scholarly journals I. On the relations of the vomer, ethmoid, and intermaxillary bones

1862 ◽  
Vol 11 ◽  
pp. 162-166
Keyword(s):  
Sphenopalatine Foramen ◽  
Palate Bone

The author commences by describing the connexions of the vomer in mammalia generally, and states that of these by far the most constant in occurrence and invariable in its nature is one to which he believes he has been the first to attract attention, viz. that by which it comes in contact with the lateral masses of the ethmoid. He states that this connexion is effected by the alæ of the vomer being continued into two laminæ which pass beneath the turbinations of the ethmoid, and are united to the framework of the lateral masses at a point corresponding to the margins of the sphenopalatine foramina. These laminae he calls the “ethmovomerine laminæ,” and for the sphenopalatine foramen he adopts the term “nasal foramen of the palate-bone,” because it is not the sphenoid, but the ethmoid, which completes that foramen in cases where it is not quite encircled by the palate-bone.

scholarly journals Middle turbinate angiofibroma in an elderly woman

2009 ◽  
Vol 66 (7) ◽  
pp. 583-586 ◽  
Author(s):  
Aleksandar Peric ◽  
Nenad Baletic ◽  
Snezana Cerovic ◽  
Biserka Vukomanovic-Djurdjevic
Keyword(s):  
Nasal Cavity ◽  
Elderly Woman ◽  
Anterior Part ◽  
Middle Turbinate ◽  
Immunohistochemical Analysis ◽  
Vascular Tumors ◽  
Male Adolescents ◽  
Sphenopalatine Foramen ◽  
First Case ◽  
Left Middle

Background. Angiofibromas are histologically benign vascular tumors, originating from the nasopharynx, near by the area of sphenopalatine foramen. These neoplasms occur typically in male adolescents. Reports of primary extranasopharyngeal angiofibromas have appeared sporadically in the literature in English. We present the first case of an elderly woman with tumor arising from the middle turbinate, diagnosed as angiofibroma. Case report. A 63-year-old female presented with left-sided nasal obstruction and epistaxis. Endoscopic evaluation revealed a polypoid mass arising from the anteroinferior portion of the left middle turbinate. Computed tomography (CT) scan showed a soft-tissue opacity that filled the anterior part of the left nasal cavity. After the endoscopic excision of the mass, postoperative pathohistological and immunohistochemical analysis confirmed the diagnosis of an angiofibroma. Two years later, the patient was free of symptoms and without endoscopic evidence of recurrence. Conclusion. Extranasopharyngeal angiofibromas arising from the nasal cavity are extremely rare tumors. Immunohistochemical analysis is very important in all doubtful cases, especially in those with atypical location.

scholarly journals 326. Radiologic Findings of COVID-19 Associated Mucormycosis (CAM) from India

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S268-S269
Author(s):  
Aswath Govindaraju ◽  
Deepti H Vijayakumar ◽  
Raghavendra Tirupathi ◽  
Jaffar A Al-Tawfiq ◽  
Ali A Rabaan
Keyword(s):  
Optic Neuritis ◽  
Paranasal Sinuses ◽  
Orbital Cellulitis ◽  
Pterygopalatine Fossa ◽  
Fungal Culture ◽  
Imaging Features ◽  
Middle Meatus ◽  
Sphenopalatine Foramen ◽  
Contrast Enhanced ◽  
Left Middle

Abstract Background The unique feature of the second wave of the COVID -19 pandemic in India has been the alarming surge of acute invasive fungal infection among COVID -19 patients. The increased incidence of rhino-orbito-cerebral mucormycosis is a matter of concern, as this fulminant infection has high morbidity and mortality. Hence, it is imperative to understand it’s imaging features, for early diagnosis, staging and treatment. Methods We systematically reviewed 32 COVID-19 cases with imaging diagnosis of acute invasive fungal rhino-sinusitis or rhino-orbital-cerebral disease between March to May 2021. These patients underwent contrast MRI of the paranasal sinus, orbit and brain. Contrast enhanced CT chest and paranasal sinuses were done as needed. Results The age group ranged between 30 to 71 yrs with male preponderance. The most common predisposing factors were intravenous steroid therapy and supplemental oxygen. All cases were confirmed by fungal culture and most common was Mucor. The rhino-orbito-cerebral mucormycosis was staged as below In our study we found that the most common site in the nasal cavity was the middle turbinate /meatus and the earliest sign was non-enhancing / “black” turbinate. Premaxillary and retroantral fat necrosis was the earliest sign of soft tissue invasion. Spread via the sphenopalatine foramen and pterygopalatine fossa was more common than bony erosions. Orbital cellulitis and optic neuritis were the most common among stage 3 cases. Of patients with CNS involvement, the most common were cavernous sinus thrombosis and trigeminal neuritis. Two patients with pulmonary mucormycosis showed large necrotic cavitary lesions, giving the characteristic “bird’s nest” appearance. Figure 1. Black turbinate Contrast enhanced coronal T1 FS images of paranasal sinuses shows necrotic non-enhancing right superior and middle turbinates (*) Figure 2: Axial contrast enhanced T1 FS image showing necrotic non enhancing premaxillary (arrowhead) and retroantral fat (straight arrow) walled off by thin enhancing rim. Figure 3: Contrast enhanced axial T1 FS images of paranasal sinuses shows necrotic non-enhancing left middle meatus spreading along sphenopalatine foramen in to pterygopalatine fossa (arrow head) Conclusion The mortality rate was 20% in our study. In our short term follow up, 30 % of recovered patients had relapse on imaging due to incomplete clearance and partial antifungal treatment. High clinical suspicion and low imaging threshold are vital for early Mucormycosis detection in COVID-19 patients. Familiarity with early imaging signs is critical to prevent associated morbidity /mortality. Figure 4: Contrast enhanced coronal T1 FS and diffusion weighted images shows necrotic non-enhancing left middle meatus with left orbital cellulitis (*) and optic neuritis (white arrow) Figure 5. Bird’s nest Axial CT chest image in lung window shows necrotic right upper lobe cavity with internal septations and debris on a background of surrounding COVID-19 changes. Disclosures All Authors: No reported disclosures

