DOCSLIB.ORG

CALDWELL-LUC (RADICAL ANTROSTOMY), INFERIOR MEATAL ANTROS- TOMY & CANINE FOSSA and INFERIOR MEATUS PUNCTURES Johan Fagan

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
CALDWELL-LUC (RADICAL ANTROSTOMY), INFERIOR MEATAL ANTROS- TOMY & CANINE FOSSA and INFERIOR MEATUS PUNCTURES Johan Fagan OPEN ACCESS ATLAS OF OTOLARYNGOLOGY, HEAD & NECK OPERATIVE SURGERY CALDWELL-LUC (RADICAL ANTROSTOMY), INFERIOR MEATAL ANTROS- TOMY & CANINE FOSSA AND INFERIOR MEATUS PUNCTURES Johan Fagan The Caldwell-Luc operation involves The canine fossa is a depression on the creating an opening into the maxillary anterior surface of the maxilla below the antrum through the canine fossa via a infraorbital foramen and lateral to the ca- sublabial approach. nine eminence and the incisive fossa (Figures 2, 3). It is larger and deeper than Canine fossa (CFP) & inferior meatal the incisive fossa, and is separated from it puncture are used to obtain samples of pus by the canine eminence, a vertical mound from the antrum, to irrigate the antrum overlying the socket of the canine tooth. (“antral washout”), or as an adjunct to en- The caninus muscle arises from the canine doscopic ethmoidectomy. fossa. Surgical anatomy Orbital rim The Caldwell-Luc operation involves en- Infraorbital foramen tering the maxillary sinus via an opening in the thin bone of the canine fossa (Figures Inferior turbinate 1-3). Canine fossa Caninus muscle Incisive fossa Nasalis muscle Depressor alae nasi Canine eminence Canine tooth Incisors Figure 2: Right canine fossa (yellow), incisive fossa and canine eminence The infraorbital foramen transmits the in- Figure 1: Thin bone of canine fossa (yel- fraorbital nerve, artery, and vein. The in- low arrow); nasolacrimal duct (red arrow) fraorbital neurovascular bundle traverses a groove in the orbital floor/roof of the sinus A series of eminences overlie the roots of which can be dehiscent. It exits through the the teeth on the inferior part of the face of infraorbital foramen, located approximate- the maxilla (Figures 2, 3). Just above the ly 5mm below the midportion of the infe- eminences of the incisor teeth is a depres- rior orbital rim to enter the soft tissues of sion called the incisive fossa; it gives ori- the cheek. Branches of the nerve supply gin to the depressor alae nasi. The nasalis the lower eyelid, nose, cheek and upper lip muscle arises just lateral to it (Figure 2). (Figures 3, 4). Care must be taken when elevating the periosteum from the anterior wall of the sinus to avoid injury to the The maxillary sinus is lined by ciliated co- infraorbital nerve where it exits the canal. lumnar epithelium. The cilia move secre- Branches of the anterior and posterior su- tions toward the natural sinus ostium; this perior alveolar nerves travel through bone explains the limited efficacy of an inferior to supply the upper teeth and gums (Fig- meatal antrostomy. The adult maxillary si- ures 3, 4). These nerves may be injured nus is 25-35mm wide, 36-45mm high, and when extending the antrostomy too low 38-45mm long, and has an average volume and cause loss of sensation to the teeth and of 15ml. The superior wall is formed by gums. the orbital floor which is thin and often de- hiscent. The infraorbital nerve is in the roof of the sinus. Medially and posteriorly the roof is composed of the floor of the ethmoid sinuses (Figure 10). The anterior Palpebral branches wall contains the nerves and vessels that Infraorbital nerve supply the upper teeth. It is thinner ante- Nasal branches riorly and thickens posterolaterally where Labial branches it joins the zygomatic process (Figure 1). Septae are present in about a third of cases, Ant superior mainly anteriorly (Figure 1). The medial alveolar nerve wall of the maxillary sinus separates it Septal branch from the nasal cavity (Figures 5, 6). Branches of post sup alveolar nerve Frontal sinus Branches to teeth Post ethmoidal foramen Branches to gums Orbital process pal bone Anterior ethmoidal Sphenopalatine for foramen Foramen rotundum Figure 3: Infraorbital nerve and branches Lacrimal fossa of the