DOCSLIB.ORG

Transpalatal Approach to the Maxillary Division of the Trigeminal Nerve for Alcohol Block

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Transpalatal Approach to the Maxillary Division of the Trigeminal Nerve for Alcohol Block J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.29.6.560 on 1 December 1966. Downloaded from J. Neurol. Neurosurg. Psychiat., 1966, 29, 560 Transpalatal approach to the maxillary division of the trigeminal nerve for alcohol block C. NORMAN SHEALY1, BENJAMIN KAUFMAN, AND ANTHONY J. TOMARO From the Division ofNeurosurgery, Department of Radiology, Western Reserve University School of Medicine, and School of Dental Surgery, and University Hospitals of Cleveland, Cleveland, Ohio, U.S.A. Occasionally an old procedure experiences a popular palatine fossa where two branches are contiguous revival; similarly, one subspecialist may chance to with the sphenopalatine ganglion which hangs like a learn an excellent technique from a colleague in grape from the major nerve trunk. The maxillary another field. Recent experience with an approach division at or near this point branches into the to the sphenopalatine ganglion aroused our interest infraorbital nerve and posterior-superior alveolar in a well-known dental technique which was formerly branches (Cunningham, 1937). used by otolaryngologists and is currently used by On a lateral radiograph of the skull, the pterygo- oral surgeons but which has not, to our knowledge, maxillary fissure is easily recognized, marked been standard among neurosurgeons. anteriorly by the posterior wall of the maxillaryguest. Protected by copyright. Sluder (1918) popularized the sphenopalatine sinus and posteriorly by the base of the pterygoid ganglion as the seat of neurological symptoms, in- process of the sphenoid base. Directly medial and cluding 'cluster' or 'Horton's' headaches. Neuro- continuous with the pterygomaxillary fissure is the surgical publications have refuted this and attacks pterygopalatine fossa, marked medially by the upon the ganglion are generally considered ill-ad- orbital and sphenoid processes of the sphenoid and vised now. We do not propose to enter the contro- superiorly by the sphenoid body. The inferior orbital versy as to aetiology or treatment of this entire fissure is continuous medically and superiorly with syndrome, but should like to report some pertinent the pterygopalatine fissure. neuro-anatomical considerations concerning the The pertinent foramen rotundum is situated in the maxillary nerve. base of the sphenoid, but because of its plane is not It is of some interest that, despite considerable easily identified radiologically. This has led to the discussion of the sphenopalatine ganglion, little has use of Water's projection to demonstrate the been said of surgical approaches to it. Moreover, foramen. When the lateral approach to the foramen even when an approach is mentioned, it is usually rotundum is used, the Water's view gives good described without noting the proximity of the entire monitoring as to depth of penetration. maxillary division of the fifth cranial nerve (White Oppositethe seconduppermolarthere is a palpable and Sweet, 1955). depression in the palatal mucosa. With slight probing Older otolaryngological texts (Morrison, 1948) here, a no. 24 needle can be inserted into the greater and current dental surgery texts (Thoma, 1963) palatine foramen leading directly through the greater http://jnnp.bmj.com/ describe briefly an anatomical approach with a palatine canal into the pterygopalatine fossa. The needle to the pterygopalatine fossa which is simple greater palatine foramen can be identified on sub- and guides one directly into the fossa. However, no- mentovertical skull films (Fig. 1). Lesser palatine one has reported the radiological analysis of this foramina, variable in size and number, are situated approach. Simple lateral and anterior-posterior posterior to the greater palatine foramen. If the x-ray films of the skull will immediately confirm the needle is inserted into one of the lesser foramina an