Sphenopalatine Foramen Computed Tomography Landmarks

2020 ◽  
Vol 31 (1) ◽  
pp. 210-213
Author(s):  
Mohammad Waheed El-Anwar ◽  
Alaa Omar Khazbak ◽  
Atef Hussein ◽  
Sameh Saber ◽  
Ahmed Awad Bessar ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Sphenopalatine Foramen

scholarly journals Mapping surgical coordinates of the sphenopalatine foramen: surgical navigation study

2009 ◽  
Vol 123 (7) ◽  
pp. 742-745 ◽  
Author(s):  
L Hadoura ◽  
C Douglas ◽  
G W McGarry ◽  
D Young
Keyword(s):  
Surgical Navigation ◽  
Three Dimensional ◽  
Observer Variation ◽  
Radiological Anatomy ◽  
Sphenopalatine Foramen ◽  
Bony Landmarks ◽  
Anterior Nasal Spine ◽  
Nasal Floor ◽  
Navigation Software ◽  
Piriform Aperture

AbstractObjectives: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.

scholarly journals Management of Intractable Nasal Hyperreactivity by Selective Resection of Posterior Nasal Nerve Branches

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Daisuke Takahara ◽  
Sachio Takeno ◽  
Takao Hamamoto ◽  
Takashi Ishino ◽  
Katsuhiro Hirakawa
Keyword(s):  
Clinical Effectiveness ◽  
Inferior Turbinate ◽  
Nasal Symptom ◽  
Autonomic Nerve ◽  
Invasive Technique ◽  
Endoscopic Surgical Procedure ◽  
Sphenopalatine Foramen ◽  
Nasal Bleeding ◽  
The Mean ◽  
Standard Medical Treatment

The posterior nasal nerves emerge from the sphenopalatine foramen and contain sensory and autonomic nerve components. Posterior nasal neurectomy is an effective method to remove pathological neural networks surrounding the inferior turbinate that cause unregulated nasal hypersensitivity with excess secretion in patients with severe allergic rhinitis (AR). We describe the sophisticated endoscopic surgical procedure that allows feasible access to the confined area and selective resection of the nerve branches with the preservation of the sphenopalatine artery (SPA). We retrospectively analyzed the cases of 23 symptomatic severe AR patients who failed to respond to standard medical treatment and underwent surgery. There have been no major complications after surgery including nasal bleeding or transient numbness of the upper teeth. The mean total nasal symptom scores (TNSS) were decreased by 70.2% at 12 months after the procedure. Our comparison of the clinical effectiveness based on the number of severed nerve branches revealed that the improvement of the TNSS was significantly higher in patients with >2 branches. We conclude that this minimally invasive technique that preserves the SPA is clinically useful and decreases the rate of postoperative complications. This trial is registered with UMIN000029025.

Usefulness of a bioengineered oral mucosa model for preventing palate bone alterations in rabbits with a mucoperiostial defect

2016 ◽  
Vol 11 (1) ◽  
pp. 015015 ◽  
Author(s):  
Ricardo Fernández-Valadés-Gá ◽  
Ingrid Garzón ◽  
Esther Liceras-Liceras ◽  
Antonio España-López ◽  
Víctor Carriel ◽  
...  
Keyword(s):  
Oral Mucosa ◽  
Palate Bone

scholarly journals Anatomicosurgical References for Endoscopic Localization of Sphenopalatine Foramen: A Cadaveric Study

2016 ◽  
Vol 9 (3) ◽  
pp. 109-114
Author(s):  
Ashok Gupta ◽  
Daisy Sahni ◽  
Tulika Gupta ◽  
Anjali Aggarwal
Keyword(s):  
Nasal Cavity ◽  
Cadaveric Study ◽  
Lateral Nasal Wall ◽  
Anatomical Landmarks ◽  
Middle Meatus ◽  
Sphenopalatine Foramen ◽  
Common Location ◽  
Superior Meatus ◽  
Endoscopic Localization ◽  
Accessory Foramina

