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    Clinically relevant morphometric analysis of pterygopalatine fossa and its volumetric relationship with adjacent paranasal sinuses: a CT-based study
    (Springer, 2024) Ayas, Betuel Digilli; Cicekcibasi, Aynur Emine; Goksan, Ahmet Safa; Acar, Guelay; Aydogdu, Demet
    ObjectivesThis study aimed to perform morphometric measurements of the pterygopalatine fossa (PPF), the transition zone to critical neurovascular structures. The second aim was to investigate the relationship between the volumes of the PPF and the paranasal sinuses and the effect of nasal septum deviation (NSD) types on all these measurements.MethodsWe performed PPF's morphometry and all volume measurements on the CT images of 260 patients (130 male and 130 female, age range 18-79).ResultsAll volumetric measurements and the angle between foramen rotundum (FR) and pterygomaxillary fissure (PMF) were significantly higher in males than females. In contrast, the distance between sphenopalatine foramen (SPF) and PMF was considerably higher in females than in males. The PPF volume, the distance between the pterygoid canal (PC) and maxillary sinus, and the angle between FR and PMF were significantly higher on the right side than on the left. In contrast, the angle between PC and SPF and between greater palatine canal and PPF were considerably higher on the left side than on the right. The angle between PC and SPF decreased markedly with age. Only sphenoidal sinus volume was significantly smaller on the same side as the septal deviation. There was no correlation between PPF volume with maxillary and sphenoid sinus volumes from adjacent paranasal sinuses.ConclusionsVolumetric and morphometric data obtained from PPF and paranasal sinuses can aid clinicians in diagnosing and treating patients by guiding them in selecting the right surgical approach or tools, especially in endoscopic procedures.
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    Effectiveness of Spreader Graft Versus Autospreader Flap in Reducing Nasal Air Resistance
    (Lippincott Williams & Wilkins, 2023) Cemiloglu, Muhammed; Aricigil, Mitat; Bayrakci, Erdem; Acar, Guelay; Arbag, Hamdi
    Objective:The authors aimed to compare the functional outcomes of 2 different techniques, spreader graft and autospreader flap, by using them for nasal valve surgery in cadavers using acoustic rhinometry (AR).Method:Ten frozen cadavers who underwent nasal valve surgery between May 2017 and August 2018 were randomly divided into 2 groups. Spreader grafts were applied to 10 nasal valve regions in 1 group, while the autospreader flap method was used on the other 10 nasal valve regions. The effectiveness of the surgical techniques was evaluated utilizing AR.Result:We objectively evaluated the effect of surgery on nasal air resistance by comparing the preoperative and postoperative AR values (MCA1, MCA2, volume) in both the spreader graft and the autospreader flap groups. In addition, the differences in nasal potency gain after the application of both techniques were compared and the superiority of the 2 surgeries in terms of functional gains was evaluated. A statistically significant difference was observed in preoperative and postoperative MCA1, MCA2, and volume values in both the techniques and sides. The authors found more significant nasal valve opening for the spreader graft technique using acoustic rhinometric values when compared with the autospreader flap technique.Conclusions:In both methods, the air resistance was observed to decrease objectively in the nasal valve region. Autospreader flaps increase the nasal valve angle without the need for additional cartilage tissue, and it could be an alternative to spreader grafts.