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2014, Number 4

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Cir Cir 2014; 82 (4)

Anatomic variations and references of the sphenopalatine foramen in cadeveric specimens: a Mexican study

Morales-Cadena M, González-Juárez F, Tapia-Álvarez L, Fernando-Macías VL
Full text How to cite this article

Language: Spanish
References: 6
Page: 367-371
PDF size: 355.97 Kb.


Key words:

Sphenopalatine foramen, sphenopalatine artery, vidian nerve, posterior epistaxis, ethmoid crest, lateral nasal wall.

ABSTRACT

Background: The sphenopalatine foramen is located on the lateral nasal wall and has multiple variants and anatomic landmarks that are important to know to optimize results in the surgical management of posterior epistaxis.
Objective: This study describes the endoscopic anatomy of the sphenopalatine foramen, related structures and anatomic variations in a Mexican population.
Methods: We performed a prospective, observational, and experimental study. Five cadaveric specimens were included. Dissections were performed to identify the anatomy of the sphenopalatine foramen and anatomic variants. Measurements were obtained from different anatomic references to the columella.
Results: Of a total of ten dissections, in 100% of cases ethmoid crests were identified anterior to the sphenopalatine foramen. Localization of the sphenopalatine foramen in the lateral nasal wall in 60% cases was in the transition from middle meatus with superior meatus. The vidian nerve in 90% of cases was located superior and posterior to the sphenopalatine foramen. For the measurements, no significant differences between the two sides of each specimen were noticed.
Conclusions: The sphenopalatine foramen presents multiple anatomic variants and numerous landmarks, which are important to comprehend in order to perform a successful and safe endoscopic sinus surgery.


REFERENCES

  1. Voegels RL, Thomé DC, Vasquez Iturralde PP, Butugan O. Endoscopic Ligature of the Sphenopalatine Artery for Severe Posterior Epistaxis. Otolaryngol Head Neck Surg 2001;124(4):464-467.

  2. Loughran S, Hilmi O, McGarry GW. Endoscopic sphenopalatine artery ligation - when, why and how to do it. An on-line video tutorial. Clin Otolaryngol 2005;30(6):539-543.

  3. Prades JM, Asanau A, Timoshenko AP, Faye MB, Martin Ch. Surgical anatomy of the sphenopalatine foramen and its arterial content. Surg Radiol Anat 2008;30(7):583-587.

  4. 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(10):1813-1817.

  5. Bolger WE, Borgie RC, Melder P. The role of the crista ethmoidalis in endoscopic sphenopalatine artery ligation. Am J Rhino 1999;13(2):81-86.

  6. Padua GM, Voegels RL. Severe Posterior Epistaxis-Endoscopic Surgical Anatomy. Laryngoscope 2008:118(1):156-161




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Cir Cir. 2014;82