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Mapping surgical coordinates of the sphenopalatine foramen: surgical navigation study

Published online by Cambridge University Press:  08 January 2009

L Hadoura ,
C Douglas ,
G W McGarry  and
D Young
L Hadoura*
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Glasgow Royal Infirmary, Glasgow, Scotland, UK
C Douglas
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Glasgow Royal Infirmary, Glasgow, Scotland, UK
G W McGarry
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Glasgow Royal Infirmary, Glasgow, Scotland, UK Department of Otolaryngology-Head and Neck surgery, Gartnavel General Hospital, Greater Glasgow and Clyde Trust, Glasgow, Scotland, UK
D Young
Affiliation:
Department of Statistics and Modelling Science, University of Strathclyde, Glasgow, Scotland, UK
*
Address for correspondence: Miss Lubna Hadoura, SpR in ENT, Department of Otolaryngology–Head and Neck Surgery, Glasgow Royal Infirmary, 16 Alexandra Parade, Glasgow G31 2ER, Scotland, UK. Fax: 0141 575 2841 E-mail: [email protected]
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Abstract

Objectives:

To identify measurements that may help intra-operative localisation of the sphenopalatine foramen.

Design:

The study used three-dimensional surgical navigation software to study radiological anatomy, in order to define the distances and angulations between identifiable bony landmarks and the sphenopalatine foramen.

Results:

The distance from the anterior nasal spine to the sphenopalatine foramen was 59 mm (±4 mm; inter-observer variation = 0.866; intra-observer variation = 0.822). The distance from the piriform aperture to the sphenopalatine foramen was 48 mm (±4 mm; inter-observer variation = 0.828; intra-observer variation = 0.779). The angle of elevation from the nasal floor to the sphenopalatine foramen was 22° (±3°; inter-observer variation = 0.441; intra-observer variation = 0.499).

Conclusions:

The sphenopalatine foramen is consistently identifiable on three-dimensional, reconstructed computed tomography scans. Repeatable measurements were obtained. The centre point of the foramen lies 59 mm from the anterior nasal spine at 22° elevation above the plane of the hard palate and 48 mm from the piriform aperture. We discuss how these data could be used to facilitate intra-operative location of the sphenopalatine foramen in difficult cases.

Keywords

EpistaxisSphenopalatine ArteryEndoscopic Surgical ProcedureLigationSphenopalatine ForamenSurgical Navigation
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 7 , July 2009 , pp. 742 - 745
Copyright
Copyright © JLO (1984) Limited 2009

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Footnotes

Presented at the Scottish Otolaryngology Society Winter Meeting, 25 November 2005 in Edinburgh, Scotland, UK.

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