position of the needle and allow greater accuracy in easy passage to the pterygopalatine fossa may not be injection of alcohol. found. Almost immediately on emerging from the on September 29, 2021 by greater palatine canal, the needle is very close to the NEURO-ANATOMICAL AND RADIOLOGICAL APPROACH foramen rotundum. Two simple x-ray views now The maxillary division of the trigeminal nerve passes suffice to monitor the procedure. A Water's view through the foramen rotundum into the pterygo- will ascertain the relation of the needle to the fora- "Present address: Gundersen Clinic, La Crosse, Wisconsin 54601, men rotundum and a lateral view will give the exact U.S.A. degree of penetration into the pterygopalatine fossa. 560 J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.29.6.560 on 1 December 1966. Downloaded from Transpalatal approach to the maxillary division of the trigeminal nerve for alcohol block 561 FIG. 3. guest. Protected by copyright. FIG. 1. Submentovertical view ofa skull. The arrowpoints to the greater palatine foramen. Immediately posteriorly is a smaller lesser palatine foramen. FIG. 2a. A lateral view of a skull specimen. The upper arrow points to the wire in a pipe cleaner which emerges anteriorly through the foramen rotundum. The lower arrow points to the section ofa paper clip which is inserted through the greater palatine foramen and is in the inferior part ofthe pterygopalatine fossa. FIG. 2b. A submentovertical view ofhalfa skullspecimen showing the meeting of the paper clip and the pipe cleaner wire at the foramen rotundum. FIG. 3. Lateral view ofa skull specimen showing that the paper clip has been advanced to the level ofthe optic fora- http://jnnp.bmj.com/ men which is situated immediately below the planum sphenoidale. on September 29, 2021 by F:IG. 2b. J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.29.6.560 on 1 December 1966. Downloaded from 562 C. Norman Shealy, Benjamin Kaufman, and Anthony J. Tomaro The tip of the needle enters the lower third of the complained of severe rhinorrhoea from the left nostril. fossa as viewed on the lateral radiographs (Figs. 2a Numerous tests for sugar were negative so that we were and 2b). Deeper penetration may be necessary, but convinced that this probably represented unchecked and closer to nasal secretions, perhaps aggravated by some interference also advances the needle higher the with autonomic supply to the nasal mucosa. Antihista- important superior structures, optic nerves and minesandanticholinergicdrugsfailedtohelp. A temporary extraocular nerves (Fig. 3). The course of the optic block of the left sphenopalatine ganglion with xylocaine nerve can be identified either by considering the bony gave transient dryness of the left nose. optic canal or by relating the portion of the optic On 12 December 1964 the region of the left spheno- canal to the planum sphenoidale. Since the needle is palatine ganglion visible radiologically was injected with in a narrow bony canal, its course is fixed in two 1 ml. absolute alcohol inserted through a no. 22 needle directions, leaving depth as the only variable. passed through the greater palatine foramen into the Actually, depth of not more than 2 or 3 mm. into this pterygopalatine fossa (Figs. 4a and 4b). After this procedure there was satisfactory dryness of fossa should suffice and this will avoid injury to the the left nose for six months, with gradual return of important optic and extraocular nerves. secretions over the next two months. We have found that a lateral view of the skull identifies exactly the position of the needle tip and One of us (A.J.T.) has used this approach for a establishes whether the needle is still in the greater number of years to block the maxillary division of the palatine canal or has entered the inferior pterygo- trigeminal nerve, with excellent results. Recently we palatine fossa, the ideal area for alchohol injection. have easily performed by this route a maxillary block In the traditional lateral approach, a Water's in a patient with trigeminal neuralgia. view is not necessary