anterior superior alveolar and pos- Uncinate Max sinus ostium terior superior alveolar nerves; antros- Inferior turbinate Pterygoid canal tomy in canine fossa (red circle); stippled Palatine bone lines indicate nerves within the bone Lateral pterygoid plate Pyramidal process palatine of bone Figure 5: Lateral view with windows cut in lateral and medial walls of maxillary sinus The inferior turbinate is attached along the nasal wall below the level of the maxillary sinus ostium (Figure 6). The nasolacrimal duct traverses the thicker bone at the junction of the medial and anterior walls before opening into the nose below the in- ferior turbinate (Figures 1, 12). The sinus Figure 4: Branches of V2 (An Atlas of communicates with the nasal cavity via the Anatomy, by regions; 1962: Grant) maxillary sinus ostium in the hiatus semi- 2 Frontal sinus Anterior cranial fossa floor Crista galli Frontonasal duct Sella turcica Lacrimal sac in lacrimal fossa Anterior end of maxillary sinus Inferior turbinate Uncinate Maxillary sinus ostium Medial pterygoid plate Pterygoid hamulus Figure 7: Coronal CT slice through lacri- mal fossa Figure 6: Bony anatomy of the lateral wall of the nose Floor anterior cranial fossa lunaris of the middle meatus (Figures 8, Lamina papyracea 9). The posterior wall is the infratemporal Middle turbinate surface of the maxilla and separates the Uncinate process sinus from the pterygomaxillary fissure and the pterygopalatine fossa which con- Infraorbital nerve tains the internal maxillary artery and its Maxillary sinus branches and the pterygopalatine ganglion Inferior turbinate and its branches (Figure 4). The radiological anatomy of the maxillary sinus is assessed on plain X-rays or by co- Figure 8: Coronal plane through anterior ronal and axial CT scans and is essential to ethmoids midway along the maxillary sinus do prior to a Caldwell-Luc procedure (Fi- gures 1, 7-13). Figures 7-10 demonstrate Fovea ethmoidalis the coronal anatomy at the anterior, mid- and posterior maxillary sinus. Figure 11) is Anterior ethmoidal foramen a slice immediately behind the maxillary Lamina papyracea sinus in which the internal maxillary arte- Uncinate process ry and its branches as well as the spheno- palatine ganglion and its branches are Infraorbital nerve encountered within the pterygopalatine fossa. The pterygopalatine fossa communi- cates laterally with the infratemporal fossa via the pterygomaxillary fissure and me- dially with the nasal cavity via the spheno- palatine foramen. Figure 9: Anatomy at uncinate process 3 Posterior ethmoidal foramen Optic nerve Infraorbital foramen Lamina papyracea Inferior turbinate Ground lamella Zygoma Inferior orbital fissure Pterygomaxillary fissure Pterygoid plates Figure 10: Coronal slice through posterior Figure 13: Axial cut at level of infraorbital maxillary sinus; note its relationship to the foramen and pterygoid plates ethmoids Orbital apex Sphenopalatine foramen Pterygopalatine fossa Pterygomaxillary fissure Pterygoid plates Figure 11: Coronal cut immediately be- hind the maxillary sinus Figures 12 & 13 show axial views demon- Figure 14: Hypoplastic maxillary sinus strating the pterygopalatine fossa, pterygo- maxillary fissure and pterygoid plates. The dimensions of the maxillary sinus Imaging may also reveal important anato- change with age, and may affect surgery. mical variations that can affect the surgical Expansion at 2-3 mm/year of the maxillary approach e.g. congenital hypoplasia sinuses continue until adulthood. At birth (Figure 14). they are small and the floors of the sinuses are approximately 4mm above the nasal floor; at 8-9 years of age the floors of the sinuses and nasal cavity are at about the same levels and the sinus dimensions are 2 Infraorbital nerve x 2 x 3cms. In adults the sinus floor is 0.5- Nasolacrimal duct 1 cm below that of the nasal cavity (Figure Zygoma 15). The maxillary alveolus atrophies in edentulous patients so that the floor may Pterygomaxillary fissure be even lower. Pterygopalatine fossa Figure 12: Axial cut at level of infraorbital nerve and orbital floor 4 Figure 