Computed Tomography Research: Relative Anatomy of Caldwell–Luc Approach in Pterygopalatine Fossa Surgery

Abstract With the development of endoscopic technique, Caldwell–Luc approach has more wide applications and becomes a common method of pterygopalatine fossa (PPF) surgery. Few data can be used in this approach to avoid injuring the vessels and nerves within this area. In this study, the authors used computed tomography to get the coordinates of inferior orbital fissure, foramen rotundum, sphenopalatine foramen, internal opening of pterygoid canal, the strangulation of PPF, and the greater palatine foramen with canine fossa as the origin. Parameters of 60 patients (120 observations) between 35 and 55 years who have no experience of trauma or surgery before were involved in this study. The data were analyzed by SPSS, statistical software with the comparison between sexes and sides. After calculating the relative distances and angles between these points and canine fossa, the authors get the proportions of the upper part of PPF, and the pterygopalatine canal to PPF, respectively. The authors finally got the safety surgical range. The results are meaningful to safety in surgery and complication avoidance, which can be great references in clinical applications.

[1]  Xinsheng Huang,et al.  The Endoscopic Prelacrimal Recess Approach to the Pterygopalatine Fossa and Infratemporal Fossa. , 2017, The Journal of craniofacial surgery.

[2]  R. K. Datta,et al.  Caldwell Luc Surgery: Revisited , 2016, Indian Journal of Otolaryngology and Head & Neck Surgery.

[3]  R. Carrau,et al.  Effect of Incremental Endoscopic Maxillectomy on Surgical Exposure of the Pterygopalatine and Infratemporal Fossae , 2015, Journal of Neurological Surgery—Part B.

[4]  M. Preul,et al.  Comparison of Surgical Freedom and Area of Exposure in Three Endoscopic Transmaxillary Approaches to the Anterolateral Cranial Base , 2013, Journal of Neurological Surgery—Part B.

[5]  Yong Tian,et al.  Internal Carotid Artery in Endoscopic Endonasal Transsphenoidal Surgery , 2012, The Journal of craniofacial surgery.

[6]  Ruan Bia The anatomy study of the pterygopalatine fossa through the posterior wall of the maxillary sinus , 2012 .

[7]  Z. Hua Different endoscopic surgical approaches to the pterygopalatine fossa and infratemporal fossa: anatomic study and clinical evaluation , 2011 .

[8]  Hua Zhang,et al.  [The anatomical study of the pterygopalatine fossa under endoscopy via the nasal cavity approach]. , 2009, Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology, head, and neck surgery.

[9]  A. Gupta,et al.  Endoscopic approach to juvenile nasopharyngeal angiofibroma: our experience at a tertiary care centre , 2008, The Journal of Laryngology & Otology.

[10]  Xiaojiang Li,et al.  [The study on the microsurgical anatomy of maxillary sinus approach pterygopalatine fossa]. , 2007, Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology, head, and neck surgery.

[11]  J. Duncavage,et al.  Contemporary indications for the Caldwell-Luc procedure , 2003, Current opinion in otolaryngology & head and neck surgery.

[12]  L. Hua Anatomic basis of endoscopic transnasal surgery in the pterygopalatine fossa , 2001 .