An Unusual Variant of the Sphenopalatine Foramen and Artery with an Absent Crista Ethmoidalis: An Intra-Operative Challenge
Unusual Variant of Sphenopalatine Foramen and Artery
Abstract
Sphenopalatine artery ligation (SPL) is a surgical remedy for severe epistaxis. This procedure requires extensive knowledge of the various anatomical variants. Its topographical anatomy varies and reliable landmark such as the crista ethmoidalis may be absent. These variations are crucial and they dictate the outcome of the surgery. We present a peculiar case of a postero-superiorly located variant of the sphenopalatine foramen and artery with an absent crista ethmoidalis. The sphenopalatine foramen was found superiorly at the superior meatus beyond the horizontal part of the lamella of the superior concha. Only one trunk was seen exiting the sphenopalatine foramen. The sphenopalatine foramen was measure rom the anterior part of the nose. It was 69mm from the nasal sill and 54mm limen nasi.
Keywords :
crista ethmoidalis,
epistaxis,
sphenopalatine artery,
Sphenopalatine foramen,
Abstrak
Ligasi arteri sphenopalatine merupakan satu terapi pembedahan untuk masalah hidung berdarah. Prosedur ini memerlukan pengetahuan yang luas mengenai variasi anatomi hidung. Walaubagaimanapun, petanda yang biasanya dipercayai seperti crista ethmoidalis mungkin tidak dijumpai atau tiada langsung. Variasi tersebut adalah penting dan boleh menentukan keberkesanan prosedur ini. Kami memaparkan satu kes variasi foramen dan arteri sphenopalatine yang tiada crista ethmoidalis. Foramen sphenopalatine dijumpai di bahagian atas meatus superior melepasi lamella concha superior di bahagian horizontalnya. Hanya satu cabang arteri yang ditemui keluar daripada foramen sphenopalatine. Foramen sphenopalatine diukur daripada bahagian depan hidung. Ia berukuran 69 mm dari “nasal sill” dan 54 mm dari limen nasi.
Kata Kunci :
arteri sphenopalatine,
crista ethmoidalis,
Foramen sphenopalatine,
hidung berdarah,
Correspondance Address
Fahrin Zara Nasseri, Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia. Tel: +60391456599 Fax: +60391456675 E-mail: zaranasseriwork@gmail.com
