Kwon Dohyun, Kim Soung Min, Lee Jong-Ho
Department of Oral and Maxillofacial Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-Ro, Jongno-Gu, Seoul, Korea.
BMC Oral Health. 2024 Dec 18;24(1):1494. doi: 10.1186/s12903-024-05176-8.
The posterior maxilla and skull base is a region with a complex anatomy. Accurate resection of the pterygoid plate is critical during a maxillectomy procedure. However, there is a paucity of functional and anatomical studies on the pterygoid plate and skull base. This study aimed to investigate functional anatomy of the pterygoid plate and its surrounding structures in the posterior maxilla to provide a better understanding of surgical procedures in this region.
3D software was used to measure 3D distances, angles, and areas of key anatomical landmarks on CT images of 100 hemifaces. Morphological classification of pterygoid plates was then performed.
Results of comparing right and left pterygoid plates revealed no significant differences in dimensions or angles. Comparisons between sexes revealed that a few parameters were significantly different (P < 0.01), including pterygoid height on the left side, distance from the zygomatico-maxillary buttress to the infraorbital fissure (Zy-IOF), and area of the left lateral pterygoid plate. The morphology of the lateral pterygoid plate was classified into four types based on the shape of the middle region: middle convex (42%), double concave (36%), flattened (10%), and middle concave (12%). The morphology of pterygoid plates was classified based on the divergence of medial and lateral pterygoid plates, with the narrow type (56%) being more common than the wide type in this study cohort.
This 3D digital anatomical study measured key landmarks for maxillary resection. Such measurement has never been reported. This anatomical study provides surgeons with information on the anatomy of the posterior maxilla and allows for safer and more accurate resection of the difficult-to-resect posterior maxilla.
上颌骨后部和颅底是一个解剖结构复杂的区域。在进行上颌骨切除术时，准确切除翼突至关重要。然而，关于翼突和颅底的功能及解剖学研究较少。本研究旨在探讨上颌骨后部翼突及其周围结构的功能解剖，以便更好地理解该区域的手术操作。
使用三维软件测量100个半侧面部CT图像上关键解剖标志的三维距离、角度和面积。然后对翼突进行形态学分类。
左右翼突比较结果显示，尺寸和角度无显著差异。性别比较显示，一些参数存在显著差异（P < 0.01），包括左侧翼突高度、颧上颌支柱至眶下裂的距离（Zy-IOF）以及左侧翼外板面积。根据中间区域的形状，翼外板的形态分为四种类型：中间凸起型（42%）、双凹型（36%）、扁平型（10%）和中间凹陷型（12%）。根据翼内、外板的分叉情况对翼突形态进行分类，在本研究队列中，窄型（56%）比宽型更常见。
这项三维数字解剖学研究测量了上颌骨切除术的关键标志。此类测量此前未见报道。这项解剖学研究为外科医生提供了上颌骨后部的解剖信息，有助于更安全、准确地切除难以切除的上颌骨后部。
