Heterotopic Brain in the Pterygopalatine Fossa (original) (raw)
Related papers
Brain Heterotopia in Pharyngeal Region. A Morphological and Immunohistochemical Study
Pathology - Research and Practice, 2002
Pharyngeal brain heterotopia is a congenital and generally biologically benign lesion. In contrast to brain heterotopia in the nose, the most common site of this lesion, brain heterotopia in the pharynx is very rare. Pharyngeal heterotopic tissue can be composed of various components, i.e., astrocytes, neurons, ependyma or choroid plexus, oligodendrocytes, retina, and, occasionally, neoplastic nodules. In contrast, nasal lesions are often only composed of astrocytes. We report a case of brain heterotopia in the pharyngeal region, diagnosed in a newborn female infant, causing serious respiratory distress. The infant underwent surgical excision of the lesion, and after 1 year of follow-up, she is recurrencefree. The mass, about 3 cm in diameter and showing no connection with encephalic structures, was characterized by numerous papillary structures and areas containing stellate-like or spindle cells focally forming nodules. Moreover, there was inflammatory infiltration, whereas mitoses, hemorrhages, and necroses were absent. Immunohistochemistry revealed a choroid plexus nature of the papillary formations (S-100, cytokeratins, transthyretin and vimentin-positive) and the presence of glial and neuronal cells in the remaining areas (glial fibrillary acidic protein, neuron-specific enolase, neurofilaments, synaptophysin, and S-100 positive). This case report confirms that the presence of choroid plexus is not uncommon and that pharyngeal brain heterotopia is usually benign.
Pterygopalatine Fossa: Not a Mystery!
Canadian Association of Radiologists Journal, 2017
The pterygopalatine fossa is an important anatomic crossroads that is connected with numerous intra- and extracranial spaces via foramina and fissures. Although this fossa is small, its central location in the skull base and its communications provide clinical, radiological, and anatomical significance. In this pictorial review, we aimed to describe the radiologic anatomy of the pterygopalatine fossa, as well as to give some pathologic examples to better understand this major conduit.
Heterotopic brain in the parapharyngeal space
International Journal of Pediatric Otorhinolaryngology, 1996
There have been numerous reports of various types of heterotopic tissue in the head and neck. Heterotopic cartilage, gastric tissue, thyroid, and salivary gland in such various locations as tongue, gingiva, palate, nasopharynx, parapharyngeal space, and neck have been frequently reported. Heterotopic brain in the parapharyngeal space causing airway obstruction in the neonate has been rarely described. These benign masses are capable of expansion and because of their location, can lead to significant airway and feeding difficulties. We describe 3 cases of heterotopic brain tissue in the parapharyngeal space causing feeding difficulties and airway obstruction in the neonatal period. Two were initially misdiagnosed as lymphatic malformations. In the third, a nine month delay in diagnosis occurred. The diagnostic features of heterotopic brain in this location and some management suggestions in treating such a lesion are discussed.
A case of nasal glial heterotopia in an adult
Case reports in otolaryngology, 2014
We report a rare case of nasal glial heterotopia in an adult. After the surgery, frontal lobe cerebral hemorrhage developed. A 58-year-old man had unilateral nasal obstruction that progressed for one year. He had been treated for hypertension, chronic heart failure, and cerebral infarction with aspirin and warfarin. A computed tomography scan showed that the tumor occupied the right nasal cavity and the sinuses with small defect in the cribriform plate. The tumor was removed totally with endoscopy. After the operation, the patient developed convulsions and frontal lobe cerebral hemorrhage. The hemorrhage site was located near a defect in the cribriform plate. Nasal glial heterotopia is a rare developmental abnormality, particularly rare in adult. Only few cases were reported. We could not find any report of adult nasal glial heterotopias that developed cerebral hemorrhage as a complication of the surgery.
The pterygopalatine recess of the superior nasal meatus
Surgical and Radiologic Anatomy, 2016
The pneumatizations surrounding the pterygopalatine fossa (PPF) and closely related to the sphenopalatine foramen are anatomically variable. During the assessment of a cone beam computed tomography of a 64-year-old male patient, we found bilaterally a previously unreported anatomic variant. This was represented by a lateral or pterygopalatine recess (PPR) of the superior nasal meatus which extended in the anterior wall of the PPF and protruded within the maxillary sinus to determine a maxillary bulla. The PPR was antero-superior to the sphenopalatine foramen. Additionally were found a right nasal septal deviation, seemingly compensated by a left middle concha bullosa and a left prominent ethmoidal bulla. The superior turbinates were also pneumatized. Such anatomic variants related to the pterygopalatine angle of the maxillary sinus should be explored prior to surgical or endoscopic procedures which target the maxillary sinus, the pterygopalatine fossa, or the skull base.
Case of Nasal Glial Heterotopia: A Diagnostic Dilemma
MMJ-A Journal by MIMER Medical College, Pune, India, 2017
&RS\ULJKW 7UDQVIHU)LQDQFLDO 'LVFORVXUH&RQIOLFW RI ,QWHUHVW CONDITIONS FOR SUBMISSION The articles must represent original research material, should not have been published before, and should not be under consideration of publication elsewhere. This however does not include previous publication in form of an abstract or as part of published literature (review or thesis). It is the duty of the author to obtain the necessary permissions for extensive quotations, tables, illustrations, or any other copyrighted material they are using in the paper before a paper can be considered for publication.
