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 pterygopalatine fossa and is anterior to the pterygoid osis sphenoidal process. A ganglion is understood to be an accumulation of nerve cell bodies belonging to the peripheral nervous system. Since ganglia mostly have nodular thickenings, they are also known as nerve ganglions. Functions of the pterygopalatine ganglion include switching parasympathetic (secretory) fibers for the palatine, pharyngeal, nasal, and lacrimal glands. The same is true for the vessels of the brain and face.
Anatomy and structure
Anatomically, the pterygopalatine ganglion is located near the sphenopalatine foramen, maxillary nerve, and maxillary artery. The ganglion is traversed by sympathetic, parasympathetic, and sensory fibers. However, interconnection within the ganglion occurs only in the parasympathetic fibers. Thus, it serves only as a passageway for the other fibers. The parasympathetic fibers are part of the neurons of the nucleus salivatorius superior. Within the geniculate ganglion, their splitting off from the facial nerve occurs. Together with the nervus canalis pterygoidei as well as the nervus petrosus major (great petrosal nerve) they run towards the ganglion pterygopalatinum. There, their wiring to the postganglionic neuron occurs. Predominantly via the branches of the facial nerve, the fibers are transmitted to their organs of success. Thus, they reach the nasal mucosa via the rami nasales posteriores superiores in the posterior nasal cavity, the mucosa of the sphenoid sinuses via the rami orbitales, as well as the ethmoid cells and the ramus pharyngeus to the mucosa of the pharynx. Other target organs of the fibers are the nasal and palatal mucosa, which they reach via the nervus palatinus major, the mucosa of the anterior palate via the nervus nasopalatinus, the soft palate via nervi palatini minores, and the lacrimal gland (glandula lacrimalis) via the nervus lacrimalis and the nervus zygomaticus. Sensory fibers originating from the maxillary nerve are supplied to the pterygopalatinum ganglion via the rami ganglionares. They pass through the ganglion unconnected and have afferents from the mucosa of the pharynx, nose, and palate. They also reach the pterygopalatine ganglion via the rami ganglionares. The postganglionic sympathetic fibers of the pterygopalatinum ganglion originate in the superior cervical ganglion. They reach the nerve node via the internal carotid plexus, the profound petrosal nerve and the pterygoid canal nerve. In doing so, they pass through the ganglion unconnected in the direction of the lacrimal gland.
Function and Tasks
The function of the pterygopalatine ganglion is to switch parasympathetic fibers for cerebral and facial vessels as well as for the nasal gland, pharyngeal gland, palatal gland, and lacrimal gland. The branches that emerge from the wing palatal ganglion lead toward the orbit, nasal cavity, pharynx, and palate. The rami orbitales, rami nasalis posteriores mediales, rami nasalis posteriores laterales, the pharyngeal nerve, and the palatal nerve provide innervation to the mucosa of the meatus nasi medius and meatus nasi superior, the upper portions of the nasal septum (septum nasi), the pharynx, the eustachian tube (eustachian tube), and the anterior palatal mucosa. Also of importance are the palatal nerves (nervi palatini), which supply the palatal mucosa, the palatine tonsil, the maxillary dentition, the maxillary sinus (sinus maxillaris), and the inferior meatus nasi. Within the pterygopalatine ganglion, the parasympathetic fibers switch to the second neuron. This process allows secretory innervation of the glands of the palate and nose.
Diseases
Possible diseases of the pterygopalatine ganglion include Sluder’s neuralgia, also called sphenopalatine syndrome. Neuralgia is considered a model used to explain facial nerve pain.In this case, the affected persons suffer from facial pain for a maximum of 20 minutes, which may 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 root of the nose and the eyeball. In some cases, the pain radiates to the neck or shoulder. In some cases, even hemiplegia of the soft palate is possible. Sluder’s neuralgia was named after the American otolaryngologist Greenfield Sluder (1865-1928), who introduced the model in 1908. In addition, the laryngologist treated the condition by injecting alcohol into the pterygopalatine ganglion. In modern times, Sluder’s neuralgia is considered a manifestation of cluster headache. Sluder held that in some facial neuralgias there is reflex irritation of facial nerve fibers of the trigeminal nerve (trigeminal nerve). However, the explanatory model is now controversial among medical experts. 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 pterygium ganglion via a nasal probe. It has long been suspected by physicians that the nerve node plays a role in the development of migraine. Studies have shown positive results of this treatment method, which led to a noticeable reduction in pain. About 88 percent of all patients treated required less pain medication after pterygopalatine ganglion therapy because administering lidocaine has the effect of a reset switch on the migraine circuit.
