A new method of identifying the posterior inferior nasal nerve: implications for posterior nasal neurectomy.
BACKGROUND
Posterior nasal neurectomy is an effective way of treating recalcitrant rhinitis. The aim of this study is to describe the anatomic relationship between the posterior inferior nasal nerve (PINN) and the structures that might be important for posterior nasal neurectomy.


METHODS
An anatomic study was conducted in a university hospital dissection laboratory with 15 formalin-fixed, sagittally cut adult cadaver heads. The distance between PINN and (1) nasal sill, (2) maxillary sinus ostium, (3) posterior fontanel, (4) torus tubarius, and (5) crista ethmoidalis was measured and the location of PINN with respect to the sphenopalatine artery was assessed to define the exact location of PINN.


RESULTS
The mean distance between PINN and nasal sill (56.4 mm), maxillary sinus ostium (27 mm), posterior fontanel (12.5 mm), torus tubarius (13 mm), and crista ethmoidalis (8 mm) was determined. PINN was found consistently posterior to the sphenopalatine artery where the inferior turbinate attaches to the lateral nasal wall.


CONCLUSIONS
Instead of finding PINN around the sphenopalatine foramen, PINN can be located more easily posterior to the sphenopalatine artery where the inferior turbinate attaches to the lateral nasal wall without cauterizing the sphenopalatine artery.
*Department of Otolaryngology, Atatürk Research and Education Hospital, Izmir Katip Çelebi University, Izmir, Turkey †Departments of Anatomy ‡Otolaryngology, Dokuz Eylül University School of Medicine, Izmir, Turkey.
Erdem
E
Eren
Gülşah
G
Zeybek
Cenk
C
Ecevit
Seçil
S
Arslanoğlu
Ipek
I
Ergur
Amaç
A
Kiray
D000328:Adult; D002908:Chronic Disease; D003391:Cranial Nerves / Q000033:anatomy & histology* / Q000601:surgery*; D006801:Humans; D008866:Microsurgery / Q000379:methods; D009296:Nasal Cavity / Q000033:anatomy & histology* / Q000294:innervation* / Q000601:surgery*; D012220:Rhinitis / Q000601:surgery*