Douglas Richard, Wormald Peter-John
Department of Surgery, Otolaryngology-Head and Neck Surgery, Adelaide & Flinders Universities, Woodville, Australia.
Laryngoscope. 2006 Jul;116(7):1255-7. doi: 10.1097/01.mlg.0000226005.43817.a2.
In the literature, there has been controversy regarding the length of the greater palatine canal. If the pterygopalatine fossa is infiltrated in an attempt to reduce bleeding during sinus surgery, this information is important to be able to place local anesthetic with maximal effect and the least likelihood of complications.
The authors conducted a prospective cadaver-based study using high-definition computed tomography (CT) scans.
Twenty-two cadaver heads were CT scanned and the greater palatine canal length, pterygopalatine fossa height, and thickness of the soft tissue in the roof of the mouth were measured on parasagittal images using the CT scanner workstation.
The mean length of the greater palatine canal was 18.5 mm (95% confidence interval [CI]=17.9-19.1) and the mean height of the pterygopalatine fossa was 21.6 mm (95% CI=20.7-22.5). The mean thickness of the soft tissue in the roof of the mouth overlying the foramen of the greater palatine canal was 6.9 mm (95% CI=6.2-7.6).
To perform an effective infiltration of the pterygopalatine fossa, the needle should be bent at 25 mm from the tip at an angle of 45 degrees.
在文献中，关于腭大管的长度存在争议。如果在鼻窦手术中为减少出血而对翼腭窝进行浸润麻醉，那么为了能够以最大效果和最低并发症可能性进行局部麻醉，这一信息就很重要。
作者进行了一项基于尸体的前瞻性研究，使用高清计算机断层扫描（CT）。
对22个尸头进行CT扫描，并使用CT扫描仪工作站在矢状位图像上测量腭大管长度、翼腭窝高度以及腭顶软组织厚度。
腭大管的平均长度为18.5毫米（95%置信区间[CI]=17.9 - 19.1），翼腭窝的平均高度为21.6毫米（95% CI=20.7 - 22.5）。覆盖腭大管孔的腭顶软组织平均厚度为6.9毫米（95% CI=6.2 - 7.6）。
为有效浸润翼腭窝，针头应在距尖端25毫米处弯曲成45度角。
