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Open Access Landmarks for rapid localization of the sphenopalatine foramen: A radiographic morphometric analysis

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Transnasal endoscopic sphenopalatine artery ligation is becoming the procedure of choice for surgical management of intractable posterior epistaxis. Landmarks for localization of the sphenopalatine foramen can assist in rapid surgical exposure of the sphenopalatine artery.


This study examined distances from easily identified endoscopic surgical landmarks to the sphenopalatine foramen.


By using computed tomography of the sinus to study radiologic anatomy in 50 adults, distances were measured between five simple endoscopic landmarks and the sphenopalatine foramen. The two-tailed t-test was used for statistical analysis.


Right- and left-sided measurements were similar. The mean (standard deviation [SD]) anteroposterior distances to the sphenopalatine foramen were the following: from the maxillary line (36.7 ± 5.5 mm), anterior head of the middle turbinate (33.8 ± 6.7 mm), basal lamella (11.8 ± 1.9 mm), and choanal arch (−9.2 ± 1.4 mm). The mean (SD) distance in the vertical dimension from the nasal floor was 26.6 ± 2.6 mm. Female patients had statistically shorter distances to the sphenopalatine foramen from the maxillary line, anterior head of the middle turbinate, choanal arch, and nasal floor.


Reliable endoscopic landmarks exist in relation to consistent anatomic structures and can be used to help quickly estimate the location of the sphenopalatine foramen at the onset of the procedure.
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Keywords: SPA ligation; Sphenopalatine artery; arterial ligation; computed tomography; crista ethmoidalis; epistaxis; sinonasal anatomy; sphenopalatine foramen

Document Type: Research Article

Affiliations: Department of Otolaryngology—Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA

Publication date: 2017-06-01

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  • In the fields of rhinology & allergy, as in all medical fields, there is a need for a greater number of journals which publish in the open access format. The underlying spirit of this format is to break down the barriers to knowledge sharing. Allergy & Rhinology, was created to serve this need; and is proud to take the lead in publishing quality research work as an experiment in the open format. As long as the fiscal model works, the Journal shall allow all users the right to freely read, download, copy, distribute, print, search, or link to the full texts of its articles.

    The academic standard of Allergy & Rhinology is designed to be no different than traditional subscription-based, scientific and scholarly journals in that the quality of the research work which it publishes shall meet the rigors of peer-review and other scholarly quality controls.

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