Abstract:

Objective　To study the anatomical characteristics of several important structures in the human lateral nasal wall in order to offer anatomical evidence for surgical application.　Methods　Thirty sides of 15 adult cadaver heads were used. The relationship of the key structures in the lateral nasal wall was observed using microscope and endoscope.　Results　The sphenopalatine artery is the main blood supply of the lateral nasal wall. It divides into two major branches (the posterior lateral nasal artery and the septal artery) when passing through the sphenopalatine foramen. The posterior lateral nasal artery leaves the sphenopalatine artery by its inferior side in 24 cases (80%) and by its superior side in 6 cases (20%). The location where the sphenopalatine artery branches is right behind the ethmoidal crest. The septal artery divides into two branches at the anteroinferior wall of the sphenoid sinus in 26 cases (86.7%) and after entering the nasal septum in 4 cases (13.3%). The natural ostium of the maxillary sinus is at the hiatus semilunaris in the middle meatus, with 20 cases (66.7%) in the middle part of the hiatus semilunaris, 9 cases (30%) in the posterior part of the hiatus semilunaris and one case (3.3%) in the superior meatus. The superior margin of the ostium locates higher than the lowest orbital floor in 26 of 30 cases (86.7%). The average size of the nasal fontanelle is (14.81±4.28)mm (anteroposterior axis) ×(9.71±1.43)mm (inferosuperior axis).　Conclusion　The sphenopalatine artery and its branches, as well as the nasal fontanelle, are the key landmarks in the surgery relative to the lateral nasal wall. Better understanding of their anatomic relationships will guarantee efficacy and safety in endoscopic sinus surgery.

Key words: Lateral nasal wall, Microsurgical anatomy, Sphenopalatine artery, Sphenopalatine foramen, Nasal fontanelle