Anatomia cirúrgica do nervo maxilar na região zigomática

Anatomic knowledge on the zygomatic fossa is of primary importance to improve the regional anesthetic technique of the maxillary nerve. Few reports in the literature have addressed the trajectory of the maxillary nerve and its branches in this region; thus, this study aimed at presenting information about the trajectory of these nerves. Thirty human half-heads of both genders were fixed in 10% formalin and demineralized in 5% nitric acid, and the maxillary nerve was dissected since its origin on the pterygopalatine fossa until penetration into the inferior orbital fissure. It was observed that the maxillary nerve sends one to three posterior superior alveolar branches and tuberal descendent branches, which supply the soft tissue structures of the region. The posterior superior alveolar nerves are inferiorly oriented near the maxillary tuberosity, where they penetrate the alveolar canals with the posterior superior alveolar artery and send small nerve branches that continue in an extraosseous trajectory. This study found that nearly 2/3 of the trajectory of the maxillary nerve is located in the zygomatic region, with a short segment (1/3) in the pterygopalatine fossa.O conhecimento anátomo-cirúrgico da região zigomática é fundamental para o aprimoramento de técnicas anestésicas tronculares do nervo maxilar. A literatura pouco se refere à trajetória do nervo maxilar e seus ramos nessa região, portanto, o presente estudo tem como objetivo esclarecer o percurso desses nervos. Foram dissecadas ao microscópio cirúrgico MC900 (D.F.Vasconcelos), 30 hemicabeças humanas, de ambos os sexos, que foram previamente formolizadas a 10% e desmineralizadas em ácido nítrico a 5%. Observou-se que o nervo maxilar, desde sua origem na fossa pterigopalatina até penetrar na fissura orbital inferior, emite de um a três ramos alveolares superiores posteriores e ramos tuberais descendentes que vão para estruturas moles da região. Os nervos alveolares superiores posteriores, descem adjacentes à tuberosidade da maxila, na qual penetram através dos canais alveolares junto com a artéria homônima e podem emitir filetes nervosos que continuam trajeto extra-ósseo. Contrariando os achados da literatura, com este estudo observou-se que o nervo maxilar apresenta praticamente dois terços de sua trajetória na região zigomática e o restante na fossa pterigopalatina

Anatomical study of the sphenopalatine foramen

As variações anatômicas do forame esfenopalatino podem corresponder às alterações na entrada da irrigação nasal arterial, condição relevante para o tratamento das epistaxes graves através da ligadura da artéria esfenopalatina. OBJETIVO: Estudar o forame esfenopalatino quanto à sua variação numérica e sua localização na parede lateral nasal em relação à crista etmoidal óssea do osso palatino. Material e Método: Os estudos anatômicos foram realizados em 54 hemicrânios. RESULTADOS: O forame esfenopalatino apresentou a seguinte variação numérica: único (87,0% ou 47 peças), duplo (11,1% ou 6 peças) e triplo (1,9% ou uma peça); foi localizado no meato nasal superior em 81,5% ou 44 peças, 14,8% (8 peças) entre os meatos nasais médio e superior e no meato nasal médio apenas em um caso (1,9%). CONCLUSÃO: Foi demonstrada a variação numérica do FEP, a sua relação com a crista etmoidal óssea, e sua localização nos meatos nasais superior, médio e em ambos.Anatomical variations of the sphenopalatine foramen may correspond to alterations at the arterial nasal irrigation input, which is a relevant condition to treat severe epistaxis through ligation of the sphenopalatine artery. AIM: To study the sphenopalatine foramen in terms of its numeric variation and its location on the lateral nasal wall in relation to the bony ethmoidal crest of the palatine bone. MATERIALS AND METHODS: The anatomical studies were carried out in 54 hemifaces. RESULTS: the sphenopalatine foramen presented the following numeric variation: single (87%, or 47 specimens), double (11,1%, or 6 specimens), and triple (1.9% or one specimen); it was located at the superior nasal meatus in 81.5%, or 44 specimens; 14.8% (8 specimens) between the middle and superior nasal meatus and in the middle nasal meatus in only one case (1.9%). CONCLUSION: We have been able to show a numeric variation of the SPF, its relation with the bony ethmoidal crest and its location in the superior meatus, middle meatus, and in both

Surgical anatomy of the maxillary nerve in the zygomatic region

Anatomic knowledge on the zygomatic fossa is of primary importance to improve the regional anesthetic technique of the maxillary nerve. Few reports in the literature have addressed the trajectory of the maxillary nerve and its branches in this region; thus, this study aimed at presenting information about the trajectory of these nerves. Thirty human half-heads of both genders were fixed in 10% formalin and demineralized in 5% nitric acid, and the maxillary nerve was dissected since its origin on the pterygopalatine fossa until penetration into the inferior orbital fissure. It was observed that the maxillary nerve sends one to three posterior superior alveolar branches and tuberal descendent branches, which supply the soft tissue structures of the region. The posterior superior alveolar nerves are inferiorly oriented near the maxillary tuberosity, where they penetrate the alveolar canals with the posterior superior alveolar artery and send small nerve branches that continue in an extraosseous trajectory. This study found that nearly 2/3 of the trajectory of the maxillary nerve is located in the zygomatic region, with a short segment (1/3) in the pterygopalatine fossa