Clinic of Oral Surgery, Faculty of Stomatology, University of Belgrade, Belgrade, Serbia.
Int J Oral Maxillofac Surg. 2010 May;39(5):493-6. doi: 10.1016/j.ijom.2009.11.002. Epub 2009 Dec 2.
The anatomy of the pterygopalatine fossa pertinent to the technique of maxillary nerve block at the foramen rotundum was investigated and the ability of inexperienced surgeons to apply the required angles of the injection needle to the sagittal plane in a clinical environment. In 85 dried human skulls the volume, length, width and depth of 159 intact pterygopalatine fossae were measured. The frequency of reaching the sphenopalatine foramen using a 20 G spinal needle advanced from the frontozygomatic angle through the pterygomaxillary fissure was determined. 49 oral surgery postgraduates aligned the injection needle with angles of 60 degrees and 80 degrees to the sagittal plane of a volunteer's head. The dimensions of the pterygopalatine fossa were inconsistent; volume (0.1-1 cm(3)), width (1-9 mm) and depth (6-22 mm) showed the greatest variations. An enlarged sphenoidal process and a narrow pterygomaxillary fissure (<2 mm) were found in 15% and 8%, respectively. The sphenopalatine foramen was reached successfully in 75%. Postgraduates in oral surgery were highly accurate in the assessment of the 60 degrees and 80 degrees angles to the sagittal plane. A previously described technique of blocking the maxillary nerve at the foramen rotundum was adjusted and recommendations given to overcome anatomical obstacles.
翼腭窝的解剖结构与圆孔处上颌神经阻滞技术相关，本研究旨在调查经验不足的外科医生在临床环境下将所需的注射针角度应用于矢状面的能力。在 85 个人颅骨标本中，测量了 159 个完整的翼腭窝的体积、长度、宽度和深度。通过从前额颧突角经翼钩裂进针，用 20G 脊髓针测量到达蝶腭孔的频率。49 名口腔外科研究生将注射针与志愿者头部矢状面成 60 度和 80 度角排列。翼腭窝的尺寸不一致；体积（0.1-1cm3）、宽度（1-9mm）和深度（6-22mm）变化最大。发现 15%的患者存在蝶骨棘增大，8%的患者存在翼钩裂狭窄（<2mm）。成功到达蝶腭孔的比例为 75%。口腔外科研究生在评估矢状面 60 度和 80 度角时非常准确。对圆孔处上颌神经阻滞技术进行了调整，并提出了克服解剖障碍的建议。
