The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Nyall R London - One of the best experts on this subject based on the ideXlab platform.
-
a novel landmark for endonasal surgery of the Pterygopalatine fossa and inferior orbital fissure the orbito pterygo sphenoidal ligament
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2021Co-Authors: Daniel M Prevedello, Nyall R London, Ricardo L. CarrauAbstract:The Pterygopalatine fossa contains a dense and complex array of neurovascular structures vulnerable to accidental surgical injury. This study aims to describe a novel landmark, the orbito-pterygo-sphenoidal ligament (OPSL), and implications of this structure for surgery in the Pterygopalatine fossa and the inferior orbital fissure. Six cadaveric specimens (12 sides) were dissected using an endonasal approach to expose the periosteal layers associated with the Pterygopalatine fossa and orbit. The thickened triangular-shaped ligament at their confluence was termed the OPSL. Dimensions of its lateral, inferior, and medial borders were measured, and their anatomical relationships defined. The Pterygopalatine Ganglion and the maxillary nerve lie immediately inferior and deep into the OPSL. The superior aspect of the posterior nasoseptal artery and nerve are covered by the medial OPSL. The lateral and inferior borders of the OPSL are contiguous with the periorbita and the periosteum of the Pterygopalatine fossa, respectively. Along the medial border of the ligament, the openings of the palatovaginal fissure, vidian canal, and foramen rotundum were sequentially identified in a medial to lateral trajectory. The length of the lateral, inferior, and medial borders of the triangular OPSL were 13.25 ± 0.62, 14.25 ± 0.45, and 12.08 ± 0.90 mm, respectively. The OPSL is a thick, triangular-shaped fascial confluence, which may serve as a landmark for procedures within the Pterygopalatine fossa and the inferior orbital fissure.
-
endoscopic prelacrimal approach to lateral recess of sphenoid sinus feasibility study
International Forum of Allergy & Rhinology, 2020Co-Authors: Daniel M Prevedello, Nyall R London, Lifeng Li, Ricardo L. CarrauAbstract:BACKGROUND: Various pathologies, including cerebrospinal fluid leaks and meningoencephaloceles, may arise in the lateral recess of the sphenoid sinus (LRSS), which may be accessed via an endonasal transpterygoid approach. The objective of this study was to evaluate the feasibility of accessing the LRSS via an endoscopic prelacrimal approach. Furthermore, we hypothesized that this approach may protect the Pterygopalatine Ganglion and vidian nerve. METHODS: Five cadaveric heads (9 sides) with a well-pneumatized LRSS were identified and an endonasal prelacrimal approach was performed. The infraorbital nerve, at the orbital floor, served as a critical landmark. After identification of the foramen rotundum at the pterygoid base, the vascular compartment of the Pterygopalatine fossa and the Pterygopalatine Ganglion were displaced inferomedially and superomedially, respectively. Drilling of the bone inferomedial to the foramen rotundum allowed entry into the LRSS. RESULTS: The average distances from the prelacrimal window to the pterygoid base and the posterior wall of the LRSS were 6.22 ± 0.39 cm and 7.16 ± 0.50 cm, respectively. The average areas of the bony prelacrimal window and pterygoid base window were 4.33 ± 0.32 cm2 and 0.73 ± 0.10 cm2 , respectively. The LRSS could be accessed using a 0-degree endoscope, and Pterygopalatine neurovascular structures, including the Pterygopalatine Ganglion and vidian nerve, could be preserved on all 9 sides. CONCLUSION: Our findings suggest that an endonasal prelacrimal approach provides a reasonable alternative to access the LRSS while preserving the vidian nerve and Pterygopalatine Ganglion.
-
Endoscopic prelacrimal approach to lateral recess of sphenoid sinus: feasibility study.
