title: Sphenopalatine foramen: endoscopic approach with bony landmarks.
abstract: OBJECTIVE
  To establish whether nasal bony landmarks on computed tomography could be utilised reliably in endoscopic approaches to the sphenopalatine foramen.
  
  
  METHODS
  A prospective analysis of 102 consecutive helical computed tomography scans of the paranasal sinuses was carried out by 2 senior ENT surgeons. Distances from the sphenopalatine foramen to endoscopically palpable bony landmarks were measured.
  
  
  RESULTS
  There were a total of 102 patients (45 females and 57 males), with a mean age of 62 years. The mean distance from the posterior fontanelle to the sphenopalatine foramen was 14.1 mm (standard deviation = 2.13). The average vertical distance of the sphenopalatine foramen opening from the bony attachment of the inferior turbinate was 14.13 mm. There were no statistically significant differences between any of these measurements (foramen width p-value = 0.714, distance from fontanelle p-value = 0.43 and distance from inferior turbinate p-value = 0.48).
  
  
  CONCLUSIONS
  Determination of reliable bony landmarks is clinically useful in endoscopic surgery and can aid identification of the sphenopalatine foramen. The inferior turbinate concha and posterior fontanelle may be used as reliable computed tomography landmarks for endoscopic approaches to the sphenopalatine foramen.
authors: Division of Otolaryngology,Head and Neck Surgery,Royal North Shore Hospital,Sydney,New South Wales,Australia.
authors: S
authors: S
authors: Nalavenkata
authors: Division of Otolaryngology,Head and Neck Surgery,Royal North Shore Hospital,Sydney,New South Wales,Australia.
authors: C
authors: C
authors: Meller
authors: Division of Otolaryngology,Head and Neck Surgery,Royal North Shore Hospital,Sydney,New South Wales,Australia.
authors: D
authors: D
authors: Novakovic
authors: Division of Otolaryngology,Head and Neck Surgery,Royal North Shore Hospital,Sydney,New South Wales,Australia.
authors: M
authors: M
authors: Forer
authors: Division of Otolaryngology,Head and Neck Surgery,Royal North Shore Hospital,Sydney,New South Wales,Australia.
authors: N P
authors: NP
authors: Patel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059925:Anatomic Landmarks / Q000000981:diagnostic imaging* / Q000601:surgery; D001158:Arteries / Q000033:anatomy & histology; D002648:Child; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009295:Nasal Bone / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000601:surgery; D009297:Nasal Mucosa / Q000098:blood supply; D010256:Paranasal Sinuses / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D011446:Prospective Studies; D056739:Pterygopalatine Fossa / Q000033:anatomy & histology / Q000098:blood supply / Q000601:surgery; D036542:Tomography, Spiral Computed / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D014420:Turbinates / Q000033:anatomy & histology / Q000000981:diagnostic imaging
keywords: Epistaxis; Pterygopalatine Fossa; Sphenopalatine Artery; Sphenopalatine Foramen