with transpalatine approach. CASE REPORT DISCUSSION guest. Protected by copyright. A brief r6sume is given here of the patient who aroused Eagle (1942) gives a long discussion of sphenopala- our interest in the procedure described. tine ganglion neuralgia; mostly he treated this with J.M. (U.H. NO. 744-916) This 24-year-old housewife un- cocaine placed behind the middle nasal turbinate. derwent successful removal of a large neurinoma of the He mentions alcohol injections into the ganglion via left gasserian ganglion in 1962. Afterwards she had total this route in five patients, but says the procedure 'is palsies of the left cranial nerves Ill, V, and VI and she not without danger'. http://jnnp.bmj.com/ on September 29, 2021 by FIG. 4a. (Patient J.M.) Lateral view of skull. A no. 22 FIG. 4b. Water's projection showing course ofthe needle. needle is seen traversing the greater palatine foramen. The The rightforamen rotundum is seen and the depth relation- tip of the needle is touching the sphenoid bone and pene- ship ofthe tip ofthe needle to the unvisualized leftforamen tration is in the lowerpart ofthe pterygopalatinefossa and rotundum can be appreciated. However, since the needle has well below the optic nerve. This penetration is deeper than traversed a small canal, it is obvious that the lateral view is necessary for initial injection. the critical one. J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.29.6.560 on 1 December 1966. Downloaded from Transpalatal approach to the maxillary division ofthe trigeminal nervefor akohol block 563 Sluder (1918) recommended alcohol injection deeper penetration to the nearby superior orbital into the ganglion, but mentions the possibility of fissure. haemorrhage when this is done through the nose. The 'traditional' lateral approach was developed, As late as 1948 Morrison described alcohol injection according to White and Sweet (1955), by Levy and of the sphenopalatine ganglion through the 'pos- Bandow and introduced into the U.S.A. by Patrick. terior palatine canal' (Sluder, 1918). Two textbooks Although it offers a good chance for success in ex- (Boies, Hilger and Priest, 1964; DeWeese and perienced hands, many failures have been reported.
Load more

Recommended publications
  • Craniodental Anatomy of a New Late Cretaceous Multituberculate Mammal from Udan Sayr, Mongolia
    University of Louisville ThinkIR: The University of Louisville's Institutional Repository Electronic Theses and Dissertations 8-2014 Craniodental anatomy of a new late cretaceous multituberculate mammal from Udan Sayr, Mongolia. Amir Subhash Sheth University of Louisville Follow this and additional works at: https://ir.library.louisville.edu/etd Part of the Anatomy Commons, and the Medical Neurobiology Commons Recommended Citation Sheth, Amir Subhash, "Craniodental anatomy of a new late cretaceous multituberculate mammal from Udan Sayr, Mongolia." (2014). Electronic Theses and Dissertations. Paper 1317. https://doi.org/10.18297/etd/1317 This Master's Thesis is brought to you for free and open access by ThinkIR: The nivU ersity of Louisville's Institutional Repository. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of ThinkIR: The nivU ersity of Louisville's Institutional Repository. This title appears here courtesy of the author, who has retained all other copyrights. For more information, please contact [email protected]. CRANIODENTAL ANATOMY OF A NEW LATE CRETACEOUS MULTITUBERCULATE MAMMAL FROM UDAN SAYR, MONGOLIA By Amir Subhash Sheth B.A., Centre College, 2010 A Thesis Submitted to the Faculty of the School of Medicine of the University of Louisville in Partial Fulfillment of the Requirements for the Degree of Master of Science Department of Anatomical Sciences and Neurobiology University of Louisville Louisville, Kentucky August 2014 CRANIODENTAL ANATOMY OF A NEW LATE CRETACEOUS MULTITUBERCULATE MAMMAL FROM UDAN SAYR, MONGOLIA By Amir Subhash Sheth B.A., Centre College, 2010 A Thesis Approved on July 18th, 2014 By the Following Thesis Committee: ________________________________ (Guillermo W.
