; 1971.
36. Solan S, Reddy Nune GK. Anomalous Ossified Pterygospinous Ligament In Eastern Zone - A Case Study. J Dent Med Scien. 2014;13(4):60–2.
37. Erdogmus S, Pinar Y, Celik S. A cause of entrapment of the lingual nerve: ossified pterygospinous ligament – a case report. Neuroanatomy. 2009;8:43–5.
38. Piagkou M, Demesticha T, Skandalakis P, Johnson EO. Functional anatomy of the mandibular nerve: consequences of nerve injury and entrapment. Clin Anat. 2011;24(2):143–50.
39. Gerber AM. Improved visualization of the foramen ovale for percutaneous approaches to the gasserian ganglion. Technical note. J Neurosurg. 1994;80(1):156–9.
40. Skrzat J, Walocha J, Srodek R, Nizankowska A. An atypical position of the foramen ovale. Folia Morphol. 2006;65(4):396 –9. 41. Hai J, Li ST, Pan QG. Treatment of atypical trigeminal neuralgia with microvascular decompression. Neurol India.
2. Natsis K, Piagkou M, Skotsimara G, Totlis T, Apostolidis S, Panagiotopoulos NA, Skandalakis P. Anatomical Study of Pterygospinous and Pterygoalar Bar in Human Skulls with their Phylogeny and Clinical Significance. J Craniomaxillofac Surg. 2014;42(5):e266 –70.
3. Piagkou M, Demesticha T, Piagkos G, Georgios A, Panagiotis S. Lingual nerve entrapment in muscular and osseous structures. Int J Oral Sci. 2010;2(4):181–9.
4. Goyal N, Jain A. An anatomical study of the pterygospinous bar and foramen of Civinini. Surg Radiol Anat. 2016;38(8):931–6.
5. Atamaz-Pinar Y, Arsu G, Aktan-Ekiz ZA, Bilge O. Pterygospinous and pterygoalar bridges. Sendrom. 20 0 4;16(7):66 – 9.
6. Breathnach AS. Frazer's Anatomy of the Human Skeleton. 5th Ed. London, UK: J. and A. Churchill; 1958.
7. Saran RS, Ananthi KS, Subramaniam A, Balaji MT, Vinaitha D, Vaithianathan G. Foramen of civinini: a new anatomical guide for maxillofacial surgeons. J Clin Diagn Res. 2013;7(7):1271–5.
8. Rouvière H, Delmas A. Descriptive, Topographic and Functional Human Anatomy Reviewed and Augmented. 10th Ed. Paris, Francia: Edición Barcelona; 1999.
9. Antonopoulou M, Piagou M, Anagnostopoulou S. An anatomical study of the pterygospinous and pterygoalar bars and foramina - their clinical relevance. J Craniomaxillofac Surg. 2008;36(2):104–8.
10. Yadav A, Kumar V, Niranjan R. Pterygospinous Bar and Foramen in the Adult Human Skulls of North India: Its Incidence and Clinical Relevance. Anat Res Int. 2014;2014:1–5.
11. von Lüdinghausen M, Kageyama I, Miura M, Alkhatib M. Morphological peculiarities of the deep infratemporal fossa in advanced age. Surg Radiol Anat. 2006;28(3):284–92.
12. Wood-Jones F. The non-metrical Morphological Characters of the Skull as Criteria for Racial Diagnosis: Part II: The non-metrical Morphological Characters of the Hawaiian Skull. J Anat. 1931;65(Pt 3):368–78.
13. Peker T, Karaköse M, Anil A, Turgut HB, Gülekon N. The incidence of basal sphenoid bony bridges in dried crania and cadavers: their anthropological and clinical relevance. Eur J Morphol. 2002;40(3):171–80.
14. Nayak SR, Saralaya V, Prabhu LV, Pai MM, Vadgaonkar R, D'Costa S. Pterygospinous bar and foramina in Indian skulls: incidence and phylogenetic significance. Surg Radiol Anat. 2007;29(1):5–7.
15. Suazo GI, Zavando MD, Smith RL. Anatomical Study of the Pterygospinous and Pterygoalar Bony Bridges and Foramens in Dried Crania and its Clinical Relevance. Int J Morphol. 2010;28(2):405–8.
16. Rosa RR, Faig-Leite H, Faig-Leite FS, Moraes LC, Moraes ME, Filho EM. Radiographic study of ossification of the pterygospinous and pterygoalar ligaments by the Hirtz axial technique. Acta Odontol Latinoam. 2010;23(1):63–7.
17. Kapur E, Dilberović F, Redzepagić S, Berhamović E. [Variation in the lateral plate of the pterygoid process and the lateral subzygomatic approach to the mandibular nerve]. Med Arh. 2000;54(3):133–7.
18. Das S, Paul S. Ossified pterygospinous ligament and its clinical implications. Bratisl Lek Listy. 2007;108(3):141–3.
19. Tubbs RS, May WR Jr, Apaydin N, Shoja MM, Shokouhi G, Loukas M, Cohen-Gadol AA. Ossification of ligaments near the foramen ovale: an anatomic study with potential clinical significance regarding transcutaneous approaches to the skull base. Neurosurgery. 2009;65(6 Suppl):60–4.
