20.500.12556/DiRROS-28513 Injectate distribution patterns with the posterior infrazygomatic and transoral approaches to the pterygopalatine fossa Background: Injectate distribution patterns in the pterygopalatine fossa may differ based on the drug administration approach used. This study primarily aimed to assess and compare injectate distribution following the posterior infrazygomatic and transoral approaches. The secondary aim was to evaluate the safety of both approaches. Methods: Injectate distribution patterns were evaluated in 13 cadaveric head specimens. The vessels were perfused with a gelatin-based solution containing an iodinated contrast agent. The ultrasound-guided posterior infrazygomatic approach and transoral approach were performed on contralateral sides, and needle placement was confirmed using computed tomography (CT). A methylene blue and iodinated contrast agent solution was administered following successful needle placement. Injectate distribution and injuries were assessed via CT and anatomical dissection. Results: With the posterior infrazygomatic approach, methylene blue consistently stained the maxillary artery and nerve, sphenopalatine ganglion, and lateral pterygoid muscle, whereas with the transoral approach, it most frequently surrounded the maxillary artery and structures within the greater palatine canal. The iodinated contrast agent was distributed predominantly along the needle trajectories for both approaches. Injuries to the maxillary artery and facial nerve were documented following the posterior infrazygomatic approach, whereas an injury to the lateral pterygoid plate was observed following the transoral approach. Conclusions: With the posterior infrazygomatic approach, contrast agent encompassed the entire pterygopalatine fossa, whereas the transoral approach yielded a more localized distribution, primarily within the inferior portion and greater palatine canal. These differences in distribution patterns should guide the selection of the most appropriate approach based on the specific clinical indication. ganglion local anesthetics maxillary artery maxillary nerve pterygopalatine fossa sphenopalatine ganglion block ganglion lokalni anestetiki maksilarna arterija maksilarni živec pterigopalatinska fosa blok sfenopalatinskega ganglija true false true Angleški jezik Slovenski jezik Neznano 2026-03-23 11:59:30 2026-03-23 11:59:30 2026-03-26 04:02:22 0000-00-00 00:00:00 2025 0 0 str. 592-600 iss. 6 Vol. 78 2025 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 611 2005-6419 10.4097/kja.24907 237420291 RAZ_Jerman_Anze_2025.pdf RAZ_Jerman_Anze_2025.pdf 1 C7414ECA7B4122362F87F619E37FB8D6 05e7f2817184599496704b1a467c8471bca221a4118eaa3f68b067e330337342 8f1172ef-26a7-11f1-aa40-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=42284 https://ekja.org/journal/view.php?doi=10.4097/kja.24907 1 62d1b9d6-26a7-11f1-aa40-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=42283 Univerzitetni klinični center Ljubljana 0 0 0