    [Show full text]
  • Yagenich L.V., Kirillova I.I., Siritsa Ye.A. Latin and Main Principals Of
    Yagenich L.V., Kirillova I.I., Siritsa Ye.A. Latin and main principals of anatomical, pharmaceutical and clinical terminology (Student's book) Simferopol, 2017 Contents No. Topics Page 1. UNIT I. Latin language history. Phonetics. Alphabet. Vowels and consonants classification. Diphthongs. Digraphs. Letter combinations. 4-13 Syllable shortness and longitude. Stress rules. 2. UNIT II. Grammatical noun categories, declension characteristics, noun 14-25 dictionary forms, determination of the noun stems, nominative and genitive cases and their significance in terms formation. I-st noun declension. 3. UNIT III. Adjectives and its grammatical categories. Classes of adjectives. Adjective entries in dictionaries. Adjectives of the I-st group. Gender 26-36 endings, stem-determining. 4. UNIT IV. Adjectives of the 2-nd group. Morphological characteristics of two- and multi-word anatomical terms. Syntax of two- and multi-word 37-49 anatomical terms. Nouns of the 2nd declension 5. UNIT V. General characteristic of the nouns of the 3rd declension. Parisyllabic and imparisyllabic nouns. Types of stems of the nouns of the 50-58 3rd declension and their peculiarities. 3rd declension nouns in combination with agreed and non-agreed attributes 6. UNIT VI. Peculiarities of 3rd declension nouns of masculine, feminine and neuter genders. Muscle names referring to their functions. Exceptions to the 59-71 gender rule of 3rd declension nouns for all three genders 7. UNIT VII. 1st, 2nd and 3rd declension nouns in combination with II class adjectives. Present Participle and its declension. Anatomical terms 72-81 consisting of nouns and participles 8. UNIT VIII. Nouns of the 4th and 5th declensions and their combination with 82-89 adjectives 9.
    [Show full text]
  • Radiological Localization of Greater Palatine Foramen Using Multiple Anatomical Landmarks
    MOJ Anatomy & Physiology Research Article Open Access Radiological localization of greater palatine foramen using multiple anatomical landmarks Abstract Volume 2 Issue 7 - 2016 Identification of greater palatine foramen is of prime value for dentists and the oral and Viveka S,1 Mohan Kumar2 maxillofacial surgeons. The objective of present study was to radiologically localize greater 1Department of Anatomy, Azeezia Institute of Medical Sciences, palatine foramen with multiple anatomical landmarks. All Computer Tomography scans India of individuals who have undergone paranasal sinus evaluation were obtained from the 2Department of Radiology, Azeezia Institute of Medical Sciences, Department of Radiology, Azeezia Institute of Medical Sciences, from April 2015 to April India 2016. Distance of greater palatine foramen from various known anatomical landmarks was measured across the CT slices. Forty-four CT scans were studied, mean age was 32(±2.3) Correspondence: Viveka S, Assistant professor, Department years. All scans were from individuals of south Indian origin. GPF was located at 38.38mm of Anatomy, Azeezia Institute of Medical Sciences, Kollam, India, from incisive fossa, 17.6mm from posterior nasal spine, 18.38mm from intermaxillary Email [email protected] suture, 5.03mm from second molar and 5.28mm from third molar. Distances of GPF from incisive foramen and intermaxillary suture differed significantly on right and left sides. In Received: May 25, 2016 | Published: December 29, 2016 25(56.8%) cases GPF was located closer to third molar. In seven cases, it was closer to second molar and in 12 cases, GPF was located at the junction of second and third molar. Posterior location of GPF, posterior to third molar is not noted.
    [Show full text]
  • Hard Palate, Intermaxillary Sulcus, Greater Palatine Foramen, Lesser Palatine Foramen
    Basic Sciences of Medicine 2020, 9(3): 44-45 DOI: 10.5923/j.medicine.20200903.02 Twin Foramina in Posterior Third of an Adult Hard Palate and Their Significance Rajani Singh Department of Anatomy, UP University of Medical Sciences, Saifai Etawah, India Abstract Hard palate is formed by union of maxillary process of palatine bone and horizontal plate of palatine bone during development of foetus in 12th week. Three types of foramina, greater palatine allowing greater palatine nerves and vessels, lesser palatine and incisive foramina allowing passage of lesser palatine and nasopalatine nerves respectively are normally present in hard palate. The purpose of study is to report two novel foramina in hard palate and to bring out associated clinical significance. The author observed two new foramina one on either side of intermaxillary sulcus at the junction of anterior 2/3rd and posterior 1/3rd of hard palate during scanning of base of skulls for any abnormality in the Department of Anatomy of my native institute. The diameters of the right sided foramen was 6 mm while that of on left sided was 5 mm. The distance of foramen from midline on the right side was 3 mm while that of on left side was 2 mm. The distance of foramen on the right side from the centre of inferior border of hard palate was 13 mm while that of left side was 10 mm. The hard palate separates nasal cavity and oral cavity and essential for speech, feeding and respiration. The anomalous foramina observed may create problems during speech, feeding and respiration.
