An anatomic study using three‐dimensional reconstruction for pterygopalatine fossa infiltration via the greater palatine canal

Abstract

The pterygopalatine fossa (PPF) is accessed via the greater palatine canal (GPC) in an attempt to reduce bleeding during paranasal sinus surgery. This study aims to investigate the anatomy of the greater palatine foramen (GPF), GPC, and the PPF, with reference to PPF infiltration using three-dimensional reconstruction of computer tomographic (CT) scan measurements. The CT scans of 50 patients were retrospectively evaluated. The morphology of the GPF, GPC, and the PPF was assessed in a three-dimensional model. The thickness of the mucosa over the GPF was evaluated in the parasagittal plane. The mean length of the GPC was 13.8 ± 2.0 mm, and the mean height of the PPF was 21.0 ± 3.4 mm. The mean angles of the GPC in relation to the hard palate and the PPF were 67.4° ± 6.9° and 159.8° ± 7.1°, respectively. The GPF was 16.2 ± 1.3 mm lateral to the sagittal plane of the posterior nasal spine (PNS) and 6.1 ± 1.7 mm anterior to the coronal plane of the PNS. The mean volume of the PPF was 1039.9 ± 280.0 mm(3) . The mean thickness of the mucosa overlying the GPF was 10.7 ± 1.8 mm. We recommend that the PNS may be used as the bony landmark to locate the position of the GPF during PPF infiltration. The needle delivering the anesthetic should be bent 25 mm from the tip at a 45° angle, and a 1-ml injection of anesthetic should be administered in adults.

Topography of the greater palatine artery and the palatal vault for various types of periodontal plastic surgery

“…For example, the GPA at the position of the GPF could be damaged by a misdirected osteotome during maxillary osteotomy, as well as during excessive harvesting of graft tissue in periodontal plastic surgeries. Many studies have investigated the location and diameter of the GPF (Kim et al, ; Methathrathip et al, ; Hwang et al, ). The location of the GPF varies with race (Wang et al, ).…”

“…It descends in the pterygopalatine canal and travels through the greater palatine foramen (GPF) together with the greater palatine nerve. The GPF is located just anterior to the posterior edge of the hard palate, and can be found by palpating the palate with the finger (Hwang et al, ). After passing the GPF, the name of the artery changes to the greater palatine artery (GPA), and it supplies posterior two‐thirds of the hard palate as it runs anteriorly in a curved groove near the alveolar ridge (Klosek and Rungruang, ).…”

Morphometric Study of the Greater Palatine Foramen in the Dried Bones of Eastern India

“…Hwang et al in 2011 [7] studied 55 CT scans and found that the transverse diameter of the GPF in male is significantly larger than that of the female. Patil et al [8] in 2016 studied 123 dry skulls in which both the transverse diameter and AP diameters were significantly largerin males.…”

The Length of the Greater Palatine Canal in a Lebanese Population: a Radio-anatomical Study

“…Methathrathip et al (4), and Urbano et al (5) evaluate it on dry skulls, while others used the imaging technology like CT, CBCT, etc. (1, 6-10). …”

“…Concerning the canal length, it was either assessed as an isolated entity from the PPF (6, 10), or considered extending superiorly from different landmarks in the PPF such as the higher bony aspect of the PPF (11), the foramen rotundum (4), the sphenopalatine foramen (9), and the vidian canal (1, 7, 8) to the greater palatine foramen inferiorly.…”