20. Ghai R, Jain S, Khare S, Anand C, Tripathi A, Kaushik RK. Ossified Pterygospinous Ligament-An anomaly in the infratemporal region of human Skulls and its applied importance . Indian J Clin Anat Physiol. 2016;3(2):230–3.
21. Krmpotić-Nemanić J, Vinter I, Hat J, Jalsovec D. Mandibular neuralgia due to anatomical variations. Eur Arch Otorhinolaryngol. 1999;256(4):205–8.
22. Pinar Y, Arsu G, Aktan Lkiz ZA, Bilge O. The pterygo-spinous and the pterygoalar bridges. Sendrom. 2004;18:66–9.
23. Agarwal B, Gupta M, Kumar H. Ossified ligaments of the skull. J Anat Soc India. 2012;61(1):37–40.
24. Verma RK, Rani A, Chopra J, Pankaj AK, Kumar N. Civinini Bar: incidence in North Indians and its clinical relevance. National J Clin Anat. 2013;2:128–33.
25. B KK, K V. Anatomical Study of Pterygospinous and Pterygoalar Bar in Human Skulls with their Phylogeny and Clinical Significance. J Clin Diagn Res. 2014;8(9):AC10–3.
26. Shaw JP. Pterygospinous and pterygoalar foramina: A role in the etiology of trigeminal neuralgia? Clin Anat. 1993;6(3):173–8.
27. Chouké KS. On the incidence of the foramen of Civinini and the porus crotaphiticobuccinatorius in American Whites and Negroes. II. Observations on 2745 additional skulls. Am J Phys Anthropol. 1947;5:79–86.
28. Suazo GI, Zavando MD, Smith RL. Anatomical Study of the Pterygospinous and Pterygoalar Bony Bridges and Foramens in Dried Crania and its Clinical Relevance. Int J Morphol. 2010;28(2):405–8.
29. Oetteking B. Memoirs of the American Museum of Natural History. New York, USA: American Museum of Natural History; 1930.
30. Akabori E. Crania nipponicarecentia I. Analytical inquiries into the non-metric variations in Japanese skull according to age and sex. Jpn J Med Sci I Anatomy. 1934;4:61–315.
31. Lepp FH, Sandner 0. Anatomic-radiographic study of ossified pterygospinous and "innominate" ligaments. Oral Surg Oral Med Oral Pathol. 1968;26(2):244–60.
32. Wurzburg JL. Skull Base and Related Structures Atlas of Clinical Anatomy. 2nd Ed. New York, USA: Schattauer; 1995.33. Nayak SR, Rai R, Krishnamurthy A, Prabhu LV, Ranade AV, Mansur DI, Kumar S. An unusual course and entrapment of the lingual nerve in the infratemporal fossa. Bratisl Lek Listy. 2008;109(11):525–7.
34. Shinde VS, Mallikarjun M, Patil R. A Study on an Ossified Pterygospinous Ligamen. J Clin Diagn Res. 2011;5(5 ):9 78 – 9.
35. Newton TH, Gordon D. Radiology of the skull and brain. 1st Ed. Saint Louis: Mosby; 1971.
36. Solan S, Reddy Nune GK. Anomalous Ossified Pterygospinous Ligament In Eastern Zone - A Case Study. J Dent Med Scien. 2014;13(4):60–2.
37. Erdogmus S, Pinar Y, Celik S. A cause of entrapment of the lingual nerve: ossified pterygospinous ligament – a case report. Neuroanatomy. 2009;8:43–5.
38. Piagkou M, Demesticha T, Skandalakis P, Johnson EO. Functional anatomy of the mandibular nerve: consequences of nerve injury and entrapment. Clin Anat. 2011;24(2):143–50.
39. Gerber AM. Improved visualization of the foramen ovale for percutaneous approaches to the gasserian ganglion. Technical note. J Neurosurg. 1994;80(1):156–9.
40. Skrzat J, Walocha J, Srodek R, Nizankowska A. An atypical position of the foramen ovale. Folia Morphol. 2006;65(4):396 –9. 41. Hai J, Li ST, Pan QG. Treatment of atypical trigeminal neuralgia with microvascular decompression. Neurol India.
Published
2019-03-18
How to Cite
SOMAYAJI, Krishnaraj; RAO, Mohandas; SOMAYAJI, Nagabhushan.
Anatomical and clinical significance of Pterygospinous and Pterygoalar ligaments and bony bars in dentistry..
Journal of Oral Research, [S.l.], v. 8, n. 1, p. 82-90, mar. 2019.
ISSN 0719-2479.
Available at: <https://www.joralres.com/index.php/JOralRes/article/view/joralres.2019.003>. Date accessed: 25 apr. 2024.
doi: https://doi.org/10.17126/joralres.2019.003.
Issue
Section
Reviews
Keywords
Pterygoid; ligaments; foramen ovale; sphenoid bone; oral and maxillofacial surgeons.
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