As an important landmark, the posterolateral wall of maxillary sinus can help to locate numbers of significant signs such as maxillary artery and its branches, maxillary nerve and infraorbital nerve, infratemporal fossa and pterygopalatine fossa etc. in the endoscopic surgery for paranasal sinuses and lateral skull base. This article reviewed related researches about the anatomy and endoscopic surgery of posterolateral wall of maxillary sinus.
Endoscopy ; Humans ; Maxillary Artery ; Maxillary Nerve ; Maxillary Sinus ; anatomy & histology ; Nasal Surgical Procedures ; Pterygopalatine Fossa

OBJECTIVETo observe the travel, divisions, and the lengths, diameters, branches, artery supplies of the main segments of maxillary nerve.

METHODSFifty formalin-preserved adult half-head specimens with intravascular injection of red color emulsion were used for the gross and microanatomical studies of maxillary nerve. The lengths, diameters, branches and artery supplies of four main segments of maxillary nerve were observed. SPSS 11.5 software was used to analyze the data.

RESULTSThe length and diameter of cranial middle fossa segment of maxillary nerve were (10.70 ± 1.31) mm and (4.01 ± 0.52) mm respectively, which was supplied by inferior-lateral cavernous sinus artery. The length and diameter of pterygopalatine fossa segment were (16.21 ± 1.80) mm and (3.27 ± 0.62) mm respectively, in which one zygomatic branch, one to three posterior superior alveolar nerves, two ganglion branches and tuberal descending branches; were given off, and the segment was supplied by foramen rotundum artery. The length and diameter of infraorbital segment were (25.73 ± 2.03) mm and (3.30 ± 0.52) mm and it gave off middle superior alveolar nerve (64%) and anterior superior alveolar nerve and was supplied by infraorbital artery. Facial segment gave off superior labial branches, internal and external nasal branches, inferior palpebral branches, buccal branch and zygomatic branch and these branches were supplied by infraorbital artery and superior labial and angular artery originating from facial artery.

CONCLUSIONSUnderstanding of travel and artery supply of maxillary nerve is helpful to regional anaesthesia and surgery for maxillary nerve. Foramen rotundum, sphenopalatine foramen and infraorbital nerve are important marks for endoscopic surgery in pterygopalatine fossa.

The present case report describes a complication involving facial blanching symptoms occurring during inferior alveolar nerve block anesthesia (IANBA). Facial blanching after IANBA can be caused by the injection of an anesthetic into the maxillary artery area, affecting the infraorbital artery.
Anesthesia* ; Anesthesia, Dental ; Arteries ; Mandibular Nerve* ; Maxillary Artery ; Nerve Block

In the field of oromaxillofacial surgery, it is not common to meet arteriovenous malformation(AVM) patients. AVMs are the result of congenital abnormality, or the result of trauma of adjacent vessels. This patients need special care in surgical procedure. Also, they need management include clinical, radiographic, and angiographic assessment. We report a case of the AVM in right maxillary artery, who embolized PVA and obtained good result.
Angiography ; Arteriovenous Malformations* ; Congenital Abnormalities ; Humans ; Maxillary Artery

OBJECTIVE: To present a rare case of post-traumatic recurrent epistaxis in an elderly woman.
METHODS:
  Design: Case Report
  Setting: Tertiary Private Hospital
  Patient: One
RESULT: A  93-year-old  woman  had  multiple  admissions  for  recurrent  life  threatening  nose-bleeding  that  was  not  controlled  until  a  post-traumatic pseudoaneurysm  of  the  infraorbital artery was diagnosed and embolized.
CONCLUSION: The diagnosis of pseudoaneurysm should be considered in such cases, and treatment involving surgeons and interventional radiologists should be initiated to minimize morbidity and mortality.

Major maxillofacial bone injury itself can be life threatening from both cardiovascular point of view, as well as airway obstruction. Significant hemorrhage from facial fracture is an uncommon occurrence, and there is little in the literature to guide the management of these patients. We report a 73-year-old male driver who was transported to our hospital after a motor vehicle collision. The patient was hypotensive and tachycardic at presentation and required active fluid resuscitation and transfusion. The patient was intubated to protect the airway. All external attempts to control the bleeding, from packing to fracture reduction, were unsuccessful. Emergency angiogram revealed the bleeding to originate from terminal branches of the sphenopalatine artery, which were embolized. This was associated with cessation of bleeding and stabilization of vital signs. Despite the age and severity of injury, the patient recovered well and was discharged home at 3 months with full employment. In facial trauma patients with intractable bleeding, transcatheter arterial embolization should be considered early in the course of management to decrease mortality rate.
Aged ; Airway Obstruction ; Angiography ; Arteries ; Emergencies ; Employment ; Hemorrhage* ; Humans ; Male ; Maxillary Artery ; Maxillary Fractures ; Mortality ; Motor Vehicles ; Resuscitation ; Vital Signs