15: Floor of sinus lower than nasal floor in adults Figure 17: Branches of internal maxillary No significant vessels are encountered dur- nd ing Caldwell-Luc antrostomy other than artery; blue shaded area is the 2 part of the small infraorbital vessels that exit the artery before it enters the pterygopalatine infraorbital foramen to supply the over- fossa lying soft tissues of the face (Figure 16). Angular vein Angular artery Infraorbital artery Figure 18: Branches of internal maxillary Figure 16: Vasculature around the orbit artery Only if one breaks through the posterior wall of the sinus does one encounter the Caldwell-Luc / Radical antrostomy internal maxillary artery, a branch of the external carotid artery, which, passes The Caldwell-Luc operation involves through the pterygomaxillary fissure to making an opening in the thin bone of the enter the pterygopalatine fossa (Figures canine fossa and entering the maxillary 17, 18). sinus. It was first employed to remove in- fection and to strip diseased mucosa from the maxillary sinus; counter-drainage into the nose was established via an inferior meatal antrostomy. However with an im- proved understanding of sinus pathophy- siology, and introduction of endoscopic, mucosa-sparing functional sinus surgical 5 techniques, the Caldwell-Luc procedure is Imaging now infrequently used to treat sinusitis. This is routinely done to assess the size of Indications the sinus and the height of its floor relative to the nasal floor, to exclude hypoplasia • Biopsy or resection of tumours of the and unerupted dentition, and to evaluate nose and paranasal sinuses underlying pathology. Even though centres • Transantral access for tumours in the may only have access to sinus X-rays, CT pterygopalatine fossa scan is a far superior investigation. Both • Transantral ligation of internal maxil- axial and coronal CT should be requested. lary artery and its branches for epi- Coronal views provide information about staxis the orbit, orbital floor, sinus floor and al- • Transantral access for fractures of the veolus, and lateral wall of the nose and si- midface and orbital floor nus ostia. Axial views provide information • Orbital decompression about the anterior wall of the sinus, the • As part of medial maxillectomy pro- pterygopalatine fossa and infratemporal cedure e.g.
Load more

Recommended publications
  • Chapter 2 Implants and Oral Anatomy
    Chapter 2 Implants and oral anatomy Associate Professor of Maxillofacial Anatomy Section, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University Tatsuo Terashima In recent years, the development of new materials and improvements in the operative methods used for implants have led to remarkable progress in the field of dental surgery. These methods have been applied widely in clinical practice. The development of computerized medical imaging technologies such as X-ray computed tomography have allowed detailed 3D-analysis of medical conditions, resulting in a dramatic improvement in the success rates of operative intervention. For treatment with a dental implant to be successful, it is however critical to have full knowledge and understanding of the fundamental anatomical structures of the oral and maxillofacial regions. In addition, it is necessary to understand variations in the topographic and anatomical structures among individuals, with age, and with pathological conditions. This chapter will discuss the basic structure of the oral cavity in relation to implant treatment. I. Osteology of the oral area The oral cavity is composed of the maxilla that is in contact with the cranial bone, palatine bone, the mobile mandible, and the hyoid bone. The maxilla and the palatine bones articulate with the cranial bone. The mandible articulates with the temporal bone through the temporomandibular joint (TMJ). The hyoid bone is suspended from the cranium and the mandible by the suprahyoid and infrahyoid muscles. The formation of the basis of the oral cavity by these bones and the associated muscles makes it possible for the oral cavity to perform its various functions.
