Surgical Anatomy of the Sphenopalatine Artery in Lateral Nasal Wall

• Published in: The Laryngoscope 2002-10, Vol.112 (10), p.1813-1818
• Main Authors: Lee, Hye Yeon, Kim, Hyun-Ung, Kim, Sung-Shik, Son, Eun Jin, Kim, Ji Woo, Cho, Nam Hoon, Kim, Kyung-Su, Lee, Jeung-Gweon, Chung, In Hyuk, Yoon, Joo-Heon
• Format: Article
• Language: English
• Subjects: Arteries - anatomy & histology; Arteries - injuries; Biological and medical sciences; fontanelle branch; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Humans; inferior turbinate branch; Intraoperative Complications; Medical sciences; Nasal Cavity - blood supply; Nasal Mucosa - blood supply; Nose - blood supply; Nose - surgery; posterior lateral nasal artery; Sphenopalatine artery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the upper aerodigestive tract; Turbinates - blood supply
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1097/00005537-200210000-00020

Objective We investigated the surgical anatomy of the sphenopalatine artery. First, the location of the sphenopalatine foramen on the lateral nasal wall and the pattern of the main branches of the sphenopalatine artery from the sphenopalatine artery were studied. Second, the course of the posterior lateral nasal artery with respect to the posterior wall of the maxillary sinus, the perpendicular plate of the palatine bone, and the pattern of distribution of its branches on the fontanelle was determined. Third, the distribution pattern on the inferior turbinate was analyzed. Study Design Fifty midsagittal sections of randomly selected Korean adult cadaver heads with intact sphenoid sinus and surrounding structures were used in the study. Methods The mucosa on the sphenopalatine foramen and its surrounding mucosa were removed with a microscissors, a fine forceps, and a pick to expose the sphenopalatine artery under an operating microscope (original magnification ×6). Results The feeding vessels of the superior turbinate were from the septal artery in 36 cases (72%). The feeding vessels to the middle turbinate branch originated from the proximal portion of the posterior lateral nasal artery just after exiting the sphenopalatine foramen in 44 cases (88%). Some portion of the posterior lateral nasal artery ran anterior to the posterior wall of the maxillary sinus in 38%. The major feeding arteries to the fontanelle were from the inferior turbinate branch in 25 cases (50%). In most cases, the inferior turbinate branch was the end artery of the posterior lateral nasal artery (98%). Conclusions The study provides detailed information concerning the sphenopalatine artery, which we hope will help explain the arterial bleeding that may occur during ethmoidectomy, middle meatal antrostomy, conchotomy, and endoscopic ligation of the sphenopalatine artery.