TY - JOUR
T1 - The pterygospinous and pterygoalar ligaments and their relationship to the mandibular nerve
T2 - Application to a better understanding of various forms of trigeminal neuralgia
AU - Iwanaga, Joe
AU - Clifton, William
AU - Dallapiazza, Robert F.
AU - Miyamoto, Yusuke
AU - Komune, Noritaka
AU - Gremillion, Henry A.
AU - Dumont, Aaron S.
AU - Tubbs, R. Shane
N1 - Funding Information:
The authors would like to thank those who donated their body for the advancement of medical education and research. All the authors have read the manuscript and have approved this submission.
Publisher Copyright:
© 2020 Elsevier GmbH
PY - 2020/5
Y1 - 2020/5
N2 - Introduction: Ossification of the pterygospinous and pterygoalar ligaments has been well documented forming pterygospinous and pterygoalar bars. However, the actual ligaments have been rarely shown in the existing literature. Therefore, this study aimed to reveal the anatomy of the pterygoalar ligament/bar and pterygospinous ligament/bar, and its relationship with the branches of the mandibular nerve. Methods: Thirty sides from fifteen Caucasian fresh frozen cadaveric heads were used in this study. The branches of the mandibular nerve and any ligaments or bony bridges between the lateral plate of the pterygoid process and spine of the sphenoid were observed. Results: A pterygospinous ligament/bar and pterygoalar ligament/bar were defined based on the relationship with the branches of the mandibular nerve. The pterygoalar ligament/bar was further classified into two types. Twenty-seven sides (90%) had at least one pterygoalar ligament/bar or pterygospinous ligament/bar. A pterygospinous ligament/bar was found on 15 sides (50.0%). A pterygoalar ligament/bar was found on 16 sides (53.3%), and a type I on 11 sides and type II on 5 sides. Conclusions: This finding and classification are simple to understand and easy to apply for future studies, and have important implications regarding the clinical anatomy of trigeminal neuralgia and facial pain.
AB - Introduction: Ossification of the pterygospinous and pterygoalar ligaments has been well documented forming pterygospinous and pterygoalar bars. However, the actual ligaments have been rarely shown in the existing literature. Therefore, this study aimed to reveal the anatomy of the pterygoalar ligament/bar and pterygospinous ligament/bar, and its relationship with the branches of the mandibular nerve. Methods: Thirty sides from fifteen Caucasian fresh frozen cadaveric heads were used in this study. The branches of the mandibular nerve and any ligaments or bony bridges between the lateral plate of the pterygoid process and spine of the sphenoid were observed. Results: A pterygospinous ligament/bar and pterygoalar ligament/bar were defined based on the relationship with the branches of the mandibular nerve. The pterygoalar ligament/bar was further classified into two types. Twenty-seven sides (90%) had at least one pterygoalar ligament/bar or pterygospinous ligament/bar. A pterygospinous ligament/bar was found on 15 sides (50.0%). A pterygoalar ligament/bar was found on 16 sides (53.3%), and a type I on 11 sides and type II on 5 sides. Conclusions: This finding and classification are simple to understand and easy to apply for future studies, and have important implications regarding the clinical anatomy of trigeminal neuralgia and facial pain.
UR - http://www.scopus.com/inward/record.url?scp=85078246109&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85078246109&partnerID=8YFLogxK
U2 - 10.1016/j.aanat.2020.151466
DO - 10.1016/j.aanat.2020.151466
M3 - Article
C2 - 31972273
AN - SCOPUS:85078246109
VL - 229
JO - Annals of Anatomy
JF - Annals of Anatomy
SN - 0940-9602
M1 - 151466
ER -