Computed tomography morphometric analysis of the greater palatine canal: a study of 1,500 head CT scans and a systematic review of literature

Abstract

We have performed a detailed morphometric analysis of the length and anatomic routes of the greater palatine canal (GPC) and a systematic review of the literature on the anatomy of the GPC with the aim of informing dentists, maxillofacial surgeons, otorhinolaryngologists and other specialists performing procedures in the area of the GPC. In total, we analysed 1,500 archived adult head computed tomography scans to determine the length of the GPC and of the routes on both sides, as well as the dimensions and opening directions of the greater palatine foramen. The systematic review of the literature was performed according to PRISMA guidelines. The study group comprised 783 females (52.2 %) and 717 males with a mean (± standard deviation) age of 42.1 ± 16.9 years; there was significant difference in age between sexes (p = 0.33). The average length of the GPC was 31.1 ± 2.9 (range 15–44) mm. The GPC travelled three different paths in the sagittal plane and four different paths in the coronal plane. Most often it descended from the pterygopalatine fossa inferiorly before changing to an anterior-inferior direction (68.4 %; sagittal plane) and inferior-laterally before changing to an inferior-medial direction (40.7 %; (coronal plane). In total, the GPF had four different opening directions: inferior-anterior-medial (82.1 %), inferior-anterior-lateral (4.0 %), anterior (7.6 %), and vertical (5.3 %). Twenty-five studies were included in the systematic review. In conclusion, the information presented here provides clinicians with the anatomical knowledge necessary to minimize the risk of complications when performing procedures involving infiltration of the GPC.

The Length of the Greater Palatine Canal in a Lebanese Population: a Radio-anatomical Study

“…On the other hand, in our sample the connection GPC length - gender was statistically non significant (p = 0.36) which was not similar to what has been reported by Sheikhi et al (8) (p = 0.001) and Tomaszewska et al (7) (p < 0.0001). This difference may be due to ethnicity reason or caused by the limited size of our sample compared to others, especially the one of Tomaszewska et al who analyzed the largest sample to date (1500 scans).…”

“…Our results were consistent with the ones of Haward-Swirzinski et al (1), Tomaszewska et al (7), and Sheikhi et al (8), who adopted the same technique for the canal measurement and found respectively, 29 ±3 mm (22 to 40 mm), 31.1 ± 2.9 mm (15 to 44 mm) and 31.82 ± 1.37 mm.…”

“…Concerning the canal length, it was either assessed as an isolated entity from the PPF (6, 10), or considered extending superiorly from different landmarks in the PPF such as the higher bony aspect of the PPF (11), the foramen rotundum (4), the sphenopalatine foramen (9), and the vidian canal (1, 7, 8) to the greater palatine foramen inferiorly.…”

Anatomy and clinical significance of the maxillary nerve: a literature review

“…2) Both palatine nerves -the greater and the lesser palatine nerve -originate from the sphenopalatine ganglion. The greater palatine nerve descends through the greater palatine canal (mean canal length 31 mm, range 15-44 mm) [35,36], and the greater palatine foramen to run anteriorly in a groove on the inferior surface of the hard palate. It innervates the hard palate and the palatal gingiva.…”

Evaluation of Greater Palatine Foramen and Incisive Canal Foramen among Saudi Patients using Cone Beam Computed Tomography Scans

“…Hence, it is essential for practitioners to have a good background of the anatomical relations of the field of work and the areas of needle penetration while administering the local anesthetic solution. 7,8 The CBCT is a relatively common imaging modality widely used in maxillofacial imaging to localize anatomical structures. 9 Until now, there are no reported studies on the variability of GPF and IF among Saudi patients using CBCT scans.…”