ABSTRACT Introduction In patients with posterior epistaxis, generally the source of bleeding is branches of sphenopalatine artery (SPA), which enter the nasal cavity through the sphenopalatine foramen (SPF). Cases of intractable massive bleeding may require endonasal endoscopic occlusion of these vessels. Materials and methods A total of 32 hemisections of formalinfixed cadaveric heads were used. The anatomic variations of SPF, its distance from anatomical landmarks, and angle of elevation of endoscope were studied so as to facilitate accurate localization of the foramen and endoscopic arterial ligation. Results The SPF was generally single; however, multiple exits in the form of accessory foramina were found in 36.75% hemisections. The transition of superior and middle meatuses was the most common location of SPF, followed by the superior meatus, and middle meatus was the least common site. The accessory foramina were commonly present in the superior meatus. Ethmoid crest was distinctly visible in all but two cases. In majority of the cases, the SPF was located within a range of 55 to 65 mm from the anterior nasal spine (ANS); 60 to 70 mm from piriform aperture, 50 to 60 mm from limen nasi, 20.1 to 25 mm vertically above the floor of nasal cavity, and 8 to 15 mm from the inferior turbinate (IT). The angulation of SPF from the floor of nasal cavity was 20 to 30°. Conclusion Exploration of lateral nasal wall (LNW) up to middle meatus would minimize the risk of missing any arterial branch, and the data of distance from the anatomical references would assist in more precise localization of SPF during endoscopic ligation or cauterization of the branches of the SPA. How to cite this article Aggarwal A, Gupta T, Sahni D, Gupta A. Anatomicosurgical References for Endoscopic Localization of Sphenopalatine Foramen: A Cadaveric Study. Clin Rhinol An Int J 2016;9(3):109-114.

scholarly journals Engineered mucoperiosteal scaffold for cleft palate regeneration towards the non-immunogenic transplantation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
M. I. Rizzo ◽  
L. Tomao ◽  
S. Tedesco ◽  
M. Cajozzo ◽  
M. Esposito ◽  
...  
Keyword(s):  
Tissue Engineering ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Host Cells ◽  
Mesenchymal Precursor Cells ◽  
Set Up ◽  
Palate Bone ◽  
Palatal Bone ◽  
Molecular Resonance

AbstractCleft lip and palate (CL/P) is the most prevalent craniofacial birth defect in humans. None of the surgical procedures currently used for CL/P repair lead to definitive correction of hard palate bone interruption. Advances in tissue engineering and regenerative medicine aim to develop new strategies to restore palatal bone interruption by using tissue or organ-decellularized bioscaffolds seeded with host cells. Aim of this study was to set up a new natural scaffold deriving from a decellularized porcine mucoperiosteum, engineered by an innovative micro-perforation procedure based on Quantum Molecular Resonance (QMR) and then subjected to in vitro recellularization with human bone marrow-derived mesenchymal stem cells (hBM-MSCs). Our results demonstrated the efficiency of decellularization treatment gaining a natural, non-immunogenic scaffold with preserved collagen microenvironment that displays a favorable support to hMSC engraftment, spreading and differentiation. Ultrastructural analysis showed that the micro-perforation procedure preserved the collagen mesh, increasing the osteoinductive potential for mesenchymal precursor cells. In conclusion, we developed a novel tissue engineering protocol to obtain a non-immunogenic mucoperiosteal scaffold suitable for allogenic transplantation and CL/P repair. The innovative micro-perforation procedure improving hMSC osteogenic differentiation potentially impacts for enhanced palatal bone regeneration leading to future clinical applications in humans.

A Case of Nasal Mucosa Cautery With Reintubation Under Pharyngeal Suction for Massive Epistaxis After Extubation

2021 ◽  
Vol 68 (4) ◽  
pp. 235-237
Author(s):  
Yukiko Arai ◽  
Akari Hasegawa ◽  
Aki Kameda ◽  
Saki Mitani ◽  
Takuya Uchida ◽  
...  
Keyword(s):  
Nasal Cavity ◽  
Endotracheal Tube ◽  
Nasal Mucosa ◽  
Pulmonary Aspiration ◽  
Muscle Relaxants ◽  
Suction Catheter ◽  
Mask Ventilation ◽  
Drug Selection ◽  
Sphenopalatine Foramen ◽  
Dexmedetomidine Infusion

We describe a case of massive epistaxis that occurred after removal of a nasal endotracheal tube, prompting emergent reintubation. Mask ventilation could not be performed because the nasal cavity was packed with gauze and the airway was being evacuated with a suction catheter. Therefore, instead of inhalational anesthetics and muscle relaxants, boluses of midazolam and remifentanil were administered, and reintubation was promptly performed. Sedation was maintained with dexmedetomidine infusion and midazolam. Nasal cautery was performed near the left sphenopalatine foramen. The patient was extubated without agitation or additional hemorrhage. Immediate recognition of the potential for airway loss, sufficient control of active bleeding, and drug selection in accordance with the emergent circumstances enabled prompt resecuring of the airway without pulmonary aspiration of blood.

Sign in / Sign up

Export Citation Format

Share Document