Pterygopalatine Fossa Regional Anesthesia Simulator

Mixed Simulator of Pterygopalatine Fossa Regional Anesthesia

Pterygopalatine Ganglion simulatorThis mixed-reality simulator imitates part of an anatomically correct face for practicing, learning, teaching, and debriefing pterygopalatine fossa regional anesthesia blocks with and without ultrasound guidance or assistance.

Designed for austere environments, this medical simulator does not require internet access or wet fluids and accepts 110/220V, 50/60Hz. It can be unpacked, set-up, and operational by an unfamiliar person in 5-7 minutes. The portable simulator fits inside a military-spec padded case with in-built wheels and telescoping pull-handle that can travel as checked airline luggage and weighs < 50 lbs (23 kg).

It has a modular, turnkey design whose System of Modular Mixed and Augmented Reality Tracking Simulators (SMMARTS) platform has been proven to be robust and useful during a five-month deployment in Iraq in 2018. During this time, a senior clinical instructor in the US Army took a Central Venous Access (CVA) simulator – which shares the same platform – to battalion aid stations, field hospitals, and civilian hospitals to train US military emergency medicine and anesthesia providers. The simulator was transported on personnel carriers, often stored outside, and flew on helicopters and it performed flawlessly.

Doctor working on the Pterygopalatine Ganglion simulatorThis simulator is available to University of Florida anesthesiology pain faculty for meetings, lectures, and workshops. It shares interchangeable tracked tools with the Central Venous Access simulator, the Thoracic Regional Anesthesia simulator for thoracic and paravertebral regional anesthesia, and the Cross-Sectional Literacy and Ultrasonography Trainer: the SMMARTS modular needle, the wide ultrasound probe, and the camera view controller. These particular simulators can therefore be swapped out for one another in seconds.

The SMMARTS simulation approach of a fluid-less system, combined with tactile feedback and gel that can be rejuvenated has produced a simulator that is inexpensive to reset following heavy workshop use.

All SMMARTS simulators use the SMMARTS software development kit, which allows an organization to develop their own simulator on the SMMARTS platform with one or more developers. The software development kit includes 6 degrees of freedom tracking of tools (including extensions to custom tools), ultrasonography rendering, and utilities for real-time 3D visualization, cognitive aids, integrated tutors, and xAPI connections.

PPFB Simulator One Page Fact Sheet


Pterygopalatine fossa blocks with Ultrasound Guidance/Assistance/Landmark – Out-of-Plane

Replica of human skullComponents

  • CT scan-based, 3D printed, high-anatomical fidelity plastic model of facial bones and skull encased in gel
  • Virtual model of the anatomy of the pterygopalatine ganglion, pterygopalatine fossa, muscle, veins, and arteries
  • Tracked instruments: needle, ultrasound probe, virtual camera (interoperable between SMMARTS-compliant simulators)
  • Common SMMARTS modular stand for use with other modular anatomies and procedures
  • Automated scoring and replay system for after action review

Technology Readiness Level: 9

  • Adheres to SMMARTS open architecture, rapid simulator development platform specifications
  • Quick-release placement and indexing of SMMARTS-compliant anatomies to SMMARTS platform
  • Anatomically correct, based on a highly detailed medical imaging scan of a real human patient
  • Precise sub-millimeter tracking of all tracked tools
  • High-durability skin can be rejuvenated in-situ for indefinite re-use


  • Adjustable visualization modes
  • Adjustable view modes for realism and after action reviews
  • Ultrasound probe with depth markers
  • Anisotropy simulation for needle
  • Tactile feedback of needle striking bone
  • Debriefing with replay of past/saved procedures