Morphological Description and Clinical Implication of Sphenopalatine Foramen for Accurate Transnasal Sphenopalatine Ganglion Block: An Anatomical Study

Morphometric analysis of sphenopalatine foramen on computed tomography images with clinical significance

PURPOSE

This study aimed to investigate the effect of anatomical variations in the sphenopalatine foramen and the lateral nasal wall on sphenopalatine foramen-related morphometric measurements.

METHODS

Paranasal sinus multidetector computed tomography records of 153 patients were evaluated. Morphometric measurements were made between the fixed bony landmarks and the sphenopalatine foramen. Number, shape, localization variations of the sphenopalatine foramen, concha bullosa, and septum deviation were noted and the results were compared with respect to sex, age, and laterality.

RESULTS

No significant difference was detected with respect to laterality, whereas most of the measured distances were higher in males than females. There was a significant difference between the obtained morphometric data according to age groups. In our study, 91.2% single, 7.8% double, and 1% triple sphenopalatine foramen were detected and the most common irregularly shaped (37.3%). The location of sphenopalatine foramen was reported as the most common type II. Septum deviation types have no potential influence on the location of the foramen, but most of the measured parameters were found to be significantly smaller in the presence of concha bullosa, whereas the angle was found to be higher.

CONCLUSION

This study revealed a significant relationship between the morphometric measurements of the sphenopalatine foramen and concha bullosa, while septum deviation types did not affect these results. For a safer and more effective surgery with prevention of iatrogenic complications, a surgeon should be aware of this correlation, especially in endoscopic transnasal approaches.