    [Show full text]
  • Anatomy Respect in Implant Dentistry. Assortment, Location, Clinical Importance (Review Article)
    ISSN: 2394-8418 DOI: https://doi.org/10.17352/jdps CLINICAL GROUP Received: 19 August, 2020 Review Article Accepted: 31 August, 2020 Published: 01 September, 2020 *Corresponding author: Dr. Rawaa Y Al-Rawee, BDS, Anatomy Respect in Implant M Sc OS, MOMS MFDS RCPS Glasgow, PhD, MaxFacs, Department of Oral and Maxillofacial Surgery, Al-Salam Dentistry. Assortment, Teaching Hospital, Mosul, Iraq, Tel: 009647726438648; E-mail: Location, Clinical Importance ORCID: https://orcid.org/0000-0003-2554-1121 Keywords: Anatomical structures; Dental implants; (Review Article) Basic implant protocol; Success criteria; Clinical anatomy Rawaa Y Al-Rawee1* and Mohammed Mikdad Abdalfattah2 https://www.peertechz.com 1Department of Oral and Maxillofacial Surgery, Al-Salam Teaching Hospital. Mosul, Iraq 2Post Graduate Student in School of Dentistry, University of Leeds. United Kingdom, Ministry of Health, Iraq Abstract Aims: In this article; we will reviews critically important basic structures routinely encountered in implant therapy. It can be a brief anatomical reference for beginners in the fi eld of dental implant surgeries. Highlighting the clinical importance of each anatomical structure can be benefi cial for fast informations refreshing. Also it can be used as clinical anatomical guide for implantologist and professionals in advanced surgical procedures. Background: Basic anatomy understanding prior to implant therapy; it's an important fi rst step in dental implant surgery protocol specifi cally with technology advances and the popularity of dental implantation as a primary choice for replacement loosed teeth. A thorough perception of anatomy provides the implant surgeon with the confi dence to deal with hard or soft tissues in efforts to restore the exact aim of implantation whether function or esthetics and end with improving health and quality of life.
    [Show full text]
  • Anatomical Variations of the Greater Palatine Nerve in the Greater Palatine Canal
    Anatomical Variations of the Greater Palatine Nerve in the Greater Palatine Canal Najmus Sahar Hafeez, MD, MSc; Sugantha Ganapathy, MD, FRCPC; Rakesh Sondekoppam, MD; Marjorie Johnson, PhD; Peter Merrifield, PhD; Khadry A. Galil, DDS, DO&MF Surg, PhD, FAGD, FADI, Cert. Periodontist Posted on July 21, 2015 Tags: diagnosis oral surgery Cite this as: J Can Dent Assoc 2015;81:f14 ABSTRACT The greater palatine nerve and the greater palatine canal are common sites for maxillary anesthesia during dental and maxillo­ facial procedures. The greater palatine nerve is thought to course as a single trunk through the greater palatine canal, branching after its exit from the greater palatine foramen. We describe intra­canalicular branching variations of the greater palatine nerve found in 8 of 20 embalmed dissection specimens. Such variation is previously unreported in the literature. We characterize the variations in branching pattern and discuss the possible implications for clinical practice. The greater palatine nerve (GPN), which is the continuation of the descending palatine nerve, innervates palatal tissues and the palatal gingiva posterior to the canines after passing through the greater palatine foramen. Anesthetising the GPN (i.e., GPN block) at the greater palatine foramen is common during procedures on the maxillary teeth and palate. The greater palatine canal also provides access for maxillary anesthesia in dental practice.1 Studies have suggested that the greater palatine neurovascular bundle is the most critical structure to be identified during subepithelial connective tissue palatal graft procedures.2 Multiple studies in clinical practice have demonstrated that a GPN block produces the most effective, consistent and prolonged analgesia following palatoplasty in children with cleft palate.3 Although a number of studies have shown anatomical variations in greater palatine foramen location, number and morphology,4,5 studies describing anatomical variations in the GPN within and outside the canal are sparse.