    [Show full text]
  • Atlas of the Facial Nerve and Related Structures
    Rhoton Yoshioka Atlas of the Facial Nerve Unique Atlas Opens Window and Related Structures Into Facial Nerve Anatomy… Atlas of the Facial Nerve and Related Structures and Related Nerve Facial of the Atlas “His meticulous methods of anatomical dissection and microsurgical techniques helped transform the primitive specialty of neurosurgery into the magnificent surgical discipline that it is today.”— Nobutaka Yoshioka American Association of Neurological Surgeons. Albert L. Rhoton, Jr. Nobutaka Yoshioka, MD, PhD and Albert L. Rhoton, Jr., MD have created an anatomical atlas of astounding precision. An unparalleled teaching tool, this atlas opens a unique window into the anatomical intricacies of complex facial nerves and related structures. An internationally renowned author, educator, brain anatomist, and neurosurgeon, Dr. Rhoton is regarded by colleagues as one of the fathers of modern microscopic neurosurgery. Dr. Yoshioka, an esteemed craniofacial reconstructive surgeon in Japan, mastered this precise dissection technique while undertaking a fellowship at Dr. Rhoton’s microanatomy lab, writing in the preface that within such precision images lies potential for surgical innovation. Special Features • Exquisite color photographs, prepared from carefully dissected latex injected cadavers, reveal anatomy layer by layer with remarkable detail and clarity • An added highlight, 3-D versions of these extraordinary images, are available online in the Thieme MediaCenter • Major sections include intracranial region and skull, upper facial and midfacial region, and lower facial and posterolateral neck region Organized by region, each layered dissection elucidates specific nerves and structures with pinpoint accuracy, providing the clinician with in-depth anatomical insights. Precise clinical explanations accompany each photograph. In tandem, the images and text provide an excellent foundation for understanding the nerves and structures impacted by neurosurgical-related pathologies as well as other conditions and injuries.
    [Show full text]
  • Splanchnocranium
    splanchnocranium - Consists of part of skull that is derived from branchial arches - The facial bones are the bones of the anterior and lower human skull Bones Ethmoid bone Inferior nasal concha Lacrimal bone Maxilla Nasal bone Palatine bone Vomer Zygomatic bone Mandible Ethmoid bone The ethmoid is a single bone, which makes a significant contribution to the middle third of the face. It is located between the lateral wall of the nose and the medial wall of the orbit and forms parts of the nasal septum, roof and lateral wall of the nose, and a considerable part of the medial wall of the orbital cavity. In addition, the ethmoid makes a small contribution to the floor of the anterior cranial fossa. The ethmoid bone can be divided into four parts, the perpendicular plate, the cribriform plate and two ethmoidal labyrinths. Important landmarks include: • Perpendicular plate • Cribriform plate • Crista galli. • Ala. • Ethmoid labyrinths • Medial (nasal) surface. • Orbital plate. • Superior nasal concha. • Middle nasal concha. • Anterior ethmoidal air cells. • Middle ethmoidal air cells. • Posterior ethmoidal air cells. Attachments The falx cerebri (slide) attaches to the posterior border of the crista galli. lamina cribrosa 1 crista galli 2 lamina perpendicularis 3 labyrinthi ethmoidales 4 cellulae ethmoidales anteriores et posteriores 5 lamina orbitalis 6 concha nasalis media 7 processus uncinatus 8 Inferior nasal concha Each inferior nasal concha consists of a curved plate of bone attached to the lateral wall of the nasal cavity. Each consists of inferior and superior borders, medial and lateral surfaces, and anterior and posterior ends. The superior border serves to attach the bone to the lateral wall of the nose, articulating with four different bones.
