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This is the free full text of AppSurgeOn - 3D Skull Atlas.

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Palatine Bone

The palatine bone is L-shaped, contributing to the floor and lateral walls of the nose, to the floor of the orbit, and the floor of the hard palate. It constitutes the medial wall of the pterygopalatine fossa, and contributes to the pterygoid fossa with its pyramidal process. It is composed of two plates (horizontal and perpendicular) and of three processes (pyramidal, orbital, and sphenoidal). It articulates with the maxillary, inferior concha, ethmoid, sphenoid, vomer, and contralateral palatine bones.

 

Parts

 

Horizontal plate

The quadrangular process, with a concave and thin posterior border, forming the posterior quarter of the hard palate. The posterior edge joins the contralateral one to form the posterior nasal spine. The medial border projects superiorly forming the posterior part of the nasal crest, which is completed by the contralateral horizontal plate. Its inferior surface shows the greater palatine foramen and the palatine crest, which extends medially from behind the foramen. The palatine sulci are visible arising from the greater palatine foramen.

 

 

Perpendicular plate

The ethmoidal and conchal crests are visible on the nasal surface, and define the portions of the perpendicular plate contributing to the inferior, middle, and superior nasal meatuses. The maxillary surface is rough where it articulates with the maxillary bone; on the contrary, it is smooth anteriorly, where the maxillary process overlaps with the maxillary hiatus forming part of the medial wall of the maxillary sinus. The posterosuperior part of the maxillary surface constitutes also the medial wall of the pterygopalatine fossa.

Greater palatine groove

The greater palatine groove is present on the maxillary surface. In some cases, the greater palatine canal is formed by the palatine bone only.

The superior border shows the orbital process, the sphenoidal process, and the sphenopalatine notch between them. The pyramidal process is in continuity with the posterior and the inferior borders. The inferior border presents the lower end of the greater palatine groove.

 

Orbital Process

A superolaterally directed process arising from the anterior border of the perpendicular plate. It contributes to the orbit between the maxillary and the ethmoidal bones, and shows an air sinus completed by the sphenoidal concha. It also constitutes the medial part of the inferior edge of the inferior orbital fissure, and may present a groove in continuity with the maxillary nerve groove on the maxillary bone.

 

Pyramidal process

A posteroinferiorly directed process arising at the junction between the perpendicular and the horizontal plates. It occupies the space between the maxillary bone and the pterygoid process.
The lesser palatine foramina are present on its inferior surface and communicates with the greater palatine groove.

  

 

Sphenoidal process

Thin, posterosuperiorly directed process, arising from the posterior border of the perpendicular plate. A groove contributing to the formation of the palatovaginal canal is present on its superior surface. The vaginal process of the sphenoid bone, which articulates with the posterior border of the sphenoidal process, completes the palatovaginal canal. The inferomedial surface constitutes part of the roof and the lateral wall of the nasal cavity, with its medial border articulating with the vomer, while the lateral surface articulates with the medial pterygoid plate posteriorly.

 

Articulations

 

The palatine bone articulates with the maxillary, inferior concha, ethmoid, sphenoid, vomer, and contralateral palatine bones.

 

Anatomical Details

Conchal Crest

The ridge projecting from the medial surface of the palatine bone to articulate with the inferior nasal concha.

 

Ethmoidal Crest

The ridge projecting from the medial surface of the palatine bone to articulate with the middle nasal concha.

 

Greater Palatine Canal

The inferior prolongation of the greater palatine groove in cases where the neurovascular bundle traverses the palatine bone.

 

Greater Palatine Foramen

The foramen that lies behind the transverse palatine suture, near its lateral end. It is the exit point of the grater palatine neurovascular bundle that reaches the mouth cavity.

 

Greater Palatine Groove

A deep, anteroinferiorly descending groove lying on the maxillary surface to transmit the greater palatine vessels and nerve. It is converted into a canal by the maxillary bone to form the greater palatine canal.

