Objectives: To compare between radiological & surgical measurements for landmarks of the sphenopalatine foramen.
Background: Transnasal endoscopic sphenopalatine artery ligation is becoming the procedure of choice for surgical management of severe intractable posterior epistaxis. Establishment of landmarks for localization of the sphenopalatine foramen can help rapid surgical exposure of the sphenopalatine artery for its ligation.
Patients and Methods: This study is a cross sectional comparative study, in which we had established landmarks for localization of sphenopalatine foramen (SPF); Radiologically & Surgically during endoscopic sinonasal surgeries. Patients for this study were selected from otorhinolaryngology department, Menoufia University. Distances were measured between five simple endoscopic landmarks and the sphenopalatine foramen radiological before surgeries and during surgical procedures. Results were collected, tabulated and statistically analyzed by an IBM compatible personal computer with SPSS statistical package version 23.
Results: The mean (standard deviation [SD]) anteroposterior distances to the sphenopalatine foramen were the following: Choanal arch radiologically (-9.49±0.545) & surgically (-9.25±0.555), maxillary line (38.51±2.34) same radiologically & surgically. Anterior head of middle turbinate (34.88±1.84) same radiologically & surgically, basal lamella radiologically (11.13±0.961) & surgically (10.09±0.676). The mean (SD) distance in the vertical dimension from the nasal floor was same radiologically & surgically (27.25±1.33). Right and left-sided measurements were similar. Female patients had statistically shorter distances to sphenopalatine foramen from the maxillary line and anterior head of the middle turbinate.
Conclusion: Radiological measurements from the SPF to maxillary line, anterior head of middle turbinate and nasal floor are reliable with surgical measurements for both sexes so, these radiological measures can help rapid estimation and localization of the SPF in cases of posterior epistaxis to facilitate rapid transnasal endoscopic sphenopalatine artery ligation (TESPAL).