International forum of allergy & rhinology, 2019Co-Authors: Nyall R London, Daniel M Prevedello, Ricardo L. CarrauAbstract:BACKGROUND Various pathologies, including cerebrospinal fluid leaks and meningoencephaloceles, may arise in the lateral recess of the sphenoid sinus (LRSS), which may be accessed via an endonasal transpterygoid approach. The objective of this study was to evaluate the feasibility of accessing the LRSS via an endoscopic prelacrimal approach. Furthermore, we hypothesized that this approach may protect the Pterygopalatine Ganglion and vidian nerve. METHODS Five cadaveric heads (9 sides) with a well-pneumatized LRSS were identified and an endonasal prelacrimal approach was performed. The infraorbital nerve, at the orbital floor, served as a critical landmark. After identification of the foramen rotundum at the pterygoid base, the vascular compartment of the Pterygopalatine fossa and the Pterygopalatine Ganglion were displaced inferomedially and superomedially, respectively. Drilling of the bone inferomedial to the foramen rotundum allowed entry into the LRSS. RESULTS The average distances from the prelacrimal window to the pterygoid base and the posterior wall of the LRSS were 6.22 ± 0.39 cm and 7.16 ± 0.50 cm, respectively. The average areas of the bony prelacrimal window and pterygoid base window were 4.33 ± 0.32 cm2 and 0.73 ± 0.10 cm2 , respectively. The LRSS could be accessed using a 0-degree endoscope, and Pterygopalatine neurovascular structures, including the Pterygopalatine Ganglion and vidian nerve, could be preserved on all 9 sides. CONCLUSION Our findings suggest that an endonasal prelacrimal approach provides a reasonable alternative to access the LRSS while preserving the vidian nerve and Pterygopalatine Ganglion.
Anton Reiner - One of the best experts on this subject based on the ideXlab platform.
-
Stimulation of Baroresponsive Parts of the Nucleus of the Solitary Tract Produces Nitric Oxide-mediated Choroidal Vasodilation in Rat Eye
Frontiers Media S.A., 2016Co-Authors: Anton Reiner, Malinda E C Fitzgerald, Nobel Del MarAbstract:PreGanglionic parasympathetic neurons of the ventromedial part of the superior salivatory nucleus (SSN) mediate vasodilation of orbital and choroidal blood vessels, via their projection to the nitrergic Pterygopalatine Ganglion (PPG) neurons that innervate these vessels. We recently showed that the baroresponsive part of the nucleus of the solitary tract (NTS) innervates choroidal control parasympathetic preGanglionic neurons of SSN in rats. As this projection provides a means by which blood pressure signals may modulate ChBF, we investigated if activation of baroresponsive NTS evokes ChBF increases in rat eye, using Laser Doppler flowmetry to measure ChBF transclerally. We found that electrical activation of ipsilateral baroresponsive NTS and its efferent fiber pathway to choroidal SSN increased mean ChBF by about 40-80% above baseline, depending on current level. The ChBF responses obtained with stimulation of baroresponsive NTS were driven by increases in both choroidal blood volume (i.e. vasodilation) and choroidal blood velocity (presumed orbital vessel dilation). Stimulation of baroresponsive NTS, by contrast, yielded no significant mean increases in systemic arterial blood pressure. We further found that the increases in ChBF with NTS stimulation were significantly reduced by administration of the neuronal nitric oxide synthase inhibitor Nω-propyl-l-arginine (NPA), thus implicating nitrergic PPG terminals in the NTS-elicited ChBF increases. Our results show that NTS neurons projecting to choroidal SSN do mediate increase in ChBF, and thus suggest a role of baroresponsive NTS in the blood pressure-dependent regulation of ChBF
-
projections from the hypothalamic paraventricular nucleus and the nucleus of the solitary tract to prechoroidal neurons in the superior salivatory nucleus pathways controlling rodent choroidal blood flow