The pterygopalatine fossa: morphometric CT study with clinical implications
Surgical and Radiologic Anatomy, 2018
Purpose The pterygopalatine fossa is a deep viscerocranial space containing the maxillary artery and nerve, the pterygopalatine ganglion, and the nerve of the pterygoid canal (vidian nerve). The endoscopic approach to this area relies on adequate preoperative imaging, such as computed tomography (CT). The aim was to determine the morphometric characteristics of the pterygopalatine fossa and its communications, including several previously unpublished measurements. Methods 100 CT scans (56 male and 44 female patients) were analyzed. The axial, coronal, and sagittal slices, together with the three-dimensional reconstructions, were used in the study. Results The central diameter and the length of the foramen rotundum, the vertical diameter and the length of the pterygoid (vidian) canal, and the diameter of the sphenopalatine foramen were significantly larger in men. The central diameters of the foramen rotundum and the vidian canal were significantly smaller than their anterior and posterior transverse diameters. The vidian canal length of 12.1 mm indicates the presence of the type 3 VC with a sensitivity of 83% and a specificity of 85%. Conclusion Several new descriptions of the pterygopalatine fossa are presented here (such as the angle between the sphenopalatine foramen and the vidian canal, a new aspect in the understanding of the FR, and the distance between the posterior wall of the maxillary sinus to the vidian canal and the foramen rotundum), which might prove useful in the comprehension of the anatomy of the pterygopalatine fossa.
The anatomy of the pterygopalatine fossa keeps a traditional level and is viewed as constant, even though a series of structures neighboring the fossa are known to present individual variations. We aimed to evaluate on 3D volume renderizations the anatomical variables of the pterygopalatine fossa, as related to the variable pneumati-zation patterns of the bones surrounding the fossa. The study was performed retrospectively on cone beam computed tomography (CBCT) scans of 100 patients. The pterygopalatine fossa was divided into an upper (orbital) and a lower (pterygomaxillary) floor; the medial compartment of the orbital floor lodges the pterygopalatine gan-glion. The pneumatization patterns of the pterygopalatine fossa orbital floor walls were variable: (a) the posterior wall pneumatization pattern was determined in 89.5 % by recesses of the sphenoidal sinus related to the maxillary nerve and pterygoid canals; (b) the upper continuation of the pterygopalatine fossa with the orbital apex was narrowed in 79.5 % by ethmoid air cells and/or a maxillary recess of the sphenoidal sinus; (c) according to its pneu-matization pattern, the anterior wall of the pterygopalatine fossa was a maxillary (40.5 %), maxillo-ethmoidal (46.5 %), or maxillo-sphenoidal (13 %) wall. The logistic regression models showed that the maxillo-ethmoidal type of pterygopalatine fossa anterior wall was significantly associated with a sphenoidal sinus only expanded above the pterygoid canal and a spheno-ethmoidal upper wall. The pterygopalatine fossa viewed as an intersinus space is related to variable pneumatization patterns which can be accurately identified by CBCT and 3DVR studies, for anatomic and preoperatory purposes.
The pterygopalatine fossa: imaging anatomy, communications, and pathology revisited
Insights into Imaging, 2016
The pterygopalatine fossa (PPF) is a small, clinically inaccessible, fat-filled space located in the deep face that serves as a major neurovascular crossroad between the oral cavity, nasal cavity, nasopharynx, orbit, masticator space, and the middle cranial fossa. Due to its inherent complex location and connections, it can potentially act as a natural conduit for the spread of inflammatory and neoplastic diseases across the various deep spaces in the head and neck. This review aims to acquaint the reader with the imaging anatomy of the PPF, its important communications, and to identify some major pathological conditions that can involve the PPF, especially in conditions where its involvement can have serious diagnostic and therapeutic implications, such as in perineural tumour spread. Teaching points • The PPF is a small neurovascular junction in the deep face with important to-and-fro connections. • Awareness of anatomy of the PPF and its communications helps to simplify imaging of its pathology. • Perineural tumour spread is clinically the most important pathology in this region. Keywords Pterygopalatine fossa. CT. MRI. Perineural tumour spread High-resolution CT NECT Non-contrast-enhanced CT CECT Contrast-enhanced CT CEMRI Contrast-enhanced MR FS Fat-saturated RT Radiotherapy AJCC TNM American Joint Committee on Cancer (tumour, node, metastasis) classification
Glial Heterotopia over the Nasal Septum: A Case Report and Review of the Literature
An International Journal Clinical Rhinology, 2015
Nasal gliomas are rare congenital lesions arising from defective embryonic development, often termed as Nasal glial heterotopias. It manifests as a mass of extra-cranial cerebral tissue unconnected with the brain. Clinically, these masses are firm and incompressible. Histopathologically, they consist of neuroglial cells and astrocytes embedded in fibrous and vascular connective tissue. Radiological investigations, such as computed tomography (CT) or magnetic resonance imaging (MRI) should be done to rule out intracranial extension. The mass was completely resected endoscopically which was attached to the anterior part of the nasal septum. Endoscopic technique provides excellent visualization. We report one case of nasal glial heterotopia in a baby from southern part of Odisha which has an unusual attachment over the septum. A review of the literatures regarding nasal glioma is also presented. How to cite this article Swain SK, Dash S, Baisakh MR, Samal R. Glial Heterotopia over the ...