Asfour - Neck Spaces

Question 1

Infratemporal Fossa

Answer 1

• Skull base deep to masseter and zygomatic arch
• Conduit for neurovascular structures entering and leaving cranial cavity
  Associated closely with:
• Pterygopalatine fossa (Via pterygomaxillary fisure)
• Temporal fossa

Question 2

Infratemporal Fossa Boundaries

Answer 2

Lateral - Condylar process and ramus of mandible
Medial - Lateral terygoid plate, tensor veli palatini, levator veli palatini, superior construictor muscles
Anterior - Posterior border of the maxilarry
Ran out of time

Question 3

Infratemporal Fossa Contents

Answer 3

Roof formed by greater wing of sphenoid bone
Contains Foramen Ovale (V3)
Contains Foramen Spinosum (Middle meningeal aftery)
Medial and lateral pterygoids located within fossa
Lateral pterygoid splits fossa contents in half, branches of mandibular nerve lay deep to muscle, maxillary artery superficial to it
Auriculotemporal, buccal, lingual and inferior
Chorda tympani
Otic ganglion

Question 4

Vasculature of INfratemporal Fossa

Answer 4

Maxillary Artery
Pterygoid venous plexus (drains eye, directly connected to cavernous sinus, relevant for ascending infection)
Maxillary Vein
MMV

Question 5

Parapharyngeal Space

Answer 5

Lateral pharyngeal space / Pharyngomaxillary space

Question 6

Parapharyngeal Space Boundaries

Answer 6

Cone shaped with base at skull base, apex at hyoid bone
Lies between angle of mandible and tonsil

Superior - Skull base (sphenoid bone)
Inferior: Junction of posterior belly of digastric and greater cornu of hyoid vone
Medial - TVPalatini, LVPalatini, Superior construictor, tonsillar fossa
Lateral - Ramus of mandible, pterygoid muscles
Ran out of time

Question 7

Parapharyngeal Space Compartments

Answer 7

Fascia lies between styloid process and TVPalatini
Prestyloid: Maxillary artery, fat, deep lobe of parotid, inferior alveolar nerve, lingual nerve, auriculotemporal nerve
Poststyloid: Neurovascular bundle (Carotid, IJ, Sympathetic chain, CN IX/X/XI

Question 8

Tumors in Parapharyngeal Space

Answer 8

80% are benign

Question 9

Prestyloid Parapharngeal Tumor

Answer 9

Salivary Gland most common, Pleomorphic Adenoma

Question 10

Paraglottic Space

Answer 10

Fibrofatty-filled space

Allows transglottic extension of glottic tumors

Question 11

Paraglottic Space Borders

Answer 11

Superomedial: Quadrangular Membrane (Fascia supporting AE fold)
Mid-Medial: Ventricle
Inferomedial: Conus Elasticus
Posterior: Piriform sinus mucosa
Inferior: Space between thyroid and cricoid cartilage
Lateral: Thyroid cartilage and C-T membrane

Question 12

Pre-Epiglottic Space

Answer 12

Midline fibrofatty-filled space, continuous with paraglottic space

Question 13

Pre-Epiglottic Space Boundaries

Answer 13

Anterior - Hyoid bone, thyrohyoid membrane
Superior - Hyoepiglottics ligament
Inferior - Thyroepiglottic ligament
Posterior - Epiglottis