Tomaszewska Iwona M, Kmiotek Elizabeth K, Pena Iwona Z, Średniawa Michał, Czyżowska Katarzyna, Chrzan Robert, Nowakowski Michał, Walocha Jerzy A
Department of Medical Education, Jagiellonian University Medical College, 16 Lazarza Street, 31-530, Krakow, Poland,
Anat Sci Int. 2015 Sep;90(4):287-97. doi: 10.1007/s12565-014-0263-9. Epub 2014 Dec 3.
We have performed a detailed morphometric analysis of the length and anatomic routes of the greater palatine canal (GPC) and a systematic review of the literature on the anatomy of the GPC with the aim of informing dentists, maxillofacial surgeons, otorhinolaryngologists and other specialists performing procedures in the area of the GPC. In total, we analysed 1,500 archived adult head computed tomography scans to determine the length of the GPC and of the routes on both sides, as well as the dimensions and opening directions of the greater palatine foramen. The systematic review of the literature was performed according to PRISMA guidelines. The study group comprised 783 females (52.2%) and 717 males with a mean (± standard deviation) age of 42.1 ± 16.9 years; there was significant difference in age between sexes (p = 0.33). The average length of the GPC was 31.1 ± 2.9 (range 15-44) mm. The GPC travelled three different paths in the sagittal plane and four different paths in the coronal plane. Most often it descended from the pterygopalatine fossa inferiorly before changing to an anterior-inferior direction (68.4%; sagittal plane) and inferior-laterally before changing to an inferior-medial direction (40.7%; (coronal plane). In total, the GPF had four different opening directions: inferior-anterior-medial (82.1%), inferior-anterior-lateral (4.0%), anterior (7.6%), and vertical (5.3%). Twenty-five studies were included in the systematic review. In conclusion, the information presented here provides clinicians with the anatomical knowledge necessary to minimize the risk of complications when performing procedures involving infiltration of the GPC.
我们对腭大管（GPC）的长度和解剖路径进行了详细的形态计量学分析，并对有关GPC解剖结构的文献进行了系统综述，目的是为在GPC区域进行手术的牙医、颌面外科医生、耳鼻喉科医生和其他专科医生提供信息。我们总共分析了1500份存档的成人头部计算机断层扫描，以确定GPC两侧的长度和路径，以及腭大孔的尺寸和开口方向。文献的系统综述按照PRISMA指南进行。研究组包括783名女性（52.2%）和717名男性，平均（±标准差）年龄为42.1±16.9岁；两性之间年龄存在显著差异（p = 0.33）。GPC的平均长度为31.1±2.9（范围15 - 44）mm。GPC在矢状面走行三种不同路径，在冠状面走行四种不同路径。最常见的是它从翼腭窝向下走行，然后改变为前下方向（68.4%；矢状面），以及从下外侧走行，然后改变为下内侧方向（40.7%；冠状面）。腭大孔总共具有四种不同的开口方向：下前内侧（82.1%）、下前外侧（4.0%）、前（7.6%）和垂直（5.3%）。系统综述纳入了25项研究。总之，本文提供的信息为临床医生在进行涉及GPC浸润的手术时提供了将并发症风险降至最低所需的解剖学知识。
