Morphometric Analysis of Greater Palatine Canal by Computed Tomography

Year 2023, Volume: 25 Issue: 3, 285 - 289, 30.12.2023

Hilal Güzel , Ozan Turamanlar , Esra Koyuncu , Erdal Horata , Çiğdem Özer Gökaslan

https://doi.org/10.18678/dtfd.1370411

Abstract

Aim: The greater palatine canal connects to the oral cavity through the greater palatine foramen. Preoperatively identifying the morphology of the greater palatine canal and greater palatine foramen is very important to avoid possible complications during surgery. This study aimed to evaluate the greater palatine canal and surrounding anatomical structures using computed tomography.
Material and Methods: Images from 100 patients (35 female and 65 male) who had previously undergone computed tomography for various reasons were evaluated. The study data were divided into three age groups, <20 years, 20-60 years, and >60 years. Morphological parameters measured in this study included; diameter measurement from the widest part of the canal, length of the canal, beginning diameter of the canal, the ends diameter of the canal, localization of the canal entrance with respect to the third molar tooth, distance of the canal entrance to palatine suture. The values obtained from the measurements were compared in terms of age group, gender, and side.
Results: The mean length of the canalis palatinus major was 15.19±4.38 mm. The diameter of the widest part of the canal and the end of the canal, and the distance between the canal entrance and the sutura palatina increased with age, but these increases were not statistically significant.
Conclusion: Proper administration of anesthesia through the greater palatine foramen in maxillofacial surgeries and related applications requires a detailed understanding of the anatomy of the greater palatine canal, and the results of the present study will contribute to the understanding of this anatomy.

Keywords

Greater Palatine Canal, Anatomy, Computed Tomography

Canalis Palatinus Major Morfometrisinin Bilgisayarlı Tomografi ile Değerlendirilmesi

Abstract

Amaç: Canalis palatinus major, foramen palatinum majus aracılığı ile ağız boşluğuna bağlanır. Canalis palatinus major ve foramen palatinum majus morfolojisinin ameliyat öncesinde belirlenmesi, ameliyat sırasında ortaya çıkabilecek olan olası komplikasyonlardan kaçınmak için oldukça önemlidir. Bu çalışmanın amacı, canalis palatinus major ve çevresindeki anatomik yapıların bilgisayarlı tomografi ile değerlendirilmesidir.
Gereç ve Yöntemler: Daha önce çeşitli nedenler ile bilgisayarlı tomografisi çekilmiş olan 100 hastanın (35 kadın ve 65 erkek) görüntüleri incelendi. Çalışma verileri <20 yaş, 20-60 yaş ve >60 yaş olmak üzere üç yaş grubuna ayrıldı. Bu çalışmada ölçülen morfolojik parametreler; kanalın en geniş kısmından çap ölçümü, kanalın uzunluğu, kanalın başlangıç çapı, kanalın uç çapı, kanal girişinin üçüncü molar dişe göre lokalizasyonu ve kanal girişinin sutura palatinaya olan uzaklığıdır. Ölçümler sonucu elde edilen değerler, yaş grubu, cinsiyet ve taraf açısından birbiriyle karşılaştırıldı.
Bulgular: Canalis palatinus majorun ortalama uzunluğu 15,19±4,38 mm idi. Kanalın en geniş yerinin çapı ile bitiş yerinin çapı ve kanal girişi ile sutura palatina arasındaki mesafe, yaş ile birlikte artmış olmakla birlikte bu artışlar istatistiksel olarak anlamlı değildi.
Sonuç: Maksillofasiyal cerrahilerde ve bununla ilgili olan uygulamalarda anestezinin foramen palatinum majus yolu ile uygun bir şekilde uygulanması için canalis palatinus major anatomisinin ayrıntılı bir şekilde anlaşılmış olmasını gerekmektedir ve bu çalışmanın sonuçları bu anatominin anlaşılmasına katkı sunacaktır.