Brain Research, 2010Co-Authors: Mark S. Ledoux, Suzhen Gong, Malinda E C Fitzgerald, Nobel Del Mar, Patrick T Ryan, Anton ReinerAbstract:Using intrachoroidal injection of the transneuronal retrograde tracer pseudorabies virus (PRV) in rats, we previously localized preGanglionic neurons in the superior salivatory nucleus (SSN) that regulate choroidal blood flow (ChBF) via projections to the Pterygopalatine Ganglion (PPG). In the present study, we used higher-order transneuronal retrograde labeling following intrachoroidal PRV injection to identify central neuronal cell groups involved in parasympathetic regulation of ChBF via input to the SSN. These prominently included the hypothalamic paraventricular nucleus (PVN) and the nucleus of the solitary tract (NTS), both of which are responsive to systemic BP and are involved in systemic sympathetic vasoconstriction. Conventional pathway tracing methods were then used to determine if the PVN and/or NTS project directly to the choroidal subdivision of the SSN. Following retrograde tracer injection into SSN (biotinylated dextran amine 3K or Fluorogold), labeled perikarya were found in PVN and NTS. Injection of the anterograde tracer, biotinylated dextran amine 10K (BDA10K), into PVN or NTS resulted in densely packed BDA10K+terminals in prechoroidal SSN (as defined by its enrichment in nitric oxide synthase-containing perikarya). Double-label studies showed these inputs ended directly on prechoroidal nitric oxide synthase-containing neurons of SSN. Our study thus establishes that PVN and NTS project directly to the part of SSN involved in parasympathetic vasodilatory control of the choroid via the PPG. These results suggest that control of ChBF may be linked to systemic blood pressure and central control of the systemic vasculature.
-
Localization of preGanglionic neurons that innervate choroidal neurons of Pterygopalatine Ganglion.
Investigative ophthalmology & visual science, 2003Co-Authors: S.l. Cuthbertson, Patrick Ryan, Mark S. Ledoux, Qihong Zhou, Seth Jones, Julia Jones, Suzhen Gong, Anton ReinerAbstract:PURPOSE. The Pterygopalatine Ganglion (PPG) receives preGanglionic input from the superior salivatory nucleus (SSN) of the facial motor complex and is the main source of parasympathetic input to the choroid in mammals. The present study was undertaken to determine in rats the location and neurotransmitters of SSN neurons innervating those PPG neurons that target the choroid and to determine the location and neurotransmitters of the PPG choroidal neurons themselves. METHODS. Retrograde labeling from rat choroid using a fluorescent tracer, in combination with immunofluorescence labeling for nitric oxide synthase (NOS), vasoactive intestinal polypeptide (VIP), and choline acetyltransferase (ChAT), was used to characterize the location and neurotransmitters of choroidal PPG neurons. To identify SSN neurons that innervate the choroidal PPG neurons, the Bartha strain of the retrograde transneuronal tracer pseudorabies virus (PRV-Ba) was injected into rat choroid, and immunolabeling for NOS or ChAT was used to characterize their neurochemistry. RESULTS. Fluorescent retrograde labeling showed that PPG neurons projecting to the choroid contained NOS, VIP, and ChAT and were widely distributed in PPG and its preGanglionic root, the greater petrosal nerve. SSN neurons were ChAT, and a subset of them was found to contain NOS. PRV-Ba transneuronal retrograde labeling revealed that choroidal preGanglionic neurons were localized to the rostral medioventral part of the ipsilateral SSN. The choroidal SSN neurons were ChAT and appeared largely to correspond to the NOS neurons of the SSN. CONCLUSIONS. These results show that preGanglionic neurons in rats that are presumed to regulate choroidal blood flow through the PPG reside within the rostral medioventral SSN, and that NOS is a marker for these SSN neurons. (Invest Ophthalmol Vis Sci. 2003;44:3713‐3724) DOI:10.1167/ iovs.02-1207
-
innervation of orbital and choroidal blood vessels by the Pterygopalatine Ganglion in pigeons