    [Show full text]
  • Atlas of Topographical and Pathotopographical Anatomy of The
    Contents Cover Title page Copyright page About the Author Introduction Part 1: The Head Topographic Anatomy of the Head Cerebral Cranium Basis Cranii Interna The Brain Surgical Anatomy of Congenital Disorders Pathotopography of the Cerebral Part of the Head Facial Head Region The Lymphatic System of the Head Congenital Face Disorders Pathotopography of Facial Part of the Head Part 2: The Neck Topographic Anatomy of the Neck Fasciae, Superficial and Deep Cellular Spaces and their Relationship with Spaces Adjacent Regions (Fig. 37) Reflex Zones Triangles of the Neck Organs of the Neck (Fig. 50–51) Pathography of the Neck Topography of the neck Appendix A Appendix B End User License Agreement Guide 1. Cover 2. Copyright 3. Contents 4. Begin Reading List of Illustrations Chapter 1 Figure 1 Vessels and nerves of the head. Figure 2 Layers of the frontal-parietal-occipital area. Figure 3 Regio temporalis. Figure 4 Mastoid process with Shipo’s triangle. Figure 5 Inner cranium base. Figure 6 Medial section of head and neck Figure 7 Branches of trigeminal nerve Figure 8 Scheme of head skin innervation. Figure 9 Superficial head formations. Figure 10 Branches of the facial nerve Figure 11 Cerebral vessels. MRI. Figure 12 Cerebral vessels. Figure 13 Dural venous sinuses Figure 14 Dural venous sinuses. MRI. Figure 15 Dural venous sinuses Figure 16 Venous sinuses of the dura mater Figure 17 Bleeding in the brain due to rupture of the aneurism Figure 18 Types of intracranial hemorrhage Figure 19 Different types of brain hematomas Figure 20 Orbital muscles, vessels and nerves. Topdown view, Figure 21 Orbital muscles, vessels and nerves.
    [Show full text]
  • European Position Paper on the Anatomical Terminology of the Internal Nose and Paranasal Sinuses
    ISSN: 03000729 INTERN AT IO N A L R H I N CONTENT O L O G I C Official Journal of the European and International Societies Position paper Lund VJ, Stammberger H, Fokkens WJ, Beale T, Bernal-Sprekelsen M, Eloy P, Georgalas C, Ger- S O C I E Y stenberger C, Hellings PW, Herman P, Hosemann WG, Jankowski R, Jones N, Jorissen M, Leunig T A, Onerci M, Rimmer J, Rombaux P, Simmen D, Tomazic PV, Tschabitscher M, Welge-Luessen A. European Position Paper on the Anatomical Terminology of the Internal Nose and Parana- VOLUME 50 | SUPPLEMENT 24 | MARCH 2014 sal Sinuses. Rhinology. 2014 Suppl. 24: 1-34. European Position Paper on the Anatomical Terminology of the Internal Nose and Paranasal Sinuses Lund VJ, Stammberger H, Fokkens WJ et al. 2014 Anatomical terminology cover JS.indd 1 27-02-14 23:03 European Position Paper on the Anatomical Terminology of the INTERN AT Internal Nose and Paranasal Sinuses IO N A L R H I N O L O G I C Official Journal of the European and International Rhinologic Societies S O C I E Y T Editor-in-Chief Address Prof V.J. Lund Journal Rhinology, c/o AMC, Mrs. J. Kosman / A2-234, PO Box 22 660, Prof W.J. Fokkens 1100 DD Amsterdam, the Netherlands. Tel: +31-20-566 4534 Associate Editor Fax: +31-20-566 9662 Prof P.W. Hellings E-mail: [email protected] Website: www.rhinologyjournal.com Managing Editor Dr. W.T.V. Germeraad Assistant Editor Dr. Ch. Georgalas Editorial Assistant (contact for manuscripts) Mrs J.
