title: Sphenopalatine artery ligation: a cadaver anatomic study.
abstract: OBJECTIVE
  To clarify endoscopic anatomy of the sphenopalatine artery (SPA) in relation to intranasal endoscopic landmarks using a human cadaver model and to simplify the surgical approach to SPA ligation.
  
  
  METHODS
  Prospective anatomic study from November to December 2009.
  
  
  METHODS
  University of Tennessee Health Science Center Gross Anatomy Lab.
  
  
  METHODS
  Fifty human cadaveric sagittally sectioned heads.
  
  
  METHODS
  The cadaveric nasal cavities were examined using a 0° endoscope, and the SPA and foramen were identified. The number of nasal cavities in which a transnasal approach successfully revealed the SPA foramen was compared with those that required maxillary antrostomy. The distance from the posterior edge of the maxillary natural ostium to the anterior edge of the SPA foramen was measured.
  
  
  RESULTS
  Successful ligation of the SPA via a lateral nasal wall incision was achieved in 45 of 50 specimens (90%). The mean distance from the posterior edge of the maxillary natural ostium to the anterior edge of the SPA foramen was 23.79 mm (95% confidence interval, 22.03-25.55).
  
  
  CONCLUSIONS
  The method of performing SPA ligation via lateral nasal wall incision alone was successful in 90% of human cadaveric heads. Maxillary antrostomy revealed the SPA in the remainder. No specimen required uncinectomy. The mean distance from the maxillary natural ostium to SPA foramen was more than 2 cm. The routine use of maxillary antrostomy and uncinectomy is not needed to locate the SPA in most nasal cavities and moreover produces unnecessary mucosal trauma in the often medically fragile or coagulopathic patient.
authors.affiliation: Department of Otolaryngology, University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: Courtney B
authors.initials: CB
authors.lastname: Shires
authors.forename: John D
authors.initials: JD
authors.lastname: Boughter
authors.forename: Merry E
authors.initials: ME
authors.lastname: Sebelik
mesh_terms: D002102:Cadaver; D004724:Endoscopy / Q000379:methods; D004844:Epistaxis / Q000601:surgery; D005260:Female; D006801:Humans; D008026:Ligation / Q000379:methods; D008297:Male; D008438:Maxillary Artery / Q000033:anatomy & histology* / Q000601:surgery*; D009296:Nasal Cavity / Q000098:blood supply*; D009297:Nasal Mucosa / Q000098:blood supply