The Journal of Comparative Neurology, 1997Co-Authors: S.l. Cuthbertson, Malinda E C Fitzgerald, B Jackson, C A B Toledo, Yungfeng Shih, Yuri Zagvazdin, Anton ReinerAbstract:Orbital and choroidal blood vessels in mammals are known to receive a parasympathetic innervation from the Pterygopalatine Ganglion, which appears to utilize vasoactive intestinal polypeptide (VIP) and nitric oxide (NO) to increase choroidal blood flow. The present studies were undertaken to elucidate the anatomical and neurotransmitter organization of the Pterygopalatine Ganglion input to orbital and choroidal blood vessels in pigeons. Single- or double-label immunohistochemistry were employed on paraformaldehyde-fixed cryostat sections of the pigeon eye and surrounding orbital tissue to localize 1) VIP+ neurons and fibers; 2) choline acetyltransferase (CHAT)-containing cholinergic neurons and fibers; 3) axons containing the 3A10 neurofilament-associated antigen; and 4) neuronal NO synthase (nNOS)-containing neurons and fibers. NOS+ neurons and fibers were also identified by NADPH-diaphorase histochemistry in sections and whole-mount specimens. The Pterygopalatine Ganglion was found to consist of an interconnected series of three to four main microganglia of about 50-200 neurons each and numerous lesser microganglia. The major microganglia of the Pterygopalatine network in pigeon lie along the superior aspect of the Harderian gland, with many additional fibers and microganglia of the network encircling the gland. Neurons of all microganglia were extremely rich in VIP, nNOS, and NADPH-diaphorase and moderate in CHAT. The majority of the Pterygopalatine Ganglion neurons were observed to co-contain VIP and nNOS. Axons labeled for VIP, nNOS, NADPH-diaphorase, or the 3A10 antigen could be traced from the Pterygopalatine Ganglion network to perivascular fiber plexi on orbital blood vessels. These orbital vessels, many of which enter the choroid posteriorly and nasally, appear to be a conduit by which Pterygopalatine postGanglionic fibers reach the choroid. The Pterygopalatine postGanglionic fibers were also seen to innervate the Harderian gland and contribute branches to the nearby ophthalmic nerve. Within the choroid, VIP+ fibers were widely scattered and sparse but were most abundant in nasal choroid. A few VIP+ and NADPH- diaphorase+ neurons were also observed in the choroid. These results suggest that Pterygopalatine Ganglion neurons of birds use VIP and NO to exert vasodilatory control over blood flow to and within the avian choroid. J. Comp. Neurol. 386:422-442, 1997. © 1997 Wiley-Liss, Inc.
Ricardo L. Carrau - One of the best experts on this subject based on the ideXlab platform.
-
a novel landmark for endonasal surgery of the Pterygopalatine fossa and inferior orbital fissure the orbito pterygo sphenoidal ligament
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2021Co-Authors: Daniel M Prevedello, Nyall R London, Ricardo L. CarrauAbstract:The Pterygopalatine fossa contains a dense and complex array of neurovascular structures vulnerable to accidental surgical injury. This study aims to describe a novel landmark, the orbito-pterygo-sphenoidal ligament (OPSL), and implications of this structure for surgery in the Pterygopalatine fossa and the inferior orbital fissure. Six cadaveric specimens (12 sides) were dissected using an endonasal approach to expose the periosteal layers associated with the Pterygopalatine fossa and orbit. The thickened triangular-shaped ligament at their confluence was termed the OPSL. Dimensions of its lateral, inferior, and medial borders were measured, and their anatomical relationships defined. The Pterygopalatine Ganglion and the maxillary nerve lie immediately inferior and deep into the OPSL. The superior aspect of the posterior nasoseptal artery and nerve are covered by the medial OPSL. The lateral and inferior borders of the OPSL are contiguous with the periorbita and the periosteum of the Pterygopalatine fossa, respectively. Along the medial border of the ligament, the openings of the palatovaginal fissure, vidian canal, and foramen rotundum were sequentially identified in a medial to lateral trajectory. The length of the lateral, inferior, and medial borders of the triangular OPSL were 13.25 ± 0.62, 14.25 ± 0.45, and 12.08 ± 0.90 mm, respectively. The OPSL is a thick, triangular-shaped fascial confluence, which may serve as a landmark for procedures within the Pterygopalatine fossa and the inferior orbital fissure.
