Surgical and Radiologic Anatomy

, Volume 41, Issue 5, pp 523–528 | Cite as

Anatomy of the pterygopalatine fossa: an innovative metrical assessment based on 3D segmentation on head CT-scan

  • Daniele GibelliEmail author
  • Michaela Cellina
  • Stefano Gibelli
  • Annalisa Cappella
  • Marta Maria Panzeri
  • Antonio Giancarlo Oliva
  • Giovanni Termine
  • Claudia Dolci
  • Chiarella Sforza
Original Article



The pterygopalatine fossa is an important anatomical structure for several surgical and anaesthesiologic procedures; yet, very few data are available about its size. This study aims at providing a metrical assessment of pterygopalatine fossa through an innovative 3D segmentation procedure on head CT-scans.


CT-scans from 100 patients (50 males and 50 females) aged between 18 and 85 years were chosen for the study. Right and left pterygopalatine fossae were segmented through ITK-SNAP open source software. Height and volume were calculated on the acquired 3D models. In addition, anterior–posterior nasal spine distance, upper facial height (nasion–prosthion) and biorbital breadth (ectoconchion–ectoconchion) were measured as well. Statistically significant differences of height and volume according to sex and side were assessed through two-way ANOVA test: sexually dimorphic measurements were further assessed through one-way ANCOVA test using the three cranial measurements as covariates (p < 0.05).


On average pterygopalatine fossa height was 24.1 ± 3.5 mm in males, and 22.8 ± 3.4 mm in females, whereas volume was 0.930 ± 0.181 cm3 in males and 0.817 ± 0.157 cm3 in females, with statistically significant differences according to sex (p < 0.05), but not to side (p > 0.05); interaction was negligible for both the measurements. ANCOVA test verified that sexual dimorphism of both measurements is independent from general cranial size (p < 0.05).


The present study highlighted the sexual dimorphism of pterygopalatine fossa: results may improve the knowledge of this anatomical structure difficult to explore, but crucial in several fields of clinics and surgery.


Anatomy Pterygopalatine fossa CT-scan 3D segmentation 



The authors thank Ms. Annalisa Gadler for data collection.

Author contributions

DG: project development, data collection, data analysis, manuscript writing, manuscript editing. MC: project development, data collection, data analysis, manuscript writing, manuscript editing. SG: project development, data collection, manuscript editing. AC: data analysis, manuscript writing, manuscript editing. MMP: data analysis, manuscript editing. AGO: data collection, manuscript editing. GT: data collection, manuscript editing. CD: data analysis, manuscript editing. CS: project development, data analysis, manuscript editing.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Dipartimento di Scienze Biomediche per la SaluteUniversità degli Studi di MilanoMilanItaly
  2. 2.Reparto di Radiologia, Ospedale FatebenefratelliASST Fatebenefratelli SaccoMilanItaly
  3. 3.Reparto di Otorinolaringoiatria, Ospedale FatebenefratelliASST Fatebenefratelli SaccoMilanItaly
  4. 4.Reparto di Radiologia DiagnosticaIRCCS Ospedale San RaffaeleMilanItaly

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