ABSTRACT
Our aim in this study was to recognize the endoscopic anatomy of the Pterygopalatine fossa [PPF] and the anatomic variations of the related neurovascular structures, to define the endoscopic endonasal approach to this region. In a case series study 17 fresh adult cadavers were studied by endoscopic endonasal approach. To reach the pterygopalatine fossa endonasally, we performed the antrostomy and uncinectomy in all cadavers. The medial and posterior walls of the maxillary sinus were defined and studied. The internal maxillary artery and pterygopalatine ganglion and the other nerves were exposed. The posterior wall of maxillary sinus was opened to expose the pterygopalatine fossa and its neurovascular contents, which were studied and documented . Mean, median, range, standard deviation, frequency and frequency percentage were determined using statistical software SPSS V.19 and using descriptive analyses. For comparison of qualitative averages, independent t test was used after the normal distribution of data was tested to determine whether it is followed by 1-sample KS; and -Chi square statistical test was used for the comparison of qualitative ratios. In all tests, significance level was considered as two tails and p value less than 0.05. The PPF was easily approached by endoscopic transnasal transmaxillary approach. The PPF region was best exposed by the middle meatus tranasal approach. In the PPF infraorbital nerve, vidian nerve, greater palatine nerve, the infraorbital artery, internal maxillary artery, sphenopalatine artery, descending palatine artery, posterior superior alveolar artery and buccal artery were exposed. During the endoscopic transnasal transmaxillary approach to the PPF, it is possible to face wide range of variations in every phase of the approach but they are similarities at the base. Understanding the anatomy of this region and the neurovascular relations from the endoscopic view by cadaver dissections, will help us to perform more controlled and safe surgery
Subject(s)
Humans , Endoscopy , Adult , Cadaver , AnatomyABSTRACT
The most important and complex phenomenon of respiratory function of the nose is related to different nasal anatomy. The differences in facial anatomic structure between different races may also be reflected in nasal resistance and airflow. Caucasians has different facial anatomic structure which is the reflection of intranasal resistance or consequence of airflow. The active anterior rhinomanometric [AAR] is recommended for objective assessment of nasal airway resistance [NAR] in inspiration and expiration which can be calculated via nasal airflow. This study designed to evaluate the resistance of the nasal airway in Iranian samples and comparing with the standard methods. An epidemiologic case series cross sectional study was designed for 100 Iranian adult volunteer without nasal breathing problems and with AAR inclusion criteria. All subjects had to undergo a primary assessment of relevant symptoms of nasal disease and nasal examination before undergoing AAR assessment. The mean values of total nasal airway resistance sere 0/38 +/- 0/17 pa/cm[2]/s in inspiration and 0/41 +/- 0/27 pa/cm[2]/s in expiration at 150 pas pressure point. Unilateral nasal resistance in right and left in inspiration were respectively 0.88 +/- 0.69 pa/cm[2]/s and 0.90 +/- 0.57 at 150 pa/cm[2]/s pas pressure point. Also unilateral nasal resistance in right and left in expiration were respectively 0.95 +/- 0.72 pa/cm[2]/s and 0.95 +/- 0.57 pa/cm[2]/s at 150 pas pressure point. The study concluded that nasal airway resistance had the same range as the standard in different races and also no correlation exist between nasal resistance and sex, age, height, weight and smoking. Our suggestion is more epidemiologic studies if there are any queries in Iranians' airway resistance in larger sample size and wider areas