-
endoscopic prelacrimal approach to lateral recess of sphenoid sinus feasibility study
International Forum of Allergy & Rhinology, 2020Co-Authors: Daniel M Prevedello, Nyall R London, Lifeng Li, Ricardo L. CarrauAbstract:BACKGROUND: Various pathologies, including cerebrospinal fluid leaks and meningoencephaloceles, may arise in the lateral recess of the sphenoid sinus (LRSS), which may be accessed via an endonasal transpterygoid approach. The objective of this study was to evaluate the feasibility of accessing the LRSS via an endoscopic prelacrimal approach. Furthermore, we hypothesized that this approach may protect the Pterygopalatine Ganglion and vidian nerve. METHODS: Five cadaveric heads (9 sides) with a well-pneumatized LRSS were identified and an endonasal prelacrimal approach was performed. The infraorbital nerve, at the orbital floor, served as a critical landmark. After identification of the foramen rotundum at the pterygoid base, the vascular compartment of the Pterygopalatine fossa and the Pterygopalatine Ganglion were displaced inferomedially and superomedially, respectively. Drilling of the bone inferomedial to the foramen rotundum allowed entry into the LRSS. RESULTS: The average distances from the prelacrimal window to the pterygoid base and the posterior wall of the LRSS were 6.22 ± 0.39 cm and 7.16 ± 0.50 cm, respectively. The average areas of the bony prelacrimal window and pterygoid base window were 4.33 ± 0.32 cm2 and 0.73 ± 0.10 cm2 , respectively. The LRSS could be accessed using a 0-degree endoscope, and Pterygopalatine neurovascular structures, including the Pterygopalatine Ganglion and vidian nerve, could be preserved on all 9 sides. CONCLUSION: Our findings suggest that an endonasal prelacrimal approach provides a reasonable alternative to access the LRSS while preserving the vidian nerve and Pterygopalatine Ganglion.
-
Endoscopic prelacrimal approach to lateral recess of sphenoid sinus: feasibility study.
International forum of allergy & rhinology, 2019Co-Authors: Nyall R London, Daniel M Prevedello, Ricardo L. CarrauAbstract:BACKGROUND Various pathologies, including cerebrospinal fluid leaks and meningoencephaloceles, may arise in the lateral recess of the sphenoid sinus (LRSS), which may be accessed via an endonasal transpterygoid approach. The objective of this study was to evaluate the feasibility of accessing the LRSS via an endoscopic prelacrimal approach. Furthermore, we hypothesized that this approach may protect the Pterygopalatine Ganglion and vidian nerve. METHODS Five cadaveric heads (9 sides) with a well-pneumatized LRSS were identified and an endonasal prelacrimal approach was performed. The infraorbital nerve, at the orbital floor, served as a critical landmark. After identification of the foramen rotundum at the pterygoid base, the vascular compartment of the Pterygopalatine fossa and the Pterygopalatine Ganglion were displaced inferomedially and superomedially, respectively. Drilling of the bone inferomedial to the foramen rotundum allowed entry into the LRSS. RESULTS The average distances from the prelacrimal window to the pterygoid base and the posterior wall of the LRSS were 6.22 ± 0.39 cm and 7.16 ± 0.50 cm, respectively. The average areas of the bony prelacrimal window and pterygoid base window were 4.33 ± 0.32 cm2 and 0.73 ± 0.10 cm2 , respectively. The LRSS could be accessed using a 0-degree endoscope, and Pterygopalatine neurovascular structures, including the Pterygopalatine Ganglion and vidian nerve, could be preserved on all 9 sides. CONCLUSION Our findings suggest that an endonasal prelacrimal approach provides a reasonable alternative to access the LRSS while preserving the vidian nerve and Pterygopalatine Ganglion.
Malinda E C Fitzgerald - One of the best experts on this subject based on the ideXlab platform.
