title: Endonasal, transmaxillary, transpterygoid approach to the foramen ovale: radio-anatomical study of surgical feasibility.
abstract: OBJECTIVE
  This study aimed to examine the feasibility of an endonasal, transmaxillary, transpterygoid approach to the foramen ovale by examining key anatomical, radiological and surgical landmarks.
  
  
  METHODS
  Measurements were taken from 183 patients' computed tomography scans using BrainLAB iPlan 1.1 Cranial software. Endoscopic dissection was then carried out on a cadaver to assess surgical viability.
  
  
  RESULTS
  We found that the distances from the posterior maxillary wall to the foramen ovale and from the anterior nasal spine to the foramen ovale were statistically significantly larger in men than women. The distance from the base of the lateral pterygoid plate to the foramen ovale, and the angle between the foramen ovale, the anterior nasal spine and the sphenoid rostrum, were constant between the sexes. The importance of the lateral pterygoid plate in locating the foramen ovale was demonstrated.
  
  
  CONCLUSIONS
  With the increasing popularity of image guidance and assisted navigation in endoscopic surgery, these findings increase anatomico-radiological understanding of the surgical approach investigated.
authors.affiliation: Laboratory of Human Anatomy, School of Life Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Scotland, UK.
authors.forename: V E
authors.initials: VE
authors.lastname: Kantola
authors.forename: G W
authors.initials: GW
authors.lastname: McGarry
authors.forename: P M
authors.initials: PM
authors.lastname: Rea
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059925:Anatomic Landmarks / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D004724:Endoscopy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D054085:Foramen Ovale / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D006801:Humans; D015192:Infratentorial Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D056739:Pterygopalatine Fossa / Q000033:anatomy & histology / Q000601:surgery; D012737:Sex Factors; D019291:Skull Base / Q000033:anatomy & histology / Q000601:surgery*; D014057:Tomography, X-Ray Computed