Keywords

Canalis Palatinus Major, Anatomi, Bilgisayarlı Tomografi

References

• Tomaszewska IM, Tomaszewski KA, Kmiotek EK, Pena IZ, Urbanik A, Nowakowski M, et al. Anatomical landmarks for the localization of the greater palatine foramen--a study of 1200 head CTs, 150 dry skulls, systematic review of literature and meta-analysis. J Anat. 2014;225(4):419-35.
• Erdogan N, Unur E, Baykara M. CT anatomy of pterygopalatine fossa and its communications: A pictorial review. Comput Med Imaging Graph. 2003;27(6):481-7.
• Douglas R, Wormald PJ. Pterygopalatine fossa infiltration through the greater palatine foramen: Where to bend the needle. Laryngoscope. 2006;116(7):1255-7.
• McKinney KA, Stadler ME, Wong YT, Shah RN, Rose AS, Zdanski CJ, et al. Transpalatal greater palatine canal injection: Radioanatomic analysis of where to bend the needle for pediatric sinus surgery. Am J Rhinol Allergy. 2010;24(5):385-8.
• Apenhasmit W, Chompoopong S, Methathrathip D, Sangvichien S, Karuwanarint S. Clinical anatomy of the posterior maxilla pertaining to Le Fort I osteotomy in Thais. Clin Anat. 2005;18(5):323-9.
• Norton NS. Netter’s head and neck anatomy for dentistry, 2nd ed. Philadelphia: Elsevier; 2012.
• Howard-Swirzinski K, Edwards PC, Saini TS, Norton NS. Length and geometric patterns of the greater palatine canal observed in cone beam computed tomography. Int J Dent. 2010;2010:292753.
• Narayan RK, Ghosh SK. Can the morphological attributes of greater palatine foramen have implications in maxillary nerve block? An analytical study using anatomical planes. Transl Res Anat. 2021;22:100093.
• Lepere AJ. Maxillary nerve block via the greater palatine canal: new look at an old technique. Anesth Pain Control Dent. 1993;2(4):195-7.
• White SC, Pharoah MJ. Oral radiology. Principle and interpretation, 7th ed. Missouri: Elsevier; 2013.
• Horng WB, Lee CP, Chen CW. Classification of age groups based on facial features. J Appl Sci Eng. 2001;4(3):183-91.
• Mehra A, Karjodkar FR, Sansare K, Kapoor R, Tambawala S, Saxena VS. Assessment of the dimensions of the pterygoid hamulus for establishing age- and sex-specific reference standards using cone-beam computed tomography. Imaging Sci Dent. 2021;51(1):49-54.
• Abdullah WH, Abbas Alhussaini AH. The role of cone beam computed tomography in determination of the greater palatine foramen position among Iraqi population. J Bagh Coll Dent. 2018;30(1):53-7.
• Campbell RG, Solares CA, Mason EC, Prevedello DM, Carrau RL. Endoscopic endonasal landmarks to the greater palatine canal. A radiographic study. J Neurol Surg B Skull Base. 2018;79(4):325-9.
• Tomaszewska IM, Kmiotek EK, Pena IZ, Średniawa M, Czyżowska K, Chrzan R, et al. Computed tomography morphometric analysis of the greater palatine canal: a study of 1,500 head CT scans and a systematic review of literature. Anat Sci Int. 2015;9084):287-97.
• Sheikhi M, Ghorbanizadeh S, Abdinian M, Goroohi H, Badrian H. Accuracy of linear measurements of galileos cone beam computed tomography in normal and different head positions. Int J Dent. 2012;2012:214954.
• Özdede M, Keriş Yıldızer E, Altunkaynak B, Peker İ. Morphometric analysis of greater palatine canal via cone-beam computed tomography. Balk J Dent Med. 2018;22(3):150-6.
• Urbano ES, Melo KA, Costa ST. Morphologic study of the greater palatine canal. J Morphol Sci. 2010;27(2):102-4.
• Hwang SH, Seo JH, Joo YH, Kim BG, Cho JH, Kang JM. An anatomic study using three-dimensional reconstruction for pterygopalatine fossa infiltration via the greater palatine canal. Clin Anat. 2011;24(5):576-82.
• Bahşi İ, Orhan M, Kervancıoğlu P, Yalçın ED. Morphometric evaluation and clinical implications of the greater palatine foramen, greater palatine canal and pterygopalatine fossa on CBCT images and review of literature. Surg Radiol Anat. 2019;41(5):551-67.
• Lacerda-Santos JT, Granja GL, de Freitas GB, Manhães Jr LRC, de Melo DP, Dos Santos JA. The influence of facial types on the morphology and location of the greater palatine foramen: a CBCT study. Oral Radiol. 2022;38(3):337-43.
• Ortug A, Uzel M. Greater palatine foramen: assessment with palatal index, shape, number and gender. Folia Morphol (Warsz). 2019;78(2):371-7.
• Radošević D, Erić M, Marić D, Vučinić N, Knezi N, Pupovac N, et al. Morphology of the greater palatine foramen: a clinical point of view. Surg Radiol Anat. 2023;45(8):1001-7.