-
Stimulation of Baroresponsive Parts of the Nucleus of the Solitary Tract Produces Nitric Oxide-mediated Choroidal Vasodilation in Rat Eye
Frontiers Media S.A., 2016Co-Authors: Anton Reiner, Malinda E C Fitzgerald, Nobel Del MarAbstract:PreGanglionic parasympathetic neurons of the ventromedial part of the superior salivatory nucleus (SSN) mediate vasodilation of orbital and choroidal blood vessels, via their projection to the nitrergic Pterygopalatine Ganglion (PPG) neurons that innervate these vessels. We recently showed that the baroresponsive part of the nucleus of the solitary tract (NTS) innervates choroidal control parasympathetic preGanglionic neurons of SSN in rats. As this projection provides a means by which blood pressure signals may modulate ChBF, we investigated if activation of baroresponsive NTS evokes ChBF increases in rat eye, using Laser Doppler flowmetry to measure ChBF transclerally. We found that electrical activation of ipsilateral baroresponsive NTS and its efferent fiber pathway to choroidal SSN increased mean ChBF by about 40-80% above baseline, depending on current level. The ChBF responses obtained with stimulation of baroresponsive NTS were driven by increases in both choroidal blood volume (i.e. vasodilation) and choroidal blood velocity (presumed orbital vessel dilation). Stimulation of baroresponsive NTS, by contrast, yielded no significant mean increases in systemic arterial blood pressure. We further found that the increases in ChBF with NTS stimulation were significantly reduced by administration of the neuronal nitric oxide synthase inhibitor Nω-propyl-l-arginine (NPA), thus implicating nitrergic PPG terminals in the NTS-elicited ChBF increases. Our results show that NTS neurons projecting to choroidal SSN do mediate increase in ChBF, and thus suggest a role of baroresponsive NTS in the blood pressure-dependent regulation of ChBF
-
projections from the hypothalamic paraventricular nucleus and the nucleus of the solitary tract to prechoroidal neurons in the superior salivatory nucleus pathways controlling rodent choroidal blood flow
Brain Research, 2010Co-Authors: Mark S. Ledoux, Suzhen Gong, Malinda E C Fitzgerald, Nobel Del Mar, Patrick T Ryan, Anton ReinerAbstract:Using intrachoroidal injection of the transneuronal retrograde tracer pseudorabies virus (PRV) in rats, we previously localized preGanglionic neurons in the superior salivatory nucleus (SSN) that regulate choroidal blood flow (ChBF) via projections to the Pterygopalatine Ganglion (PPG). In the present study, we used higher-order transneuronal retrograde labeling following intrachoroidal PRV injection to identify central neuronal cell groups involved in parasympathetic regulation of ChBF via input to the SSN. These prominently included the hypothalamic paraventricular nucleus (PVN) and the nucleus of the solitary tract (NTS), both of which are responsive to systemic BP and are involved in systemic sympathetic vasoconstriction. Conventional pathway tracing methods were then used to determine if the PVN and/or NTS project directly to the choroidal subdivision of the SSN. Following retrograde tracer injection into SSN (biotinylated dextran amine 3K or Fluorogold), labeled perikarya were found in PVN and NTS. Injection of the anterograde tracer, biotinylated dextran amine 10K (BDA10K), into PVN or NTS resulted in densely packed BDA10K+terminals in prechoroidal SSN (as defined by its enrichment in nitric oxide synthase-containing perikarya). Double-label studies showed these inputs ended directly on prechoroidal nitric oxide synthase-containing neurons of SSN. Our study thus establishes that PVN and NTS project directly to the part of SSN involved in parasympathetic vasodilatory control of the choroid via the PPG. These results suggest that control of ChBF may be linked to systemic blood pressure and central control of the systemic vasculature.
