Morphometric evaluation and clinical implications of the greater palatine foramen, greater palatine canal and pterygopalatine fossa on CBCT images and review of literature


BAHŞİ İ., ORHAN M., KERVANCIOĞLU P., YALÇIN E. D.

SURGICAL AND RADIOLOGIC ANATOMY, cilt.41, sa.5, ss.551-567, 2019 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 41 Sayı: 5
  • Basım Tarihi: 2019
  • Doi Numarası: 10.1007/s00276-019-02179-x
  • Dergi Adı: SURGICAL AND RADIOLOGIC ANATOMY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.551-567
  • Anahtar Kelimeler: Greater palatine canal, Greater palatine foramen, Lesser palatine canal, Lesser palatine foramen, Pterygopalatine fossa, Cone-beam computed tomography, Maxillary nerve block
  • Dokuz Eylül Üniversitesi Adresli: Hayır

Özet

IntroductionThe pterygopalatine fossa (PPF) infiltration is performed to reduce blood flow during endoscopic sinus surgery and septorhinoplasty, as well as to control posterior epistaxis and provide regional anesthesia in dental procedures. PPF infiltration performed with consideration of the morphometrics of greater palatine foramen (GPF), greater palatine canal (GPC) and PPF would increase the success of the procedure and reduce the risk of complications. The aim of this study is to investigate the GPF, GPC, lesser palatine foramen (LPF), lesser palatine canal (LPC) and PPF morphology via the images obtained by CBCT, to provide information for interventional procedures.Materials and methodsGPF, GPC, LPF, LPC and PPF were morphometrically evaluated retrospectively in CBCT images of 75 female and 75 male cases by Planmeca Romexis program. The 19 parameters were measured on these images.ResultsThese parameters were evaluated statistically. The comparison of these parameters by genders revealed significant differences in distances between GPC-PC, PC-IOF, LPC-GPF, GPF-MS in the coronal and transverse planes, the distance between GPF and the occlusal plane of the teeth, GPF-PNS, GPF-IF and TD-GPF, and in the area of GPF. The number of LPF was found ranging from 1 to 5.ConclusionOur results may help to insert to needle properly for application of maxillary nerve block with a high success rate and minimal complication. We recommend that the needle should be inserted 14-15mm lateral to the midsagittal plane, 19-20mm over the occlusal plane of the teeth and on the same line with the third molar teeth. For PPF infiltration through the GPF, the needle should be pushed forward 28mm upward at 66 degrees angle on the transverse plane and 14 degrees-15 degrees angle on the vertical plane.