The pterygoid venous plexus is an extensive network of veins found in the infratemporal fossa. It forms comprehensive connections with the surrounding veins and other anatomical structures and has clinical significance in transmitting infections.

The pterygoid venous plexus is positioned between the temporalis and lateral pterygoid. In fact, this plexus is located partly between the temporalis and lateral pterygoid and partly between the lateral pterygoid and medial pterygoid.

The pterygoid venous plexus surrounds the pterygoid part of the maxillary artery. Therefore, the tributaries of this plexus go along with the branches of the maxillary artery, and some of their names correspond to the names of the branches of the maxillary artery.

The main tributaries of the pterygoid venous plexus include the following veins:

Sphenopalatine vein
Anterior deep temporal and posterior deep temporal veins
Pterygoid vein
Masseteric vein
Buccal vein
Superior alveolar and inferior alveolar veins
Infraorbital vein
Middle meningeal veins

Overall, the veins forming the pterygoid venous plexus collect deoxygenated blood from the palate, nasal cavity, paranasal sinuses, nasopharynx, roof and lateral walls of the oral cavity, teeth, muscles of mastication, temporomandibular joint and the auditory tube.

Posteriorly, the veins of the plexus converge to form the maxillary vein (Read more!), which further unites with the superficial temporal vein within the tissue of the parotid gland and forms the retromandibular vein.

Clinical importance

As mentioned, the pterygoid venous plexus is a clinically significant structure as it communicates with several other essential veins and structures, including the cavernous sinus.

It connects with the cavernous sinus via the emissary veins that go through the sphenoidal emissary foramen, foramen ovale, or foramen lacerum.
The pterygoid venous plexus also communicates with the branches of the inferior ophthalmic vein that is found within the orbit. They reach the plexus via the inferior orbital fissure.
And finally, this plexus communicates with the facial vein through the deep facial vein.

These communications are clinically significant because the pterygoid venous plexus can act as a conduit for the transmission of the infection to the cranial cavity. There is a potential for an infection to spread via several direct or indirect routes through the venous system to the cavernous sinus. One of the most severe complications of infection spread is cavernous sinus thrombosis. It can be fatal if left untreated.

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Pterygoid venous plexus