    [Show full text]
  • Introduction the Material in This Program Has Been Divided Into Maxillary and Mandibular Features
    Introduction The material in this program has been divided into maxillary and mandibular features. First time learners of this material may prefer to read through the textual material in sequence while clicking on highlighted text to view anatomic features and illustrations. Students who are already familiar with radiographic anatomy and who wish a quick review of radiographic features may find the alphabetic lists that can be accessed from the menu in the frame on the left to be a more efficient way to review material. Additional views may be seen and feature descriptions may be reviewed by clicking on the image and then clicking on the desired highlighted term. Objectives As you explore this program, keep the following objectives in mind. After completing the material you should be able to: Name normal anatomic structures labeled on an intraoral radiograph, and Point out or trace on an intraoral radiograph the anatomic structures named. To help you review and make sure you've met the program objectives, quizzes are included for you to test yourself. Although this is a stand-alone exercise, it may be helpful for you to review text chapters on dental anatomy and the bones of the head to fully integrate the material into your knowledge of clinical anatomy. Material on dental anatomy and head and neck anatomy can be found in a 1 number of sources including several web locations listed on the Other Web Resources page of this program. Mandibular Anatomy To understand this part of the program well, you should already be familiar with the basic shape, and anatomical features of the mandible, and you should know the meaning of certain anatomical descriptive terms such as fossa, ridge and foramen.
    [Show full text]
  • Anatomy of the Dromedary Head Skeleton Revisited
    Original article http://dx.doi.org/10.4322/jms.100916 Anatomy of the dromedary head skeleton revisited EL ALLALI, K., ACHAÂBAN, M. R. and OUASSAT, M. Comparative Anatomy Unit-URAC49, Department of Biological and Pharmaceutical Veterinary Sciences, Hassan II Agronomy and Veterinary Institute, B.P.6202 Rabat-Instituts Rabat 10101, Morocco *E-mail: [email protected] Abstract Introduction: Dromedary Camel is known for its specific adaptation to the hostile environment of desert areas. Hence, it is a very interesting model to consider for biological and veterinary sciences. A good knowledge of camel head osteology is relevant to overcome the lack of accurate data useful for comparative anatomy, radiology and clinical practice. Methods: The present work studied the osteology of the camel skull at different age and investigates blood vessels and nerves passing through its foramina. Results: The obtained data show similarities with domestic mammals but also several peculiarities. These include particularly; the existence of an extensive temporal fossa; a prominent external sagittal crest in the adults which is replaced by a large parietal planum in the youngest; the supra-orbital foramina give access only to the frontal vein and thus cannot be used for the nerve block and anesthesia of the upper eyelids; supplementary foramens including, a retroarticular, a lateral sphenopalatine, an accessory maxillary and a lacrimal fontanel were described for the first time. Unlike that reported in the literature, the lacerate foramen is covered by a fibro-cartilaginous layer; whereas the carotid foramen is located caudally to the jugular foramen. The hyoid lingual process is lacking while the epihyoideum is well developed.
    [Show full text]
  • New Terminologia Anatomica: Cranium and Extracranial Bones of the Head P.P
    Folia Morphol. Vol. 80, No. 3, pp. 477–486 DOI: 10.5603/FM.a2019.0129 R E V I E W A R T I C L E Copyright © 2021 Via Medica ISSN 0015–5659 eISSN 1644–3284 journals.viamedica.pl New Terminologia Anatomica: cranium and extracranial bones of the head P.P. Chmielewski Division of Anatomy, Department of Human Morphology and Embryology, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland [Received: 12 October 2019; Accepted: 17 November 2019; Early publication date: 3 December 2019] In 2019, the updated and extended version of Terminologia Anatomica was published by the Federative International Programme for Anatomical Terminology (FIPAT). This new edition uses more precise and adequate anatomical names compared to its predecessors. Nevertheless, numerous terms have been modified, which poses a challenge to those who prefer traditional anatomical names, i.e. medical students, teachers, clinicians and their instructors. Therefore, there is a need to popularise this new edition of terminology and explain these recent changes. The anatomy of the head, including the cranium, the extracranial bones of the head, the soft parts of the face and the encephalon, poses a particular challenge for medical students but also engenders enthusiasm in those of them who are astute learners. The new version of anatomical terminology concerning the human skull (FIPAT 2019) is presented and briefly discussed in this synopsis. The aim of this article is to present, popularise and explain these interesting modifications that have recently been endorsed by the FIPAT. Based on teaching experience at the Division of Anatomy/Department of Anatomy at Wroclaw Medical University, a brief description of the human skull is given here.