    [Show full text]
  • Palate, Tonsil, Pharyngeal Wall & Mouth and Tongue
    Mouth and Tongue 口腔 與 舌頭 解剖學科 馮琮涵 副教授 分機 3250 E-mail: [email protected] Outline: • Skeletal framework of oral cavity • The floor (muscles) of oral cavity • The structure and muscles of tongue • The blood vessels and nerves of tongue • Position, openings and nerve innervation of salivary glands • The structure of soft and hard palates Skeletal framework of oral cavity • Maxilla • Palatine bone • Sphenoid bone • Temporal bone • Mandible • Hyoid bone Oral Region Oral cavity – oral vestibule and oral cavity proper The lips – covered by skin, orbicularis muscle & mucous membrane four parts: cutaneous zone, vermilion border, transitional zone and mucosal zone blood supply: sup. & inf. labial arteries – branches of facial artery sensory nerves: infraorbital nerve (CN V2) and mental nerve (CN V3) lymph: submandibular and submental lymph nodes The cheeks – the same structure as the lips buccal fatpad, buccinator muscle, buccal glands parotid duct – opening opposite the crown of the 2nd maxillary molar tooth The gingivae (gums) – fibrous tissue covered with mucous membrane alveolar mucosa (loose gingiva) & gingiva proper (attached gingiva) The floor of oral cavity • Mylohyoid muscle Nerve: nerve to mylohyoid (branch of inferior alveolar nerve) from mandibular nerve (CN V3) • Geniohyoid muscle Nerve: hypoglossal nerve (nerve fiber from cervical nerve; C1) The Tongue (highly mobile muscular organ) Gross features of the tongue Sulcus terminalis – foramen cecum Oral part (anterior 2/3) Pharyngeal part (posterior 1/3) Lingual frenulum, Sublingual caruncle
    [Show full text]
  • The LATIN LANGUAGE and Bases of Medical Terminology
    The LATIN LANGUAGE and Bases of Medical Terminology The LATIN LANGUAGE and Bases of Medical Terminology ОДЕСЬКИЙ ДЕРЖАВНИЙ МЕДИЧНИЙ УНІВЕРСИТЕТ THE ODESSA STATE MEDICAL UNIVERSITY Áiáëiîòåêà ñòóäåíòà-ìåäèêà Medical Student’s Library Започатковано 1999 р. на честь 100-річчя Одеського державного медичного університету (1900–2000 рр.) Initiated in 1999 to mark the Centenary of the Odessa State Medical University (1900–2000) 2 THE LATIN LANGUAGE AND BASES OF MEDICAL TERMINOLOGY Practical course Recommended by the Central Methodical Committee for Higher Medical Education of the Ministry of Health of Ukraine as a manual for students of higher medical educational establishments of the IV level of accreditation using English Odessa The Odessa State Medical University 2008 3 BBC 81.461я73 UDC 811.124(075.8)61:001.4 Authors: G. G. Yeryomkina, T. F. Skuratova, N. S. Ivashchuk, Yu. O. Kravtsova Reviewers: V. K. Zernova, doctor of philological sciences, professor of the Foreign Languages Department of the Ukrainian Medical Stomatological Academy L. M. Kim, candidate of philological sciences, assistant professor, the head of the Department of Foreign Languages, Latin Language and Bases of Medical Terminology of the Vinnitsa State Medical University named after M. I. Pyrogov The manual is composed according to the curriculum of the Latin lan- guage and bases of medical terminology for medical higher schools. Designed to study the bases of general medical and clinical terminology, it contains train- ing exercises for the class-work, control questions and exercises for indivi- dual student’s work and the Latin-English and English-Latin vocabularies (over 2,600 terms). For the use of English speaking students of the first year of study at higher medical schools of IV accreditation level.