OBJECTIVES: This study sought to investigate the positioning of the posterior superior alveolar artery in relation to the performance of the maxillary sinus bone graft procedure in a Korean population. MATERIALS AND METHODS: We identified the position of the posterior superior alveolar artery relative to 93 maxillary sinuses in 58 patients and determined the distance from the inferior border of the artery in the premolar and molar areas to the alveolar ridge and sinus floor. RESULTS: The mean distance from the alveolar ridge to the posterior superior alveolar artery in the dentate group (20.62+/-3.05 mm in the premolar region, 17.50+/-2.84 mm in the molar region) was greater than as compared to the edentulous group (18.83+/-2.79 mm in the premolar region, 15.50+/-1.64 mm in the molar region), and this difference was statistically significant (P<0.05). In contrast, there was no statistically significant difference (P>0.05) between the mean distance from the sinus floor to the posterior superior alveolar artery in the dentate group (8.21+/-2.79 mm in the premolar region, 7.52+/-2.07 mm in the molar region) or in the edentulous group (7.75+/-3.31 mm in the premolar region, 7.97+/-2.31 mm in the molar region). CONCLUSION: Prior to surgery, it is important to evaluate the position of the posterior superior maxillary artery by using computed tomography scans. The premolar area is safer than the molar area for performing the maxillary sinus bone graft without bleeding.
Alveolar Process ; Arteries ; Bicuspid ; Floors and Floorcoverings ; Hemorrhage ; Humans ; Maxillary Artery ; Maxillary Sinus ; Molar ; Sinus Floor Augmentation ; Transplants

Maxillary osteotomy(LeFort I, II, III) is a commonly performed maxillary surgical procedure for the correction of dentofacial deformities. Maxillary osteotomy necessitate seperation of the skeleton of the middle third of the face from its posterior attachments to the cranium. With conventional techniques, an osteotome is placed between the maxilla and pterygoid plates and tapped medially and anteriorly to separate the pterygomaxillary junction. To separate the pterygomaxillary junction safely, knowledge on the anatomical structures of the pterygopalatine fossa area is very important to surgeons. So, to clarify the anatomical structures as it relates to the surgical approach of the pterygomaxillary junction area, Korean skulls (male 110 sides, female 44 sides) were used. And 30 sides of Korean hemisectioned heads were dissected to study about the anatomical and surgical structures of the pterygopalatine fossa area. Suggestions are given regarding the prevention of the complication during the maxillary osteotomy. Results of the studies indicate that with regard to the course of the maxillary artery and the morphology of the pterygomaxillary junction, pterygomaxillary dysjunction would be safely done with pterygomaxillary osteotome of 15mm width in Koreans. And osteotomy should be angled inferiorly from the zygomaticomaxillary crest. This will minimize the risk of the damaging the pterygopalatine fossa area because the mean distance form the inferior border of the pterygomaxillary junction to the furcation of the descending palatine artery was 24.8mm.
Arteries ; Asian Continental Ancestry Group ; Dentofacial Deformities ; Female ; Head ; Humans ; Maxilla ; Maxillary Artery ; Maxillary Osteotomy ; Osteotomy ; Pterygopalatine Fossa* ; Skeleton ; Skull

maxillary sinus in Koreans using computed tomography of the lateral wall of the sinus, and to analyze the data according to demographic data, and to compare our results with previously published research.METHODS: One hundred and three patients (males 51, females 52) who visited the dental clinic were evaluated. We investigated the canals with cone-beam computed tomography, and measured the diameter and length from the bony notch of the vascular canal at the lateral wall of the sinus to each of the reference planes.RESULTS: Most types of vascular canal were type I & II (total 72.2%) which were driving through inside the sinus wall. Type IV, V were frequently investigated in 1st premolar and 2nd molar. Mean height; from anterior nasal spine-posterior nasal spine plane to vascular canal was 5.56 mm in 1st premolar, 2.11 mm in 2nd premolar, 0.98 mm in 1st molar, 4.32 mm in 2nd molar; from the basal layer of the sinus was 4.93 mm in 1st premolar, 5.00 mm in 2nd premolar, 6.05 mm in 1st molar, 7.91 mm in 2nd molar; and from alveolar crest, 20.80 mm in 1st premolar, 16.57 mm in 2nd premolar, 14.01 mm in 1st molar, 16.17 mm in 2nd molar. The mean height of the vascular canal of each reference plane showed no significant difference between sex, site (left or right) and age. The mean diameters of the canals were 1.76 mm in male, and 1.50 mm in female. Diameter decreased with age, and tooth site (from 1st premolar to 2nd molar).CONCLUSION: These results show that the mean diameter of the vascular canal of the maxillary sinus varies according to age, sex, and tooth site, but that the mean height of canal had no significant difference based on these three factors.]]>
Bicuspid ; Cone-Beam Computed Tomography ; Dental Clinics ; Female ; Humans ; Male ; Maxillary Artery ; Maxillary Sinus ; Molar ; Spine ; Tooth

The purpose of this study was to investigate the courses of the maxillary artery and variations of the arteries and nerves in the infratemporal fossa from 36 Korean adult cadavers. The results were as follows; 1. In the majority of the cases (81.9%), course of the maxillary artery runs lateral to the lateral pterygoid muscle. 2. The variations of the arteries and nerves in the infratemporal fossa could be classified into six types. In the most common (type 2, 61.1%), the maxillary artery runs lateral to the lateral pterygoid muscle, and the inferior alveolar lingual and buccal nerves lie medial to the maxillary artery. In the next (type 1, 20.8%), the maxillary artery runs lateral to the lateral pterygoid muscle and the inferior alveolar and lingual nerves lie medial to the maxillary artery, and buccal nerve lies lateral to the maxillary artery. The remaining types were type 3 (7.0%), type 4 (4.2%), type 5 (5.6%) and type 6 (1.4%) in order.
Adult ; Arteries* ; Cadaver ; Humans ; Lingual Nerve ; Mandibular Nerve ; Maxillary Artery ; Pterygoid Muscles