Evaluation of six computed tomographic reference points for the shenopalatine foramen localization: cross-sectional retrospective study

Background Sphenopalatine foramen (SPF) localization is utilized in a variety of endoscopic sinus surgeries. It is made simpler by employing radiologically assessed distances using easy, reliable bone landmarks. Objective To deeply analyze different six computed tomographic (CT) bone reference points regarding to the age and sex to facilitate the radiological and endoscopic SPF localization. Methods In this randomized cross-sectional study, we retrospectively examined sinus CT scans of the patients with posterior epistaxis or who were indicated for endoscopic sinus surgery. The SPF lengths to the nasal floor, the inferior turbinates’ bony attachment, were measured on coronal cuts, while axial cuts were used in measuring the SPF’s distances to the maxillary line, the middle turbinate’s anterior head, the arch of choana, and the basal lamella. These measures were analyzed statistically in relation to age and gender. Results In 100 patients (200 sides, 1200 measurements), the distances from the SPF to both the middle turbinate’s anterior head and the nasal floor were significantly longer in males ( p = 0.018 and p = 0.001 respectively). As age increased, the distance from the SPF to the anterior head of the middle turbinate increased significantly ( p = 0.016), while the distance from the SPF to the basal lamella decreased significantly ( p = 0.038). Conclusion As a part of preoperative sinus CT checklist, we demonstrate the nasal floor, the bony attachment of the inferior turbinate, the choanal arch, the anterior head of the middle turbinate, the basal lamella, and the maxillary line in the SPF localization, some of the lengths to the SPF in relation to the age and gender have significant values.