Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-20T01:43:15.225Z Has data issue: false hasContentIssue false
  • English
  • Français

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]
Get access Rights & Permissions [Opens in a new window]

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

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

References

1 Shaheen, OH. Epistaxis in the middle aged and elderly. Thesis, London: University of London, 1987Google Scholar
2 McDonald, TJ, Pearson, BW. Follow up on maxillary artery ligation for epistaxis. Arch Otolaryngol 1980;106:635–8CrossRefGoogle ScholarPubMed
3 Feusi, B, Holzmann, D, Steurer, J. Posterior epistaxis:systematic review on the effectiveness of surgical therapies. Rhinology 2005;43:300–304Google ScholarPubMed
4 Prades, J. Abord endonasal de la fosse Pterygo-Maxillaire LXXIII Cong. Franc. Compt Rendus des Seanc 1976;290–296Google Scholar
5 McGarry, GW. Nasal endoscope in posterior epistaxis: a preliminary evaluation. J Laryngol Oto 1991;105:428–31CrossRefGoogle ScholarPubMed
6 White, PS. Endoscopic ligation of the sphenopalatine artery: a preliminary description. J Laryngol Otol 1996;110:27–30Google Scholar
7 Padgham, 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
8 Lang, J. Clinical anatomy of the nose, nasal cavity and paranasal sinuses. New York: Thieme, 1989;47–57.Google Scholar
9 Lee, 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
10 Wareing, MJ, Padgham, ND. Osteologic classification of the sphenopalatine foramen. Laryngoscope 1998;108:125–7CrossRefGoogle ScholarPubMed
11 Bland, MJ, Altman, DG. Statistics Notes-Measurement Error. BMJ 1996;312:1654CrossRefGoogle ScholarPubMed
12 Feusi, B, Holzmann, D, Steurer, J. Posterior epistaxis: systematic review on the effectiveness of surgical therapies. Rhinology 2005;43:300–304Google Scholar
13 Umapathy, N, Quadri, A, Skinner, DW. Persistent epistaxis: what is the best practice? Rhinology 2005;43:305–308Google Scholar