EJMS

Abstract

In the current study 20 adult skulls of both sexes, multislice helical CT with 3-D reconstruction of SPF for 20 heads of adult living subjects of both sexes aged between 30-60 years and examination of 10 dried skulls with endoscope were used to study the number, shape and site of sphenopalatine foramen. On studying the SPF anatomically, radiologically and endoscopically it was revealed that the number of the foramina varied, where the sphenopalatine foramen was single in nearly 80 % and more than one in 20 %. The shape of the foramen was regular in 67.5 % and irregular in 32.5 % of all cases. The shape of the foramen was also variable being circular, oval, triangular, elliptical, quadrangular or even semilunar. The site of the foramen on the lateral nasal wall relative to the bony crest of middle concha revealed that in 67.5 % the SPF was placed in the superior meatus while in 32.5 % the foramen was found in superior meatus and extended to the middle one. In case of specimens with equal sized double SPF, it was found that these foramina were placed one above the other; the upper one located in the superior meatus while the lower one placed in the middle meatus. If the foramina were placed one anterior to the other both foramina were located in the superior meatus. It case of specimens with unequal sized double SPF, the upper one is large and placed in the superior meatus and extending to the middle meatus while the lower one was small and placed totally in the middle meatus. It was noted from the present study that there was variation of the number, shape and site of the SPF, and consequently of the branches of the sphenopalatine artery, which explain the surgical failure in management of severe epistaxis. The data also support the predication of more than one sphenopalatine arteries and give ample knowledge on the endoscopic study of the lateral nasal wall and consequently the surgical treatment of severe epistaxis with fewer failure rates.