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Sphenopalatine foramen: endoscopic approach with bony landmarks

Published online by Cambridge University Press:  30 March 2015

S Nalavenkata ,
C Meller ,
D Novakovic ,
M Forer  and
N P Patel
S Nalavenkata*
Affiliation:
Division of Otolaryngology, Head and Neck Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia
C Meller
Affiliation:
Division of Otolaryngology, Head and Neck Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia
D Novakovic
Affiliation:
Division of Otolaryngology, Head and Neck Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia
M Forer
Affiliation:
Division of Otolaryngology, Head and Neck Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia
N P Patel
Affiliation:
Division of Otolaryngology, Head and Neck Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia Department of Otolaryngology, Head and Neck Surgery, Macquarie University, Sydney, New South Wales, Australia
*
Address for correspondence: Dr Sunny Nalavenkata, Department of Otolaryngology, Head and Neck Surgery, Royal North Shore Hospital, Reserve Road, St Leonards 2065, Sydney, New South Wales, Australia E-mail: [email protected]
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Abstract

Objective:

To establish whether nasal bony landmarks on computed tomography could be utilised reliably in endoscopic approaches to the sphenopalatine foramen.

Methods:

A prospective analysis of 102 consecutive helical computed tomography scans of the paranasal sinuses was carried out by 2 senior ENT surgeons. Distances from the sphenopalatine foramen to endoscopically palpable bony landmarks were measured.

Results:

There were a total of 102 patients (45 females and 57 males), with a mean age of 62 years. The mean distance from the posterior fontanelle to the sphenopalatine foramen was 14.1 mm (standard deviation = 2.13). The average vertical distance of the sphenopalatine foramen opening from the bony attachment of the inferior turbinate was 14.13 mm. There were no statistically significant differences between any of these measurements (foramen width p-value = 0.714, distance from fontanelle p-value = 0.43 and distance from inferior turbinate p-value = 0.48).

Conclusion:

Determination of reliable bony landmarks is clinically useful in endoscopic surgery and can aid identification of the sphenopalatine foramen. The inferior turbinate concha and posterior fontanelle may be used as reliable computed tomography landmarks for endoscopic approaches to the sphenopalatine foramen.

Keywords

Pterygopalatine FossaSphenopalatine ForamenSphenopalatine ArteryEpistaxis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Supplement S3 , July 2015 , pp. S47 - S52
Copyright
Copyright © JLO (1984) Limited 2015 

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References

1Padua, FG, Voegels, RL. Severe posterior epistaxis-endoscopic surgical anatomy. Laryngoscope 2008;118:156–61CrossRefGoogle ScholarPubMed
2Prades, JM, Asanau, A, Timoshenko, AP, Faye, MB, Martin, C. Surgical anatomy of the sphenopalatine foramen and its arterial content. Surg Radiol Anat 2008;30:583–7CrossRefGoogle ScholarPubMed
3Hadoura, L, Douglas, C, McGarry, GW, Young, D. Mapping surgical coordinates of the sphenopalatine foramen: surgical navigation study. J Laryngol Otol 2009;123:742–5CrossRefGoogle ScholarPubMed
4Scanavine, AB, Navarro, JA, Megale, SR, Anselmo-Lima, WT. Anatomical study of the sphenopalatine foramen. Braz J Otorhinolaryngol 2009;75:37–41CrossRefGoogle ScholarPubMed
5Chiu, T. A study of the maxillary and sphenopalatine arteries in the pterygopalatine fossa and at the sphenopalatine foramen. Rhinology 2009;47:264–70CrossRefGoogle ScholarPubMed
6Abuzayed, B, Tanriover, N, Gazioglu, N, Cetin, G, Akar, Z. Extended endoscopic endonasal approach to the pterygopalatine fossa: anatomic study. J Neurosurg Sci 2009;53:37–44Google Scholar
7Cavallo, LM, Messina, A, Gardner, P, Esposito, F, Kassam, AB, Cappabianca, P et al. Extended endoscopic endonasal approach to the pterygopalatine fossa: anatomical study and clinical considerations. Neurosurg Focus 2005;19:E5Google Scholar
8Lee, HY, Kim, HU, Kim, SS, Son, EJ, Kim, JW, Cho, NH et al. Surgical anatomy of the sphenopalatine artery in lateral nasal wall. Laryngoscope 2002;112:1813–18CrossRefGoogle ScholarPubMed
9Padgham, N, Vaughan-Jones, R. Cadaver studies of the anatomy of arterial supply to the inferior turbinates. J R Soc Med 1991;84:728–30CrossRefGoogle Scholar
10Rezende, GL, Soares, VY, Moraes, WC, Oliveira, CA, Nakanishi, M. The sphenopalatine artery: a surgical challenge in epistaxis. Braz J Otorhinolaryngol 2012;78:42–7CrossRefGoogle ScholarPubMed
11El-Guindy, A. Endoscopic transseptal sphenopalatine artery ligation for intractable posterior epistaxis. Ann Otol Rhinol Laryngol 1998;107:1033–7CrossRefGoogle ScholarPubMed
12Midilli, R, Orhan, M, Saylam, CY, Akyildiz, S, Gode, S, Karci, B. Anatomic variations of sphenopalatine artery and minimally invasive surgical cauterization procedure. Am J Rhinol Allergy 2009;23:e38–41CrossRefGoogle ScholarPubMed
13Solari, D, Magro, F, Cappabianca, P, Cavallo, LM, Samii, A, Esposito, F et al. Anatomical study of the pterygopalatine fossa using an endoscopic endonasal approach: spatial relations and distances between surgical landmarks. J Neurosurg 2007;106:157–63CrossRefGoogle ScholarPubMed
14Schwartzbauer, HR, Shete, M, Tami, TA. Endoscopic anatomy of the sphenopalatine and posterior nasal arteries: implications for the endoscopic management of epistaxis. Am J Rhinol 2003;17:63–6CrossRefGoogle ScholarPubMed
15Holzmann, D, Kaufmann, T, Pedrini, P, Valavanis, A. Posterior epistaxis: endonasal exposure and occlusion of the branches of the sphenopalatine artery. Eur Arch Otorhinolaryngol 2003;260:425–8CrossRefGoogle ScholarPubMed
16Pothier, DD, Mackeith, S, Youngs, R. Sphenopalatine artery ligation: technical note. J Laryngol Otol 2005;119:810–12CrossRefGoogle ScholarPubMed
17Wareing, MJ, Padgham, ND. Osteologic classification of the sphenopalatine foramen. Laryngoscope 1998;108:125–7CrossRefGoogle ScholarPubMed
18Simmen, DB, Raghavan, U, Briner, HR, Manestar, M, Groscurth, P, Jones, NS. The anatomy of the sphenopalatine artery for the endoscopic sinus surgeon. Am J Rhinol 2006;20:502–5CrossRefGoogle ScholarPubMed