El-Anwar Mohammad Waheed, Khazbak Alaa Omar, Hussein Atef, Saber Sameh, Bessar Ahmed Awad, Eldib Diaa Bakry
Otorhinolaryngology-Head and Neck Surgery Department, Faculty of Medicine.
Radio Diagnosis Department, Faculty of Medicine, Zagazig University, Zagazig.
J Craniofac Surg. 2020 Jan/Feb;31(1):210-213. doi: 10.1097/SCS.0000000000005857.
The aim of the study was to assess different radiologic bony landmarks for endoscopic localization of the sphenopalatine foramen (SPF).
Paranasal computed tomography (CT) scans of adults without sinonasal pathology were included. On axial cuts, the anteroposterior distances from the SPF to maxillary line, anterior head of the middle turbinate, basal lamella of the middle turbinate, choanal arch, and posterior fontanel of the maxillary sinus ostium were measured. While on coronal cuts, the vertical distances from the SPF to the nasal floor was measured. The registered measurements were then studied and statistically analyzed.
In 70 patients (140 sides, 840 measurements), the mean distances from the SPF to nasal floor, choanal arch, maxillary line, anterior head of the middle turbinate, basal lamella, and posterior fontanel were 25.6 ± 2.4, 8.5 ± 1.38, 36.4 ± 2.6, 34.6 ± 4.26, 8.1 ± 1.27, and 13.7 ± 1.7 mm, respectively, without significant differences between right and left sides. Females showed significantly shorter mean distances between SPF and the nasal floor (P = 0.0011), choanal arch (P = 0.0459), and posterior fontanel (P < 0.0001) than males. While no significant differences were detected between both sexes as regard distances from SPF to maxillary line (P = 0.5579), anterior head of middle turbinate (P = 0.8581), and basal lamella (P = 0.0638).
Preoperative CT can provide multiple easily detected, reliable, and simple bony landmarks that can help SPF endoscopic localization. Thus the authors recommend adding these measurements to the preoperative CT checklist for patients scheduled for sphenopalatine artery ligation and/or excision of vascular lesions.
本研究旨在评估用于蝶腭孔（SPF）内镜定位的不同放射学骨性标志。
纳入无鼻窦病变的成人鼻窦计算机断层扫描（CT）图像。在轴位图像上，测量蝶腭孔到上颌线、中鼻甲前端、中鼻甲基板、鼻后孔弓以及上颌窦口后囟门的前后距离。在冠状位图像上，测量蝶腭孔到鼻底的垂直距离。然后对记录的测量值进行研究和统计分析。
70例患者（140侧，840次测量）中，蝶腭孔到鼻底、鼻后孔弓、上颌线、中鼻甲前端、基板和后囟门的平均距离分别为25.6±2.4、8.5±1.38、36.4±2.6、34.6±4.26、8.1±1.27和13.7±1.7mm，左右侧之间无显著差异。女性蝶腭孔到鼻底（P = 0.0011）、鼻后孔弓（P = 0.0459）和后囟门（P < 0.0001）的平均距离显著短于男性。而在蝶腭孔到上颌线（P = 0.5579）、中鼻甲前端（P = 0.8581）和基板（P = 0.0638）的距离方面，两性之间未检测到显著差异。
术前CT可提供多个易于检测、可靠且简单的骨性标志，有助于蝶腭孔的内镜定位。因此，作者建议将这些测量值添加到计划进行蝶腭动脉结扎和/或血管病变切除的患者术前CT检查清单中。