    [Show full text]
  • 1. Alveolar Process 2. Alveolar Yokes 3. Anterior Nasal Spine 4. Canine Fossa 5
    1. Alveolar process 2. Alveolar yokes 3. Anterior nasal spine 4. Canine fossa 5. Fossa for lacrimal sac 6. Frontal process 7. Glabella 8. Greather wing of sphenoid bone 9. Inferior orbital suture 10. Infraorbital foramen 11. Infraorbital groove 12. Internasal suture 13. Metopic suture 14. Middle nasal concha 15. Nasal crest 16. Nasal notch 17. Posterior ethmoidal foramen 18. Supraorbital foramen 19. Zygomatic process 20. Zygomaticofacial foramen 1. Alveolar yokes 2. Condylar process 3. Coronoid process 4. Dental alveoli 5. Digastric fossa 6. Mandibular foramen and canal 7. Mandibular lingula 8. Mandibular notch 9. Masseteric tuberosity 10. Mental foramen 11. Mental protuberance 12. Mental spine 13. Mental tubercle 14. Mylohyoid groove 15. Mylohyoid line 16. Obliqe line 17. Pterygoid tuberosity 18. Retromolar fossa 19. Sublingual fossa 20. Submandibular fossa 1. Ala of crista galli 2. Anterior clinoid process 3. Cribriform foramina 4. Foramen cecum 5. Foramen rotundum 6. Greater palatine foramen 7. Horizontal plate 8. Lateral plate 9. Middle nsal concha 10. Nasal crest 11. Orbital canal 12. Palatovaginal canal 13. Posterior nasal spine 14. Prechiasmatic groove 15. Pterygoid canal 16. Pterygoid humulus 17. Scaphoid fossa 18. Superior orbital fissure 19. Vomerovaginal groove 20. Zygomaticotemporal foramen 1. Accessory process 2. Annular epiphysis 3. Anterior articular surface 4. Anterior tubercle 5. Apex of dens 6. Costal process 7. Foramen of vertebral artery 8. Groove for spinal nerve 9. Groove for vertebral artery 10. Inferior articular facet 11. Inferior costal demifacet 12. Inferior vertebral notch 13. Lateral articular facet 14. Mammillary process 15. Pedicle of vertebral arch 16. Pedicle of vertebral arch 17.
    [Show full text]
  • Procedure, Inferior and Canine Fossa Puncture, Inferior Meatal Antrostomy
    OPEN ACCESS ATLAS OF OTOLARYNGOLOGY, HEAD & NECK OPERATIVE SURGERY CALDWELL-LUC (RADICAL ANTROSTOMY), INFERIOR MEATAL ANTROS- TOMY & CANINE FOSSA AND INFERIOR MEATUS PUNCTURES Johan Fagan The Caldwell-Luc operation involves The canine fossa is a depression on the creating an opening into the maxillary anterior surface of the maxilla below the antrum through the canine fossa via a infraorbital foramen and lateral to the ca- sublabial approach. nine eminence and the incisive fossa (Figures 2, 3). It is larger and deeper than Canine fossa (CFP) & inferior meatal the incisive fossa, and is separated from it puncture are used to obtain samples of pus by the canine eminence, a vertical mound from the antrum, to irrigate the antrum overlying the socket of the canine tooth. (“antral washout”), or as an adjunct to en- The caninus muscle arises from the canine doscopic ethmoidectomy. fossa. Surgical anatomy Orbital rim The Caldwell-Luc operation involves en- Infraorbital foramen tering the maxillary sinus via an opening in the thin bone of the canine fossa (Figures Inferior turbinate 1-3). Canine fossa Caninus muscle Incisive fossa Nasalis muscle Depressor alae nasi Canine eminence Canine tooth Incisors Figure 2: Right canine fossa (yellow), incisive fossa and canine eminence The infraorbital foramen transmits the in- Figure 1: Thin bone of canine fossa (yel- fraorbital nerve, artery, and vein. The in- low arrow); nasolacrimal duct (red arrow) fraorbital neurovascular bundle traverses a groove in the orbital floor/roof of the sinus A series of eminences overlie the roots of which can be dehiscent. It exits through the the teeth on the inferior part of the face of infraorbital foramen, located approximate- the maxilla (Figures 2, 3).
