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

Introduction: The greater palatine foramen (GPF) is located in the posterior part of the hard palate between the articulations of hard palate with the maxilla. GPF continues posteriorly and upwards as greater palatine canal (GPC) which opens in to the inferior wall of pterygopalatine fossa. Exiting the foramen rotendum, maxillary nerve enters the pterygopalatine fossa where it can be blocked. The intraoral route of GPF approach can be preferred for maxillary nerve block because of its low incidence of complications and high success rate. For achieving a painless intra operative period in procedures involving the maxillary region and for tooth extraction achieving a perfect maxillary nerve block is of at most importance. Our present study is aimed at correctly locating the position of GPF, its shape and patency in south Indian population which will be helpful for the intra oral approach of maxillary nerve block through the GPF Materials and Methods: The study was conducted in 30 dry adult skull bones of both sex. The molar relation, shape and the patency of the GPF were observed, the readings were obtained, statistically analyzed and compared with other studies. Results: In our observation on both side of skull, it was noted that GPF was located opposite to the 3rd molar in 90% of cases. Oval shaped GPF is most commonly found in our study which accounts to 53.35% and the overall patency rate for GPF was 95% in our study. Conclusion: Analysis and comparison of data has proven that the position, shape and patency of GPF may vary according to different races. This study has also confirmed that the maxillary nerve block via GPF is relatively safe and easier due to the consistency of the position, shape and the patency of the GPF in south Indian population. KEY WORDS: Greater palatine foramen, maxillary nerve block, regional blocks, Greater palatine canal, pterygopalatine fossa, Maxillary nerve.

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Radio-anatomical Study of the Greater Palatine Canal and the Pterygopalatine Fossa in a Lebanese Population: A Consideration for Maxillary Nerve Block

Journal of Clinical Imaging Science ◽

10.4103/2156-7514.190862 ◽

2016 ◽

Vol 6 ◽

pp. 35 ◽

Cited By ~ 5

Author(s):

Georges Aoun ◽

Ibrahim Nasseh ◽

Sayde Sokhn

Keyword(s):

Sagittal Plane ◽

Average Length ◽

Anatomical Study ◽

Average Diameter ◽

Pterygopalatine Fossa ◽

Maxillary Nerve ◽

Greater Palatine Foramen ◽

Lebanese Population ◽

Greater Palatine Canal ◽

The Right

Aim: The aim of this study was to describe the morphology of the component, greater palatine canal-pterygopalatine fossa (GPC-PPF), in a Lebanese population using cone-beam computed tomography (CBCT) technology. Materials and Methods: CBCT images of 79 Lebanese adult patients (38 females and 41 males) were included in this study, and a total of 158 cases were evaluated bilaterally. The length and path of the GPCs-PPFs were determined, and the data obtained analyzed statistically. Results: In the sagittal plane, of all the GPCs-PPFs assessed, the average length was 35.02 mm on the right and 35.01 mm on the left. The most common anatomic path consisted in the presence of a curvature resulting in an internal narrowing whose average diameter was 2.4 mm on the right and 2.45 mm on the left. The mean diameter of the upper opening was 5.85 mm on the right and 5.82 mm on the left. As for the lower opening corresponding to the greater palatine foramen, the right and left average diameters were 6.39 mm and 6.42 mm, respectively. Conclusion: Within the limits of this study, we concluded that throughout the Lebanese population, the GPC-PPF path is variable with a predominance of curved one (77.21% [122/158] in both the right and left sides); however, the GPC-PPF length does not significantly vary according to gender and side.

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The pterygopalatine fossa: morphometric CT study with clinical implications

Surgical and Radiologic Anatomy ◽

10.1007/s00276-018-2136-8 ◽

2018 ◽

Vol 41 (2) ◽

pp. 161-168 ◽

Cited By ~ 1

Author(s):

Aleksandra Vuksanovic-Bozaric ◽

Batric Vukcevic ◽

Marija Abramovic ◽

Nemanja Vukcevic ◽

Natasa Popovic ◽

...

Keyword(s):

Pterygopalatine Fossa ◽

Clinical Implications

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S289 – Effect of Pterygopalatine Injection on EBL in Sinus Surgery

Otolaryngology ◽

10.1016/j.otohns.2008.05.465 ◽

2008 ◽

Vol 139 (2_suppl) ◽

pp. P171-P171

Author(s):

Michael Bublik ◽

Jean A Eloy ◽

Brian Tse ◽

Ruiz Jose W ◽

Roy R Casiano

Keyword(s):

