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Sphenomaxillary Plate: Landmine or Landmark?
Tomasz Gotlib1, Magdalena Kuźmińska1, Konstancja Bobecka-Wesołowska2
1Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, Poland.
Ear, Nose, & Throat Journal
|January 31, 2022
Summary
The sphenomaxillary plate (SMP), a sinus septum, is present in over 30% of Caucasians. Trans-SMP sphenoidotomy is a feasible and safe surgical approach for sphenoid sinus access.
Area of Science:
- Otolaryngology
- Endoscopic Sinus Surgery
- Anatomy
Background:
- The sphenomaxillary plate (SMP) is an inconsistent bony septum between the maxillary and sphenoid sinuses.
- Misidentification of the SMP during endoscopic sinus surgery can lead to serious complications.
- Accurate identification of the SMP can facilitate sphenoidotomy techniques.
Purpose of the Study:
- To determine the incidence and morphology of the sphenomaxillary plate (SMP).
- To assess the feasibility and safety of performing sphenoidotomy through the SMP.
Main Methods:
- Radioanatomical analysis using multiplanar reconstruction of 117 paranasal sinus CT scans.
- Clinical evaluation of trans-SMP sphenoidotomy in patients with chronic rhinosinusitis.
Main Results:
- The SMP was identified in 25% of sides (34% of patients), consistently superolateral to the middle turbinate insertion.
- A distinct SMP prominence on the maxillary sinus posterior wall was visible in 11% of sides (19% of patients).
- Trans-SMP sphenoidotomy was successfully performed in 18 patients (30 procedures), with identification possible even without a prominent SMP.
Conclusions:
- The sphenomaxillary plate (SMP) is present in over 30% of Caucasian individuals.
- Trans-SMP sphenoidotomy is a viable and safe surgical option for accessing the sphenoid sinus.
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