Anatomy & Organs

Pterygopalatine Ganglion – Structure, Function & Diseases

Ganglion pterygopalatinum

The pterygopalatine ganglion is a parasympathetic ganglion. It is located at the base of the skull at the pterygopalatine fossa.

What is the pterygopalatine ganglion?

In medicine, the pterygopalatine ganglion is also known as the sphenopalatine ganglion or wing palate ganglion . What is meant by this is a parasympathetic ganglion. It is located near the palatine bone (os palatinum) in the palatine fossa ( fossa pterygopalatina ) and is in front of the pterygoid process osis sphenoidalis (sphenoid wing process).

A ganglion is understood to mean an accumulation of nerve cell bodies belonging to the peripheral nervous system . Since ganglia usually have nodular thickenings, they are also known as nerve nodes. The functions of the pterygopalatine ganglion include switching parasympathetic (secretory) fibers for the palatine, pharyngeal, nasal, and lacrimal glands . The same applies to the vessels of the brain and face.

Anatomy & Structure

Anatomically, the pterygopalatine ganglion is located near the sphenopalatine foramen, the maxillary nerve (maxillary nerve), and the maxillary artery (jaw artery). The nerve node is traversed by sympathetic, parasympathetic and sensory fibers.

However, an interconnection within the ganglion only takes place in the parasympathetic fibers. It only serves as a transit station for the other fibers. The parasympathetic fibers are part of the nerve cells of the nucleus salivatorius superior. Within the geniculate ganglion, it splits off from the facial nerve (facial nerve). Together with the pterygoid canal nerve and the major petrosal nerve (large petrous nerve), they run in the direction of the pterygopalatine ganglion. There they are connected to the postganglionic neuron .

The fibers are transmitted to their target organs primarily via the branches of the facial nerve. They reach the nasal mucosa via the rami nasales posteriores superiores in the rear area of ​​the nasal cavity , via the rami orbitales to the mucosa of the sphenoid sinuses (sinus sphenoidales) and the ethmoid cells and the ramus pharyngeus to the mucous membrane of the pharynx . Other target organs of the fibers are the mucous membranes of the nose and palate, which they reach via the greater palatine nerve, the mucous membrane of the anterior palate via the nasopalatine nerve, the soft palate via the minor palate nerves, and the lacrimal gland (lacrimal gland) via the lacrimal nerve and the lacrimal gland zygomatic nerve.

Sensory fibers originating from the maxillary nerve are supplied to the pterygopalatine ganglion via the rami ganglionares. They pass through the nerve node unconnected and have afferents from the mucous membrane of the pharynx, nose and palate. They also reach the pterygopalatine ganglion via the rami ganglionares.

The postganglionic sympathetic fibers of the pterygopalatine ganglion have their origin in the superior cervical ganglion (ganglion cervicale superiorius). They reach the nerve node via the internal carotid plexus, the deep petrosal nerve and the pterygoid canal nerve. They pass through the ganglion unconnected in the direction of the lacrimal gland.

Function & Tasks

The task of the pterygopalatine ganglion is the switching of parasympathetic fibers for cerebral and facial vessels as well as for the nasal gland, pharyngeal gland, palatine gland and lacrimal gland.

The branches exiting the alar palatine ganglion lead towards the eye socket (orbita), nasal cavity , pharynx and palate . The rami orbitales, rami nasalis posteriores medialis, rami nasalis posteriores laterales, the pharyngeal nerve and the palatine nerve provide the innervation of the mucous membrane of the medial and superior nasal meatus, the upper sections of the nasal septum (septum nasi), the pharynx (pharynx ), the Eustachian tube (ear trumpet) and the anterior palatal mucosa.

Also important are the palate nerves (Nervi palatini), which supply the mucous membrane of the palate, the tonsils , the gums of the upper jaw, the maxillary sinus (sinus maxillaris) and the meatus nasi inferior. Within the pterygopalatine ganglion, the parasympathetic fibers switch to the second neuron. Through this process, the glands of the palate and nose can be secretorily innervated.

Diseases

Possible disorders of the pterygopalatine ganglion include sluder neuralgia, also known as sphenopalatine syndrome. Neuralgia is a model used to explain pain in the facial nerves. The affected persons suffer from facial pain for a maximum of 20 minutes , which can also be associated with sneezing attacks.

Facial neuralgia includes parts of the upper jaw, the palate and the inner corner of the eyelid, including the bridge of the nose and the eyeball . Sometimes the pain radiates to the neck or shoulder. In some cases, paralysis of the soft palate is even possible on one side.

Sluder neuralgia was named after the American ear, nose and throat doctor Greenfield Sluder (1865-1928), who introduced the model in 1908. The laryngologist also treated the disease by injecting alcohol into the pterygopalatine ganglion. Today, sluder neuralgia is considered a manifestation of cluster headache . Sluder was of the opinion that in some facial neuralgias there is a reflex irritation of facial nerve fibers of the trigeminal nerve (Nervus trigeminalus). However, the explanation model is now controversial among medical professionals. Nevertheless, treatment is still carried out by applying local anesthetics to the nasal mucosa.

The pterygopalatine ganglion also plays an important role in the treatment of migraine . To treat the headache , an anesthetic such as lidocaine is introduced into the alar palatine ganglion via a nasal tube . For a long time, doctors have suspected that the nerve knots play a part in the development of migraines. Studies have shown positive results of this treatment method, which led to a noticeable reduction in pain . Around 88 percent of all patients treated required fewer pain medications after pterygopalatine ganglion therapy because the administration of lidocaine has the effect of a reset switch on the migraine circuit.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.