    [Show full text]
  • Facial Skeleton. Orbit and Nasal Cavity
    Facial skeleton. Orbit and nasal cavity. Sándor Katz M.D.,Ph.D. Skull Cerebrocranium= Viscerocranium= Neurocranium Facial skeleton • Frontal bone • Nasal bone • Sphenoid bone • Lacrimal bone • Temporal bone • Ethmoid bone • Parietal bone • Maxilla • Occipital bone • Mandible • Zygomatic bone • Vomer • Palatine bone • Inferior nasal concha • Hyoid bone Viscerocranium= Facial skeleton • Nasal bone • Lacrimal bone • Ethmoid bone • Maxilla • Mandible • Zygomatic bone • Vomer • Palatine bone • Inferior nasal concha • Hyoid bone Nasal bone • internasal septum • piriform aperture Lacrimal bone • posterior lacrimal crest • lacrimal groove • nasolacrimal canal • lacrimal sac Ethmoid bone: perpendicularular plate • crista galli Ethmoid bone: cribriform plate • foramina cribrosa Ethmoid bone: cribriform plate • ethmoidal air cells • ethmoidal labyrinth • orbital (lateral) plate • superior and middle nasal conchae Ethmoid bone: cribriform plate • ethmoid bulla (8) • uncinate process • semilunar hiatus Maxilla: body • infraorbital groove • infraorbital canal • infraorbital foramen • infraorbital margin Maxilla: body • canine fossa Maxilla: body • tuber maxillae • pterygomaxillary fissure • maxillary sinus • maxillary hiatus Maxilla: frontal process • aterior lacrimal crest • piriform aperture zygomatic process Maxilla: alveolar process • alveolar arch • alveolar yokes • anterior nasal spine Maxilla: alveolar process • dental alveolae • interalveolar septa • interradicular septa Maxilla: palatine process • incisive canal • median palatine suture • transverse
    [Show full text]
  • Anatomy and Clinical Significance of the Maxillary Nerve: a Literature Review I.M
    Folia Morphol. Vol. 74, No. 2, pp. 150–156 DOI: 10.5603/FM.2015.0025 R E V I E W A R T I C L E Copyright © 2015 Via Medica ISSN 0015–5659 www.fm.viamedica.pl Anatomy and clinical significance of the maxillary nerve: a literature review I.M. Tomaszewska1, H. Zwinczewska2, T. Gładysz3, J.A. Walocha2 1Department of Medical Education, Jagiellonian University Medical College, Krakow, Poland 2Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland 3Department of Oral Surgery, Jagiellonian University Medical College, Krakow, Poland [Received 18 July 2014; Accepted 28 October 2014] Background: The aim of this paper was to summarise the anatomical knowledge on the subject of the maxillary nerve and its branches, and to show the clinical use- fulness of such information in producing anaesthesia in the region of the maxilla. Materials and methods: A literature search was performed in Pubmed, Scopus, Web of Science and Google Scholar databases, including studies published up to June 2014, with no lower data limit. Results: The maxillary nerve (V2) is the middle sized branch of the trigeminal nerve — the largest of the cranial nerves. The V2 is a purely sensory nerve supplying the maxillary teeth and gingiva, the adjoining part of the cheek, hard and soft palate mucosa, pharynx, nose, dura mater, skin of temple, face, lower eyelid and conjun- ctiva, upper lip, labial glands, oral mucosa, mucosa of the maxillary sinus, as well as the mobile part of the nasal septum. The branches of the maxillary nerve can be divided into four groups depending on the place of origin i.e.
    [Show full text]