-
innervation of orbital and choroidal blood vessels by the Pterygopalatine Ganglion in pigeons
The Journal of Comparative Neurology, 1997Co-Authors: S.l. Cuthbertson, Malinda E C Fitzgerald, B Jackson, C A B Toledo, Yungfeng Shih, Yuri Zagvazdin, Anton ReinerAbstract:Orbital and choroidal blood vessels in mammals are known to receive a parasympathetic innervation from the Pterygopalatine Ganglion, which appears to utilize vasoactive intestinal polypeptide (VIP) and nitric oxide (NO) to increase choroidal blood flow. The present studies were undertaken to elucidate the anatomical and neurotransmitter organization of the Pterygopalatine Ganglion input to orbital and choroidal blood vessels in pigeons. Single- or double-label immunohistochemistry were employed on paraformaldehyde-fixed cryostat sections of the pigeon eye and surrounding orbital tissue to localize 1) VIP+ neurons and fibers; 2) choline acetyltransferase (CHAT)-containing cholinergic neurons and fibers; 3) axons containing the 3A10 neurofilament-associated antigen; and 4) neuronal NO synthase (nNOS)-containing neurons and fibers. NOS+ neurons and fibers were also identified by NADPH-diaphorase histochemistry in sections and whole-mount specimens. The Pterygopalatine Ganglion was found to consist of an interconnected series of three to four main microganglia of about 50-200 neurons each and numerous lesser microganglia. The major microganglia of the Pterygopalatine network in pigeon lie along the superior aspect of the Harderian gland, with many additional fibers and microganglia of the network encircling the gland. Neurons of all microganglia were extremely rich in VIP, nNOS, and NADPH-diaphorase and moderate in CHAT. The majority of the Pterygopalatine Ganglion neurons were observed to co-contain VIP and nNOS. Axons labeled for VIP, nNOS, NADPH-diaphorase, or the 3A10 antigen could be traced from the Pterygopalatine Ganglion network to perivascular fiber plexi on orbital blood vessels. These orbital vessels, many of which enter the choroid posteriorly and nasally, appear to be a conduit by which Pterygopalatine postGanglionic fibers reach the choroid. The Pterygopalatine postGanglionic fibers were also seen to innervate the Harderian gland and contribute branches to the nearby ophthalmic nerve. Within the choroid, VIP+ fibers were widely scattered and sparse but were most abundant in nasal choroid. A few VIP+ and NADPH- diaphorase+ neurons were also observed in the choroid. These results suggest that Pterygopalatine Ganglion neurons of birds use VIP and NO to exert vasodilatory control over blood flow to and within the avian choroid. J. Comp. Neurol. 386:422-442, 1997. © 1997 Wiley-Liss, Inc.
Daniel M Prevedello - One of the best experts on this subject based on the ideXlab platform.
-
a novel landmark for endonasal surgery of the Pterygopalatine fossa and inferior orbital fissure the orbito pterygo sphenoidal ligament
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2021Co-Authors: Daniel M Prevedello, Nyall R London, Ricardo L. CarrauAbstract:The Pterygopalatine fossa contains a dense and complex array of neurovascular structures vulnerable to accidental surgical injury. This study aims to describe a novel landmark, the orbito-pterygo-sphenoidal ligament (OPSL), and implications of this structure for surgery in the Pterygopalatine fossa and the inferior orbital fissure. Six cadaveric specimens (12 sides) were dissected using an endonasal approach to expose the periosteal layers associated with the Pterygopalatine fossa and orbit. The thickened triangular-shaped ligament at their confluence was termed the OPSL. Dimensions of its lateral, inferior, and medial borders were measured, and their anatomical relationships defined. The Pterygopalatine Ganglion and the maxillary nerve lie immediately inferior and deep into the OPSL. The superior aspect of the posterior nasoseptal artery and nerve are covered by the medial OPSL. The lateral and inferior borders of the OPSL are contiguous with the periorbita and the periosteum of the Pterygopalatine fossa, respectively. Along the medial border of the ligament, the openings of the palatovaginal fissure, vidian canal, and foramen rotundum were sequentially identified in a medial to lateral trajectory. The length of the lateral, inferior, and medial borders of the triangular OPSL were 13.25 ± 0.62, 14.25 ± 0.45, and 12.08 ± 0.90 mm, respectively. The OPSL is a thick, triangular-shaped fascial confluence, which may serve as a landmark for procedures within the Pterygopalatine fossa and the inferior orbital fissure.
