title: The sphenopalatine artery: a surgical challenge in epistaxis.
abstract: Knowledge on the anatomy of the sphenopalatine artery (SPA) and its branches is fundamental for the success of the endoscopic treatment of posterior epistaxis. However, the complex anatomical variations seen in the irrigation of the nasal cavity poses a significant surgical challenge.
  
  
  OBJECTIVE
  This paper aims to describe the endoscopic anatomy of the SPA in human cadavers.
  
  
  METHODS
  This is a contemporary cross-sectional cohort study carried out between April 2010 and August 2011. The presence of the ethmoidal crest on the lamina perpendicular to the palatine bone and the location of the principal sphenopalatine foramen (PSF) and the accessory sphenopalatine foramen (ASF) were analyzed in 28 cadavers, and the branches emerging from the foramens were counted.
  
  
  RESULTS
  Fifty-six nasal fossae were analyzed. The ethmoidal crest was present in 96% of the cases and was located anteriorly to the PSF in most cases. The PSF was located in the transition area between the middle and the superior meatus in all cases. The ASF was seen in 12 cases. Most nasal fossae (n = 12) presented a single bilateral arterial trunk emerging from the PSF. In other cases, three (n = 8) or two (n = 5) arterial trunks emerged bilaterally from the PSF. In most cases, the SPA emerged as a single trunk from the ASP.
  
  
  CONCLUSIONS
  The anatomy of the SPA is highly variable. The success of the treatment for severe epistaxis relies heavily on adequate knowledge of the possible anatomical variations of the sphenopalatine artery.
authors.affiliation: Hospital de Base do Distrito Federal. 　glararezende@gmail.com
authors.forename: Gustavo Lara
authors.initials: GL
authors.lastname: Rezende
authors.forename: Vitor Yamashiro Rocha
authors.initials: VY
authors.lastname: Soares
authors.forename: Waldete Cabral
authors.initials: WC
authors.lastname: Moraes
authors.forename: Carlos Augusto Costa Pires de
authors.initials: CA
authors.lastname: Oliveira
authors.forename: Márcio
authors.initials: M
authors.lastname: Nakanishi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000033:anatomy & histology; D002102:Cadaver; D002648:Child; D004844:Epistaxis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000098:blood supply*; D014420:Turbinates / Q000098:blood supply*; D055815:Young Adult