Anatomy of the greater palatine foramen and canal and their clinical significance in relation to the greater palatine artery: a systematic review and meta-analysis

Abstract

Purpose Accurate knowledge of greater palatine foramen (GPF) and greater palatine canal (GPC) anatomy is necessary to avoid injury to the greater palatine artery (GPA) when performing a variety of anesthesiologic, dental or surgical procedures. The aim of this paper was to perform a systematic review and meta-analysis of literature on the anatomy and localization of bony structures associated with the GPA, namely the GPF and GPC. Methods A systematic literature search was performed using PubMed, Embase, ScienceDirect, and Web of Science databases. Seventy-five studies were included in the meta-analysis (n = 22,202 subjects). Results The meta-analysis showed that the GPF is positioned 17.21 mm (95% CI = 16.34–18.09 mm) from the posterior nasal spine, 2.56 mm (95% CI = 1.90–3.22 mm) from the posterior border of the hard palate, 46.24 mm (95% CI = 44.30–48.18 mm) from the anterior nasal spine, 15.22 mm (95% CI = 15.00–15.43 mm) from the midline maxillary suture, 37.32 mm (95% CI = 36.19–38.45 mm) from the incisive foramen, and opposite the third maxillary molar (M3) in 64.9% (58.7–70.7%) of the total population. Conclusion An up-to-date, comprehensive analysis of GPF and GPC clinical anatomy is presented. The results from this evidence-based anatomical study provides a unified set of data to aid clinicians in their practice.

A Rare Case of Schwannoma of the Right Greater Palatine Nerve in a 17-Year-Old Female Patient

“…Most often, schwannomas originate from the glossopharyngeal, vagus, accessory, and hypoglossal nerve [ 9 ]. The general sensory and parasympathetic autonomic innervation of the hard palate is carried out by branches of the pterygopalatine ganglion [ 10 , 11 ]. The anterior portion of the hard palate distal to the third teeth is innervated by the incisive nerve.…”

“…The latter passes through the nasal cavity and merges with the nerve of the same name on the opposite side, forming the so-called incisive nerve appearing in the front of the hard palate at the incisive papilla [ 10 ]. The distal palatal areas backward from the fourth teeth receive innervation from both greater palatine nerves, also branches of the pterygopalatine ganglion, passing through the large palatine canal and exiting on the hard palate through the two greater palatine foramen [ 11 ]. The sagittal projection of the schwannoma excised by us on the hard palate in its area between the fourth and sixth teeth, a section that is innervated by the right greater palatine nerve, shows that it originates from the myelin sheath of this particular nerve.…”

Freeing and Stretching the Palatine Vessels From the Greater Palatine Foramen in Palatoplasty

“…Recently, a meta-analysis of the anatomy of the greater palatine foramen and canal was published. 10,11 In 13 studies (n = 4,798), the length of the greater palatine canal was 26.97 mm (95% CI, 23.65-30.29 mm). In 3 studies (n = 360), the anteroposterior diameter of the upper opening of the greater palatine canal was 3.88 mm (95% CI, 3.77-3.99 mm).…”

“…Recently, a meta-analysis of the anatomy of the greater palatine foramen and canal was published 10,11 . In 13 studies (n=4,798), the length of the greater palatine canal was 26.97 mm (95% CI, 23.65–30.29 mm).…”