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Pterygopalatine Ganglion — MFDS Part 1 MCQ

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HardAnatomy (Head & Neck)Pterygopalatine GanglionMFDS Part 1

During endoscopic surgery in the pterygopalatine fossa, the nerve of the pterygoid canal is divided immediately before it enters the pterygopalatine ganglion. Which cranial nerve pathway contributes the preganglionic parasympathetic fibres in this nerve that would normally synapse in the ganglion?

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Correct answer: C — Facial nerve (VII) via the greater petrosal nerve

The correct answer is C. Preganglionic parasympathetic fibres originating with the facial nerve travel in the greater petrosal nerve. This joins the deep petrosal nerve to form the nerve of the pterygoid canal; the parasympathetic fibres then synapse in the pterygopalatine ganglion. Postganglionic fibres are distributed with branches of the maxillary nerve to the lacrimal, nasal and palatal glands. The deep petrosal sympathetic fibres pass through the ganglion without synapsing. The lesser petrosal nerve carries glossopharyngeal parasympathetic fibres to the otic ganglion, while the auriculotemporal nerve carries postganglionic fibres away from that ganglion. The vagus and hypoglossal pathways listed do not provide parasympathetic fibres to the pterygopalatine ganglion.

Reference: Monkhouse WS. The anatomy of the facial nerve. Ear Nose Throat Journal. 1990;69(10):677–687. https://pubmed.ncbi.nlm.nih.gov/2286163/