Patterns of innervation of the anterior maxilla: a cadaver study with relevance to canine fossa puncture of the maxillary sinus
Date
2005
Authors
Robinson, S.
Wormald, P.
Editors
Advisors
Journal Title
Journal ISSN
Volume Title
Type:
Journal article
Citation
The Laryngoscope, 2005; 115(10):1785-1788
Statement of Responsibility
Simon Robinson, Peter-John Wormald
Conference Name
Abstract
<h4>Objectives/hypothesis</h4>Complications from canine fossa puncture of the maxillary sinus are caused by damage to the anterior superior alveolar nerve (ASAN) and the middle superior alveolar nerve (MSAN). The aim of this study was to elucidate the pattern of ASAN and MSAN within the anterior maxilla and to secondly determine suitable surgical landmarks to aid in accurately localizing the area of the canine fossa least likely to produce complications when a trocar is passed into the maxillary sinus.<h4>Methods</h4>Anatomic dissection of the anterior face of the maxilla from 20 cadaver heads was performed. The pattern and presence of the ASAN and MSAN was identified on each side and tabulated. Landmarks for the safest entry point for canine fossa puncture were determined, and each side had a puncture placed using these landmarks. Any disruption of nerves was noted.<h4>Results</h4>Multiple differing patterns of ASAN were identified. The ASAN emerged from its foramen as a single trunk in 30 (75%) sides and in a double trunk in 10 (25%). In 24 (60%), single or multiple branches from the ASAN trunks were identified. A MSAN was identified in 9 (23%) maxillae. The safest entry point for a canine fossa puncture was where a vertical line drawn through the mid-pupillary line was bisected by a horizontal line drawn through the floor of the pyriform aperture.<h4>Conclusions</h4>There is significant variation in the pattern of ASAN and MSAN within the anterior face of the maxilla. By using the newly described landmarks when performing a canine fossa puncture, there is reduced risk of damage to these nerves and provides a reliable point to enter the maxillary sinus.
School/Discipline
Dissertation Note
Provenance
Description
Access Status
Rights
© 2005 The Triological Society