Estudo anatômico do forame esfenopalatino

Abstract

Anat omical variations of the sphenopalatine foramen may correspond to alterations at the arterial nasal irrigation input, which is a relevant condition to treat severe epistaxis through ligation of the sphenopalatine artery. Aim: To study the sphenopalatine foramen in terms of its numeric variation and its location on the lateral nasal wall in relation to the bony ethmoidal crest of the palatine bone. Materials and methods: The anatomical studies were carried out in 54 hemifaces. Results: the sphenopalatine foramen presented the following numeric variation: single (87%, or 47 specimens), double (11,1%, or 6 specimens), and triple (1.9% or one specimen); it was located at the superior nasal meatus in 81.5%, or 44 specimens; 14.8% (8 specimens) between the middle and superior nasal meatus and in the middle nasal meatus in only one case (1.9%). Conclusion:We have been able to show a numeric variation of the SPF, its relation with the bony ethmoidal crest and its location in the superior meatus, middle meatus, and in both.

Severe Posterior Epistaxis–Endoscopic Surgical Anatomy

“…The SPF can be found on the superior meatus, 8,10 -13,15 on the transition of middle and superior meatus, 8,10,15,25 on the middle meatus region, 8,15 or superior to the superior meatus. 12 In accordance with our study, other authors 9,10,25 have observed the transition of middle and superior meatus as the most frequent location.…”

“…The presence of an accessory foramen was already described by various authors 13,[15][16][17][18] and its presence varies from 2.6% to 42%. 10,15,16,18,20 Our findings are similar to those of Wareing and Padgham 10 and Scanavini, 15 who observed 12% and 13%, respectively. Despite the fact that in this study, we located single accessory foramens, other authors found double, 13,15,18 triple, 13,18 or multiple 18 accessory foramens.…”

“…The EC is a protrusion of bone formed as the perpendicular plate of the palatine bone blends with the most posterior and inferior portion of the middle turbinate. 9,11,13,15,20,[22][23][24] It is an important anatomical landmark 3,10 to find the SPF, and it is found in 100% of cases, 10,22,23 being anterior to the SPF most of the time. 22,23 Bolger et al 22 have described a different location of the EC, in accordance with the present study.…”

“…Mean distance between SPF and anterior nasal spine found in our study was greater than that found by Lee et al 12 and Scanavini. 15 This may suggest different proportions among the various racial groups. The study by Lee et al 12 was done only in Korean individuals-characterized as of yellow color-a color that was not present in our study.…”

“…3 The failure rate of the sphenopalatine artery ligation or cauterization may vary from 2% to 10%. 2,4 -7 Some anatomical variations on the nose lateral wall are reported with reference to the sphenopalatine foramen (SPF) location, 8 -15 the presence of an accessory foramen, 10,13,[15][16][17][18] arteries ramification, 12,14,16,19,20 and SPF dimension and morphology. 8,18,21 Anatomical variations of the region and the scarcity of endoscopic studies showing landmarks to find the sphenopalatine artery and its branches may contribute to surgical failures.…”