CPT® Code 31040

The pterygomaxillary fossa, also known as the pterygopalatine fossa, is a small, pyramid-shaped anatomical space located between the pterygoid process, maxilla, and palatine bone. This fossa houses critical structures, including the pterygopalatine ganglion and the third part of the maxillary artery. Surgical intervention in the pterygomaxillary fossa is primarily indicated for the management of tumors that either originate within this space or extend into it from adjacent structures. Although tumors in this area are relatively uncommon, certain types, such as nerve sheath tumors and juvenile angiofibromas, can occur. Additionally, tumors from surrounding anatomical structures that may invade the pterygomaxillary fossa include osteomas, hemangiomas, neurofibromas, adamantinomas, congenital cysts, and parotid mixed tumors. Various surgical approaches can be utilized to access the fossa, with the anterior transmaxillary approach being one of the most frequently employed. Other approaches include lateral, retrosubmandibular, and transnasal endoscopic techniques. During the procedure, once access to the fossa is achieved, the surgeon carefully dissects the tumor from surrounding vascular structures and nerves, ligating blood vessels as necessary. The tumor is then excised, and any defects in the surrounding structures are repaired to restore anatomical integrity.