 

Horizontal Plate

The horizontal, medially directed quadrangular process that constitutes the posterior nasal floor, being transversely concave. It forms also the posterior quarter of the bony palate.

 

Lesser Palatine Foramen

The small foramina, usually two, that are present on the inferior surface of the pyramidal process, behind the greater palatine foramen. They transmit the lesser palatine nerves and vessels.

 

Maxillary Process

A pointed lamina arising anteriorly at the level of the conchal crest, projecting inferoposterior to the maxillary process of the inferior concha, and forming part of the medial wall of the maxillary sinus.

 

Orbital Process

Superolaterally directed process arising from the anterior border of perpendicular plate with a constricted neck. It reaches the orbit between the ethmoid and the sphenoid bones, contributing to form part of its medial wall and of the medial wall of the pterygopalatine fossa.

 

Palatine Air Sinus

The opening of an air sinus on the posterior (sphenoidal) surface of the orbital process. It is completed by the sphenoidal concha and, usually, communicates with the sphenoidal sinus. Sometimes, it communicates with the posterior ethmoidal air cells, while rarely it opens towards both the ethmoidal air cells and the sphenoid sinus.

 

Palatine Crest

A curved ridge that is often present on the inferior surface of the horizontal plate, extending from behind the greater palatine foramen towards the posterior nasal spine.

 

Palatine Grooves

Sulci on the inferior surface of the horizontal plate housing branches of the greater palatine neurovascular bundle from the greater palatine foramen.

 

Palatovaginal Canal

A groove that contributes to the formation of the palatovaginal canal that is visible on the superior surface of the sphenoidal process.

 

Perpendicular Plate

The thin perpendicular plate contributes to the inferior, middle and superior meatuses. Its medial surface is concave where it contributes to the inferior meatus. A shallow depression comprised between the ethmoidal and the conchal crests forms part of the middle meatus. A horizontal groove, superior to the ethmoidal crest, forms part of the superior meatus.

 

Posterior Nasal Spine

The posterior midsagittal projection of the horizontal plate that joins the contralateral one forming the posterior nasal spine.

 

Pyramidal Process

Posterolaterally sloping process arising from the junction between the horizontal and perpendicular plates reaching the angular space between the pterygoid plates of the sphenoid bone, where it completes the lower part of the pterygoid fossa. This area gives attachment to the fibers of the superficial head of medial pterygoid muscle. A smooth triangular part of the process appears in the infratemporal fossa between the lateral pterygoid plate and the maxillary tuberosity.

 

Sphenoidal Process

A thin plate, smaller than the orbital process, which is directed superomedially contributing to the roof of the nasal cavity and to part of the medial wall of the pterygopalatine fossa.

 

Sphenopalatine Notch

An indentation in the superior edge of the perpendicular plate, connecting the pterygopalatine fossa and the posterior part of the superior meatus. It allows the sphenopalatine vessels and the posterior superior nasal nerves to enter the nasal cavity. The orbital and the sphenoidal processes constitute its anterior and posterior borders, respectively.

 

References

Anatomy of the Human Body. Gray, H. Philadelphia: Lea & Febiger, 1918; Bartleby.com, 2000

Rhoton's Cranial Anatomy and Surgical Approaches. Rhoton AL. Lippincott Williams & Wil-kins; 2007

Paranasal sinuses: anatomic terminology and nomenclature. Stammberger HR, Kennedy DW, Anatomic Terminology G. Ann Otol Rhinol Laryngol Suppl 167:7-16, 1995 

Maxillary sinus anatomy: a cadaveric study with clinical implications. Gosau M, Rink D, Driemel O, Draenert FG, Anat Rec (Hoboken) 292:352-354, 2009 

 

 

Authors

 

Francesco Belotti, MD

Neurosurgery Resident
University of Brescia (Italy) 
"Spedali Civili" Hospital Brescia (Italy) 
Scientific Team - UpSurgeOn

 

Federico Nicolosi, MD

Neurosurgeon
University of Milan
"Spedali Civili" Hospital Brescia (Italy)
Scientific Team - UpSurgeOn