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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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