2020 Online Salon
Pterygo-Maxillary Fissure as a Landmark for Localization of Internal Maxillary Artery

Project Details
- Entrant Name: Elyssa Siegel
- Membership Type: Professional Submission
- Address: Pikesville, Maryland USA
- Client: Amir R. Dehdashti, MD
- Copyright: 2020 Elyssa Siegel
- Medium/software used: Adobe Photoshop and Adobe Illustrator
- Final presentation format: Printed and online journal
- Primary Audience: Medical professionals, especially neurosurgeons and neurosurgical residents
Project Description
To present the relationship between the internal maxillary artery (Imax), temporalis muscle, pterygo-maxillary fissure (PMF), and the lateral pterygoid muscle, the key landmarks used in identifying and dissecting the IMax for use in extracranial-intracranial bypass surgery. Three insets demonstrate the main steps in IMax harvesting. Surgeons locate the IMax by palpating the posterior wall of the maxilla and sliding their finger caudally into the PMF, located just medial to the lateral pterygoid muscle. Next, the lateral pterygoid muscle is transected to gain appropriate exposure for the required length of the pterygoid segment. The IMax is dissected to a sufficient length and then the proximal-donor segment is immobilized superiorly. This allows for anastomosis with the interposition graft. Throughout the illustration, selective transparencies of the muscles and skull aid the viewer in understanding the complex relationship between the IMax and surrounding structures.