Statistical Significance ◽

Demographic Data ◽

Pterygopalatine Fossa ◽

Sinus Surgery ◽

Control Group ◽

Simple Method ◽

Injection Group ◽

Greater Palatine Foramen ◽

Estimated Blood Loss ◽

The Difference

Objectives We compare estimated blood loss (EBL) during functional endoscopic sinus surgery between patients receiving transoral pterygopalatine fossa and transnasal infiltration (combined) to patients receiving only transnasal infiltration. Variables such as CT-stage, revision surgery, presence of polyps, and operative time are considered. Methods Injection with 1% lidocaine with 1:100,000 epinephrine was performed through the greater palatine foramen and transnasally in the “combined” study group (20 patients) and only transnasally in the control group (22 patients). Charts, operative reports, and CT scans were reviewed and demographic data as well as pertinent information were collected. Patients were followed up and all additional procedures and events were recorded. Results 12 females and 8 males, average age of 48, underwent combined injections; 16 males and 6 females (average age of 50) were in the control group. Using the Wilcoxon/ Kruskal-Wallis Tests (Rank Sums), mean EBL calculated for the combined injection group was 347ml and 493ml for the transnasal injection group (CI 0.95, p=0.093). Average ratio of EBL over OR time was 2.89 ml/min for the combined group and 4.11 ml/min for the control group. We also compare EBL between groups in patients with polyps, endoscopic and CT stage, and revision cases. No complications were reported. Conclusions Combined injection of the pterygopalatine fossa and nasal cavity appears to be a safe and relatively simple method to decrease EBL during sinus surgery, but initial data analysis shows that the difference did not reach statistical significance.

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A Review of Literature on the Diagnosis, Clinical Implications, and Treatment of Diastasis Recti in Older Males

Journal of Womenʼs Health Physical Therapy ◽

10.1097/jwh.0000000000000150 ◽

2019 ◽

Vol 43 (4) ◽

pp. 202-208

Author(s):

Margaret Q. McConville ◽

Jodi Schilz ◽

Deborah Doerfler ◽

Ronald Andrews

Keyword(s):

Clinical Implications ◽

Review Of Literature ◽

Diastasis Recti ◽

Older Males

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Treatment of a subtype of trigeminal neuralgia with descending palatine neurotomy in the pterygopalatine fossa via the greater palatine foramen–pterygopalatine canal approach

Journal of Cranio-Maxillofacial Surgery ◽

10.1016/j.jcms.2014.10.016 ◽

2015 ◽

Vol 43 (1) ◽

pp. 97-101 ◽

Cited By ~ 5

Author(s):

Junbing Guo ◽

Daiyin Huang ◽

Songling Chen ◽

Shuangxi Zhu ◽

Qiong Rong

Keyword(s):

Trigeminal Neuralgia ◽

Pterygopalatine Fossa ◽

Greater Palatine Foramen

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A STUDY ON THE LEVEL OF TERMINATION OF TIBIAL NERVE: REVIEW OF LITERATURE AND ITS CLINICAL IMPLICATIONS

International Journal of Anatomy and Research ◽

10.16965/ijar.2016.109 ◽

2016 ◽

Vol 4 (1) ◽

pp. 1901-1904

Author(s):

Sharma S ◽

◽

Wadhwa A ◽

Bhardwaj S ◽

◽

...

Keyword(s):

Tibial Nerve ◽

Clinical Implications ◽

Review Of Literature

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STUDY ON COMMUNICATING BRANCHES OF SURAL NERVE: REVIEW OF LITERATURE AND ITS CLINICAL IMPLICATIONS

International Journal of Anatomy and Research ◽

10.16965/ijar.2015.260 ◽

2015 ◽

Vol 3 (3) ◽

pp. 1436-1440

Author(s):

Sherry Sharma ◽

◽

Meenakshi Khullar ◽

Harpreet Singh Gulati ◽

Sunil Bhardwaj ◽

...

Keyword(s):

Sural Nerve ◽

Clinical Implications ◽

Review Of Literature ◽

Communicating Branches

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Variant Inferior Alveolar Nerves and Implications for Local Anesthesia

Anesthesia Progress ◽

10.2344/0003-3006-63.2.84 ◽

2016 ◽

Vol 63 (2) ◽

pp. 84-90 ◽

Cited By ~ 11

Author(s):

Kevin T. Wolf ◽

Everett J. Brokaw ◽

Andrea Bell ◽

Anita Joy

Keyword(s):

Surgical Procedures ◽

Surgical Complications ◽

Gross Anatomy ◽

Anatomical Variations ◽

Clinical Implications ◽

Review Of Literature ◽

Anatomy Laboratory ◽

Current Article ◽

Pathologic Processes ◽

Variant Anatomy

A sound knowledge of anatomical variations that could be encountered during surgical procedures is helpful in avoiding surgical complications. The current article details anomalous morphology of inferior alveolar nerves encountered during routine dissection of the craniofacial region in the Gross Anatomy laboratory. We also report variations of the lingual nerves, associated with the inferior alveolar nerves. The variations were documented and a thorough review of literature was carried out. We focus on the variations themselves, and the clinical implications that these variations present. Thorough understanding of variant anatomy of the lingual and inferior alveolar nerves may determine the success of procedural anesthesia, the etiology of pathologic processes, and the avoidance of surgical misadventure.

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