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A Radiographic Morphometric Analysis for the Preoperative Localization of the Sphenopalatine Artery.
Sanu P Moideen1, Thara Joseph2, Irine Thomas3
1Department of ENT, Smita Memorial Hospital, Thodupuzha, Kerala India.
Summary
Radiological measurements from bony landmarks reliably identify the sphenopalatine foramen (SPF) during endoscopic skullbase surgery. These measurements, particularly from the choanal arch and basal lamella, aid in accurate SPF localization for both sexes.
Area of Science:
- Anatomy
- Radiology
- Otolaryngology
Background:
- The sphenopalatine foramen (SPF) is vital for anterior skullbase procedures.
- Identifying the SPF can be challenging using traditional methods like the crista ethmoidalis.
Purpose of the Study:
- To evaluate radiological bony landmarks for assisting endoscopic localization of the SPF.
- To determine reliable measurements for SPF identification in endoscopic sinus surgery.
Main Methods:
- Cross-sectional study using computed tomography (CT) of paranasal sinuses in 50 patients.
- Measured distances from the SPF to nasal floor, choanal arch, maxillary line, anterior head of middle turbinate, and basal lamella.
Main Results:
- Mean SPF distance: 23.6 mm above nasal floor (vertical).
- Mean SPF distances: 36.3 mm from maxillary line, 34.8 mm from middle turbinate head, 7.5 mm from basal lamella, 9.0 mm from choanal arch (anteroposterior).
- Measurements showed minimal differences between sexes.
Conclusions:
- Radiological measurements from the SPF to specific bony landmarks are reliable for both sexes.
- The choanal arch and basal lamella of the middle turbinate are particularly reliable landmarks for SPF localization.
- These measurements offer clinical utility for rapid SPF identification in endoscopic procedures.