-
endoscopic prelacrimal approach to lateral recess of sphenoid sinus feasibility study
International Forum of Allergy & Rhinology, 2020Co-Authors: Daniel M Prevedello, Nyall R London, Lifeng Li, Ricardo L. CarrauAbstract:BACKGROUND: Various pathologies, including cerebrospinal fluid leaks and meningoencephaloceles, may arise in the lateral recess of the sphenoid sinus (LRSS), which may be accessed via an endonasal transpterygoid approach. The objective of this study was to evaluate the feasibility of accessing the LRSS via an endoscopic prelacrimal approach. Furthermore, we hypothesized that this approach may protect the Pterygopalatine Ganglion and vidian nerve. METHODS: Five cadaveric heads (9 sides) with a well-pneumatized LRSS were identified and an endonasal prelacrimal approach was performed. The infraorbital nerve, at the orbital floor, served as a critical landmark. After identification of the foramen rotundum at the pterygoid base, the vascular compartment of the Pterygopalatine fossa and the Pterygopalatine Ganglion were displaced inferomedially and superomedially, respectively. Drilling of the bone inferomedial to the foramen rotundum allowed entry into the LRSS. RESULTS: The average distances from the prelacrimal window to the pterygoid base and the posterior wall of the LRSS were 6.22 ± 0.39 cm and 7.16 ± 0.50 cm, respectively. The average areas of the bony prelacrimal window and pterygoid base window were 4.33 ± 0.32 cm2 and 0.73 ± 0.10 cm2 , respectively. The LRSS could be accessed using a 0-degree endoscope, and Pterygopalatine neurovascular structures, including the Pterygopalatine Ganglion and vidian nerve, could be preserved on all 9 sides. CONCLUSION: Our findings suggest that an endonasal prelacrimal approach provides a reasonable alternative to access the LRSS while preserving the vidian nerve and Pterygopalatine Ganglion.
-
Endoscopic prelacrimal approach to lateral recess of sphenoid sinus: feasibility study.
International forum of allergy & rhinology, 2019Co-Authors: Nyall R London, Daniel M Prevedello, Ricardo L. CarrauAbstract:BACKGROUND Various pathologies, including cerebrospinal fluid leaks and meningoencephaloceles, may arise in the lateral recess of the sphenoid sinus (LRSS), which may be accessed via an endonasal transpterygoid approach. The objective of this study was to evaluate the feasibility of accessing the LRSS via an endoscopic prelacrimal approach. Furthermore, we hypothesized that this approach may protect the Pterygopalatine Ganglion and vidian nerve. METHODS Five cadaveric heads (9 sides) with a well-pneumatized LRSS were identified and an endonasal prelacrimal approach was performed. The infraorbital nerve, at the orbital floor, served as a critical landmark. After identification of the foramen rotundum at the pterygoid base, the vascular compartment of the Pterygopalatine fossa and the Pterygopalatine Ganglion were displaced inferomedially and superomedially, respectively. Drilling of the bone inferomedial to the foramen rotundum allowed entry into the LRSS. RESULTS The average distances from the prelacrimal window to the pterygoid base and the posterior wall of the LRSS were 6.22 ± 0.39 cm and 7.16 ± 0.50 cm, respectively. The average areas of the bony prelacrimal window and pterygoid base window were 4.33 ± 0.32 cm2 and 0.73 ± 0.10 cm2 , respectively. The LRSS could be accessed using a 0-degree endoscope, and Pterygopalatine neurovascular structures, including the Pterygopalatine Ganglion and vidian nerve, could be preserved on all 9 sides. CONCLUSION Our findings suggest that an endonasal prelacrimal approach provides a reasonable alternative to access the LRSS while preserving the vidian nerve and Pterygopalatine Ganglion.