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Pterygoid Hamulus

hamulus pterygoideus

The pterygoid hamulus is a small hook-shaped projection at the inferior tip of the medial pterygoid plate of the sphenoid bone. The tensor veli palatini tendon hooks around the hamulus, changing direction from a vertical to a horizontal plane to enter the soft palate. The pterygomandibular raphe, the fibrous band that gives origin to the buccinator and the superior pharyngeal constrictor, also attaches to the hamulus.

Region: Head & Skull

Clinical Relevance

Clinical Notes

The pterygoid hamulus is a key landmark for the pterygomandibular space block (inferior alveolar nerve block) in dental anaesthesia, where the needle is directed just medial to the hamulus at the level of the pterygomandibular raphe. The hamulus can rarely fracture with forceful jaw opening, producing a painful click. In cleft palate repair, reconstruction of the tensor veli palatini tendon around the hamulus is a key step in restoring Eustachian tube function. Hamular bursitis, though rare, produces a sore palate and midline posterior palatal tenderness.

Pathology

Common Injuries & Conditions

Hamular Bursitis

Inflammation of the small bursa at the pterygoid hamulus tip produces a dull aching pain at the posterior hard palate and pterygoid hamulus region, exacerbated by jaw opening and eating, often misdiagnosed as temporomandibular pain and managed with NSAIDs and corticosteroid injection.