    [Show full text]
  • Anatomical Model for Dissection in Corpses of the Palate Vascularization
    Original Article Anatomical Model for Dissection in Corpses of the Palate Vascularization Modelo Anatômico para Dissecção em Cadáveres da Vascularização do Palato Carlos Diógenes Pinheiro Neto*, Henrique Faria Ramos**, Felipe Sartor Guimarães Fortes*, Luiz Ubirajara Sennes***, Nivaldo Alonso****, Rubens Vuono de Brito Neto***. * Specialist in Otorhinolaryngology ABORL-CCF. Graduate PhD in Otorhinolaryngology by FMUSP. ** Specialist in Otorhinolaryngology ABORL-CCF. Otolaryngologist the Office of Medical Assistance to the State Civil Servants - SP (IAMSPE). *** Lecturer, Discipline of Otorhinolaryngology, FMUSP. Associate Professor of Otorhinolaryngology at FMUSP. **** Associate Professor, FMUSP. Chief of Surgery Craniomaxillofacial, HC-FMUSP. Instituition: Faculdade de Medicina da USP. São Paulo / SP - Brazil. Mail Address: Prof. Dr. Luiz Ubirajara Sennes - 483, Teodoro Sampaio, St. - Pinheiros - São Paulo / SP - Brazil - ZIP CODE: 05405-000 - Telephone: (+55 11) 3068-9855 - E-mail: [email protected] Article received on March 9, 2010. Article approved on March 10, 2010. SUMMARY Introduction: The main artery that supplies the mucoperiosteum of the hard palate is the greater palatine artery. The knowledge detailed of the vascular anatomy of the palate and, in special, of the region of the greater palatine foramen is important for prevention of lesions vascular during procedures in this region. Among these procedures, it included the making of shreds for correction of failures in the hard palate, soft palate and cranial base. Objective: To develop an anatomical model that can illustrate the endoscopic anatomy of the greater palatine foramen and analyze the technical of injection intra vascular of colored silicone is sufficient for fill the lower arterial branches than irrigate the hard palate. Method: The form of study was experimental through the endoscopic dissection of 10 greater palatine arteries in five heads of corpses prepared with injection intra vascular of colored silicone.
    [Show full text]
  • Anatomical Study and Clinical Considerations of Greater Palatine Foramen in Adult Human Skulls of North Indian Population
    ID: IJARS/2015/15256:2085 Original Article Anatomical Study and Clinical Considerations of Greater Palatine Anatomy Section Foramen in Adult Human Skulls of North Indian Population SUSHOBHANA, SUNITI RAJ MISHRA, SHAILENDRA SINGH, JIGYASA PASSEY, RAHUL SINGH, PRIYANKA SINHA ABSTRACT Indian population. The perpendicular distance of GPF from Introduction : The knowledge of position of greater palatine mid-maxillary suture and posterior border of hard palate foramen is fundamental in oral surgery interventions because was also measured on both sides. Measurements were the neurovascular bundle, greater palatine nerve and vessels done with vernier caliper. emerge through it and can be principally assessed here for Results: The mean distance of the greater palatine foramen performing anaesthetic techniques for desensitization of the from palatine suture was 13.38 mm while the mean distance hard palate or harvesting a gingival mucoperiosteal graft. from posterior border of hard palate was 3.36 mm. There Aim : The present study was carried out to identify the was no statistically significant difference between male and morphological shape, position and location of greater female skulls as well as right and left sides. palatine foramen and the direction of greater palatine Conclusion: It was concluded that the 3rd molar can be foramen in adult human skulls. taken as a reliable landmark for locating greater palatine Materials and Methods: The location of the greater foramen and in cases of unerupted 3rd molar, palatine suture palatine foramen in relation to 3rd molar along with shape and posterior border of hard palate can be used as standard and direction of the opening on palate was observed in 50 landmarks for this purpose.
