Anatomical study of pterygoid canal (PC) and palatovaginal canal (PVC) in endoscopic trans-sphenoidal approach.

Abstract

The primary purpose of our work was to make anatomical measurements of pterygoid canal (PC) and palatovaginal canal (PVC). The secondary goal was to locate the two structures based on the landmarks in the trans-sphenoidal surgery and draw a safe corridor of fenestration in the bottom of sphenoid sinus during surgical procedure to sphenopalatine region. Computed tomographic angiography (CTA) images of PC, PVC and sphenoid sinus in 200 adults were reviewed. Multiplanar reconstruction of the CT images was performed, and the anatomical features of the PC and PVC were studied in the coronal, sagittal, and axial planes. The length, diameter and direction of PC and PVC were measured in the plane through or perpendicular to them. The anterior and posterior opening of PC and PVC were identified by the surgical landmarks such as the middle lowest point of sellar floor, the sagittal midline and the bottom of the sphenoid sinus. Both PC and PVC can be found and identified easily on CTA image, the shape and size of the PC and PVC were in agreement with those retrieved from previous literatures, the position of them can be located by the anatomical landmarks in sphenoid sinus. Knowing the anatomical features of PC and PVC and their location based on the anatomical landmarks are helpful to the endoscopic trans-sphenoidal surgery. These data in our study will provide surgeons a better understanding of PC and PVC and their relationship to sphenoid sinus. Notably, it will not help the surgeons to avoid injuring neurovascular structures as well as provided supportive information for the choice of the appropriate endoscopic equipment.