Role of multi-detector CT in analysis of the greater and lesser palatine foramina

Abstract

Background: The objective of this study was to assess variation in number, size, shape, and location of greater and lesser palatine foramina using multiple anatomical landmarks through data obtained from adult head CT scans. CT skulls of 200 adult persons were included in this study. There were 100 males and 100 females, aged from 22 to 65 years old. An e-film DICOM viewer version 2 was applied to estimate morphological parameters and to calculate the linear measurements related to the greater palatine foramen. Results: On the basis of CT findings, regarding the position of GPF in relation to maxillary molar teeth, the most frequent location was opposite the third maxillary molar (41%). Regarding the dimensions of the GPF, the mean AP diameter was 3.94 ± 1.13 mm on the right side and 4.22 ± 1.21 mm on the left. The mean LM diameter was 2.17 ± 0.59 mm on the right side and 2.28 ± 0.74 mm on the left. It was concluded that the GPF was AP elongated in 90.5% and circular in 9.5% of the examined CT scans. Linear measurements from the center of GPF to surrounding anatomical landmarks were done and showed no statistically significant difference existed between sides, but a statistically highly significant difference existed between males and females. Conclusions: Proper localization of GPF is important to facilitate therapeutic, local anesthetic, and surgical manipulation in the maxillofacial region. Based on CT findings, we demonstrated that the GPF is most often located opposite the M3 in the majority of the cases. The maxillary molars are the best landmarks for locating the GPF.

Anatomy of the greater palatine foramen and canal and their clinical significance in relation to the greater palatine artery: a systematic review and meta-analysis

“…The results of the meta-analysis regarding the distance between the greater palatine foramen and surrounding anatomical landmarks are presented in Table 4 . A total of 8 studies [ 8 , 11 , 29 , 35 , 56 , 63 , 77 , 83 ] ( n = 2358 subjects) reported data on the distance from the greater palatine foramen to the posterior nasal spine (GPF–PNS). The pooled mean, across the eight studies, was calculated to be 17.21 mm (95% CI = 16.34–18.09 mm).…”

“…The studies spanned the years 1982 to 2022 and originated from Africa, Asia, Europe, North America, and South America. Thailand Cadaveric 55 Ashwini and Jaishree [7] India Cadaveric 100 Awad et al [8] Egypt Imaging 200 Ayoub et al [9] United States Imaging 50 Badshah et al [10] Pakistan Cadaveric 85 Bahşi et al [11] Turkey Imaging 150 Beetge et al [12] South Africa Imaging 77 Cagimni et al [16] Turkey Cadaveric 120 Campbell et al [17] United States Imaging 50 Cheung et al [18] China Cadaveric 30 Chopra et al [19] India Cadaveric 100 Chrcanovic and Custódio [20] Brazil Cadaveric 80 Das et al [22] United States Imaging 100 Dave et al [23] India Cadaveric 100 D'Souza et al [21] India Cadaveric 40 Douglas and Wormald [24] Australia Cadaveric 21 Duruel et al [25] United States Imaging 131 Fonseka et al [27] Sri Lanka Imaging 50 Fu et al [28] United States Cadaveric 11 Gibelli et al [29] Italy Cadaveric 100 Hassanali and Mwaniki [31] Africa Cadaveric 125 Howard-Swirzinski et al [34] United States Imaging 500 Hwang et al [35] South Korea Imaging 50 Ikuta et al [36] Brazil Imaging 50 Ilayperuma et al [37] Sri Lanka Cadaveric 136 Jaffar and Hamadah [38] Iraq Cadaveric 50 Kaffe et al [39] Israel Imaging 58 Kang et al [40] South Korea Imaging 107 Kaur et al [41] India Cadaveric 100 Klosek and Rungruang [42] Thailand Cadaveric 41 Kumar et al [43] India Cadaveric 100 Lacerda-Santos et al [44] Brazil Imaging 60 Langenegger et al [45] South Africa Cadaveric 100 Lim et al [47] South Korea Imaging 147 Lopes et al [48] Brazil Cadaveric 94 Malamed and Trieger…”

“…A 4 Distance between the greater palatine foramen and surrounding anatomical landmarks CI confidence interval, GPF greater palatine foramen, PNS posterior nasal spine, PBHP posterior border of hard palate, ANS anterior nasal spine, MMS midline maxillary suture, IF incisive foramen a Two studies [8,63] were excluded from the subgroup analysis due to being the only studies in their own respective subgroups b Subgroup analysis for GPF-ANS was not performed due to the low number of studies (n = 9754 subjects) reported data on the greater palatine foramen being located "opposite the 3rd maxillary molar teeth". The pooled prevalence, across the 38 studies, was calculated to be 64.9% (95% CI = 58.7-70.7%).…”

“…The I 2 test showed high heterogeneity (I 2 = 96.7%; 95% CI = 94.7-97.9%). A total of 4 studies [7,8,41,48,60,64] (n = 670 subjects) reported data on the prevalence of the greater palatine foramen being "round" in shape. The pooled prevalence, across the four studies, was calculated to be 9.4% (95% CI = 3.3-23.8%).…”

Ultrasonography on the non-living. Current approaches.

“…Figure 9, shows the greater palatine nerve. Morphometric parameters have been defined for the dimensions of the greater palatine foramen, which differ between male and female gender [30,31]. It may therefore be possible that similar features can be found for ultrasonographic assessment of the greater palatine A second-harmonic imaging mode SH12 was used here, with an approximately 170 µm axial resolution and 0.5 mm lateral resolution, assuming a f-number of 3.…”