Morphometric Analysis of Accessory Palatine Canals in Human Dry Skulls: Clinical Implications for Maxillofacial Surgery.

Introduction The premaxilla, located anterior to the incisive canal and including the central and lateral incisors, plays a crucial role in oral and maxillofacial surgeries due to its neurovascular structures. Accessory palatine canals are of clinical importance as they help prevent complications such as anesthesia failure and nerve injury. While many radiological studies have examined these canals, research on dried skulls remains scarce. This study aims to offer detailed anatomical insights into accessory palatine canals, with the goal of enhancing surgical precision and minimizing complications in palatal surgeries. Aim The aim of this study is to determine the prevalence of accessory palatine canals and conduct a morphometric analysis of these canals in relation to the incisive canal in the premaxilla of human dry skulls. Materials and methods This cross-sectional observational study was conducted in the Department of Anatomy at King George's Medical University, Lucknow, India, from April 2022 to September 2023. A total of 100 dry human skulls, with unknown age and sex, were examined for the presence of accessory palatine canals, excluding the nasopalatine, greater palatine, and lesser palatine canals. Skulls with damaged, broken, or eroded maxillae were excluded from the study. The canals were analyzed for their length, vertical and horizontal diameters, and distance from the incisive foramen. All measurements were taken using the divider-scale method and a digital vernier caliper. The data were organized in an Excel file and analyzed using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, NY, USA). The frequency of occurrence of these accessory canals, along with the mean and SD, were calculated. Results Accessory palatine canals were observed in 10 out of 100 skulls. Among these, six skulls had one accessory canal, two had two canals each, and the remaining two skulls had three and four accessory palatine canals, respectively. The majority of these canals opened in the central incisor socket (70.6%), while the rest opened in the lateral incisor socket (29.4%). The mean length of the canal (3.7 ± 3 mm) could be measured in 12 of the 17 canals, as five canals were visible only as openings. The mean vertical diameter was 1.4 ± 0.9 mm, the horizontal diameter was 2 ± 1 mm, and the mean distance from the incisive canal was 6.5 ± 1.3 mm. Conclusions Although the incidence of accessory palatine canals is low, these canals can present challenges during palatine reconstructive surgeries by altering the neurovascular anatomy, thus increasing the risk of complications such as bleeding or nerve injury. A thorough understanding of the morphometry of these canals is essential for surgeons, as it enables better management of palatal surgeries for both pathologies and the reconstruction of the region.