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Midline Angular Relationships between the Hard Palate and Cribriform Plate: Implications for Surgical Access to the Pituitary Fossa
Author(s) -
Golubovskaya Yevgeniya,
Lawson William,
Fisher Juliya,
Pagano Anthony S,
Caceres Noel,
Marquez Samuel
Publication year - 2012
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.26.1_supplement.722.2
Subject(s) - cribriform plate , anatomy , cribriform , fossa , cadaveric spasm , medicine , hard palate , surgery , pathology , immunohistochemistry
Understanding of the regional anatomy and craniometric landmarks surrounding the pituitary fossa are of important use in locating the pituitary gland during endoscopic sinus surgery and in preventing complications that may arise from damage to the adjacent structures. One important anatomical relationship cited in most anatomical textbooks is that the cribriform plate is parallel to the hard palate in the midline plane. However, the cribriform plate appears inferoposteriorly oriented and the hard palate is posterosuperiorly oriented in midsagittal and parasagittal views. To better assess their orientation, we quantified the angle made by the intersection of two chords between; 1) the anterior nasal spine (ANS) and posterior nasal spine (PNS) and 2) the anterior‐ and posterior‐ midline points on the cribriform plate (ACP, PCP). In a sample of 15 bisected cadaveric heads metal rods were used to approximate the extents of the two chords. The bisected heads were photographed with the rods in place and the photographs were analyzed in the computer program Image J where the angle of intersection between the ANS‐PNS and ACP‐PCP chords was calculated. Results show that the chords are oriented an average of 7.35 degrees from each other with a range between 4 and 15 degrees. ENT surgeons must be aware of these angular relationships to ensure proper and safe access to the pituitary gland during transsphenoidal hypophysectomy. Grant Funding Source : AAA