    [Show full text]
  • Oral Cavity, Palate and Tongue
    Oral Cavity, Palate And Tongue Gastrointestinal block-Anatomy-Lecture 2 Editing file Objectives Color guide : Only in boys slides in Green Only in girls slides in Purple important in Red At the end of the lecture, students should be able to: Notes in Grey ● Describe the anatomy of the oral cavity, (boundaries, parts, nerve supply). ● Describe the anatomy of the palate, (parts, muscles, nerve & blood supply). ● Describe the anatomy of the tongue, (structure, muscles, motor and sensory nerve, blood supply and lymphatic drainage). Oral Cavity ● The mouth extends from lips to oropharyngeal isthmus (the junction between mouth & the pharynx). ● Is bounded: Above by the soft palate and the palatoglossal folds, Below by the dorsum of the tongue. it divided into Vestibule: ● It’s lies between gums & teeth internally Mouth cavity proper: and, Lips & cheeks externally. ● Which lies within the alveolar arches, ● It is a slit-like space that communicates gums, and teeth Oropharyngeal ● with the exterior through the oral fissure. isthmus has a: ● When the jaws are closed, it communicates ○ Roof: which is formed by the with the mouth proper behind the last hard & soft palate. molar tooth. ○ Floor: which is formed by the anterior 2/3 of the tongue, (oral ● The cheek forms the lateral wall of the or palatine part of the tongue). vestibule and is made up of the buccinator muscle, which is covered by skin and lined by mucous membrane. ● Opposite the upper second molar tooth, there is a small papilla on the mucous membrane, marking the opening of the parotid duct. 3 Palate It forms the roof of the mouth and divided into two parts: The Hard (Bony) palate in front.
    [Show full text]
  • Morphometric Evaluation and Clinical Implications of the Greater Palatine
    Surgical and Radiologic Anatomy (2019) 41:551–567 https://doi.org/10.1007/s00276-019-02179-x ORIGINAL ARTICLE Morphometric evaluation and clinical implications of the greater palatine foramen, greater palatine canal and pterygopalatine fossa on CBCT images and review of literature İlhan Bahşi1 · Mustafa Orhan1 · Piraye Kervancıoğlu1 · Eda Didem Yalçın2 Received: 1 August 2018 / Accepted: 3 January 2019 / Published online: 8 January 2019 © Springer-Verlag France SAS, part of Springer Nature 2019 Abstract Introduction The pterygopalatine fossa (PPF) infiltration is performed to reduce blood flow during endoscopic sinus surgery and septorhinoplasty, as well as to control posterior epistaxis and provide regional anesthesia in dental procedures. PPF infiltration performed with consideration of the morphometrics of greater palatine foramen (GPF), greater palatine canal (GPC) and PPF would increase the success of the procedure and reduce the risk of complications. The aim of this study is to investigate the GPF, GPC, lesser palatine foramen (LPF), lesser palatine canal (LPC) and PPF morphology via the images obtained by CBCT, to provide information for interventional procedures. Materials and methods GPF, GPC, LPF, LPC and PPF were morphometrically evaluated retrospectively in CBCT images of 75 female and 75 male cases by Planmeca Romexis program. The 19 parameters were measured on these images. Results These parameters were evaluated statistically. The comparison of these parameters by genders revealed significant differences in distances between GPC–PC, PC–IOF, LPC–GPF, GPF–MS in the coronal and transverse planes, the distance between GPF and the occlusal plane of the teeth, GPF–PNS, GPF–IF and TD-GPF, and in the area of GPF.
    [Show full text]