The Journal of Laryngology & Otology

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Mapping surgical coordinates of the sphenopalatine foramen: surgical navigation study

L Hadouraa1 c1, C Douglasa1, G W McGarrya1a2 and D Younga3

a1 Department of Otolaryngology–Head and Neck Surgery, Glasgow Royal Infirmary, Glasgow, Scotland, UK

a2 Department of Otolaryngology-Head and Neck surgery, Gartnavel General Hospital, Greater Glasgow and Clyde Trust, Glasgow, Scotland, UK

a3 Department of Statistics and Modelling Science, University of Strathclyde, Glasgow, Scotland, UK

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.

(Accepted October 02 2008)

(Online publication January 08 2009)

Correspondence:

c1 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: lubna0110@yahoo.com

Footnotes

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

Miss L Hadoura takes responsibility for the integrity of the content of the paper.

Competing interests: None declared