With the application of the operating microscope, surgery in the pterygomaxillary fossa is now safe and feasible for a variety of conditions, including epistaxis, vasomotor rhinitis, and sphenopalatine neuralgia. In each of these conditions, surgery should be reserved only for the occasional patient who does not respond to more conservative measures. When surgery is necessary, however, the results have been excellent in almost all cases with only occasional minor complications, most notably postoperative sinusitis.
Lofgren RH. Surgery of the Pterygomaxillary Fossa. Arch Otolaryngol. 1971;94(6):516–524. doi:10.1001/archotol.1971.00770070816006
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