Morphometric Analysis of Greater Palatine Canal via Cone-Beam Computed Tomography

Melih Özdede 1 , Elif Yıldızer Keriş 2 , Bülent Altunkaynak 3  and İlkay Peker 4
  • 1 Department of Dentomaxillofacial Radiology, Pamukkale University, Faculty of Dentistry, Denizli, Turkey
  • 2 , Çanakkale, Turkey
  • 3 Department of Statistics, Gazi University, Faculty of Arts and Sciences, Ankara, Turkey
  • 4 Department of Dentomaxillofacial Radiology, Gazi University, Faculty of Dentistry, Ankara, Turkey


Background/Aim: The morphology of the greater palatine canal (GPC) should be determined preoperatively to prevent possible complications in surgical procedures required maxillary nerve block anesthesia and reduction of descending palatine artery bleeding. The purpose of this investigation was to evaluate the GPC morphology.

Material and Methods: In this retrospective cross-sectional study, cone-beam computed tomography images obtained for various causes of 200 patients (females, 55%; males, 45%) age ranged between 18 and 86 (mean age±standard deviation=47±13.6) were examined. The mean length, mean angles of the GPC and anatomic routes of the GPC were evaluated.

Results: The mean length of the GPC was found to be 31.07 mm and 32.01 mm in sagittal and coronal sections, respectively. The mean angle of the GPC was measured as 156.16° and 169.23° in sagittal and coronal sections. The mean angle of the GPC with horizontal plane was measured as 113.76° in the sagittal sections and 92.94° in the coronal sections. The mean GPC length was longer in males than in females.

Conclusions: The results of this study showed that the most common pathway of the GPC was “first inferior, and then anterior-inferior direction” in sagittal plane and “first medial-inferior, then inferior direction” in coronal plane.

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • 1. Apinhasmit W, Chompoopong S, Methathrathip D, Sangvichien S, Karuwanarint S. Clinical anatomy of the posterior maxilla pertaining to Le Fort I osteotomy in Thais. Clin Anat, 2005;18:323-329.

  • 2. Douglas R, Wormald PJ. Pterygopalatine fossa infiltration through the greater palatine foramen: where to bend the needle. Laryngoscope, 2006;116:1255-1257.

  • 3. Lepere AJ. Maxillary nerve block via the greater palatine canal: new look at an old technique. Anesth Pain Control Dent, 1993;2:195-197.

  • 4. Malamed SF, Trieger N. Intraoral maxillary nerve block: an anatomical and clinical study. Anesth Prog, 1983;30:44-48.

  • 5. Methathrathip D, Apinhasmit W, Chompoopong S, Lertsirithong A, Ariyawatkul T, Sangvichien S. Anatomy of greater palatine foramen and canal and pterygopalatine fossa in Thais: considerations for maxillary nerve block. Surg Radiol Anat, 2005;27:511-516.

  • 6. Wong JD, Sved AM. Maxillary nerve block anaesthesia via the greater palatine canal: a modified technique and case reports. Aust Dent J, 1991;36:15-21.

  • 7. Erdogan N, Unur E, Baykara M. CT anatomy of pterygopalatine fossa and its communications: a pictorial review. Comput Med Imaging Graph, 2003;27:481-487.

  • 8. Norton NS. Netter’s head and neck anatomy for dentistry. 2nd ed. Philadelphia: Saunders; 2012:65-106 p.

  • 9. Sved AM, Wong JD, Donkor P, Horan J, Rix L, Curtin J, et al. Complications associated with maxillary nerve block anaesthesia via the greater palatine canal. Aust Dent J, 1992;37:340-345.

  • 10. Howard-Swirzinski K, Edwards PC, Saini TS, Norton NS. Length and geometric patterns of the greater palatine canal observed in cone beam computed tomography. Int J Dent, 2010 (2010) DOI:10.1155/2010/292753.

  • 11. Rossi M, Ribeiro E, Smith R. Craniofacial asymmetry in development: an anatomical study. Angle Orthod, 2003;73:381-385.

  • 12. Sheikhi M, Zamaninaser A, Jalalian F. Length and anatomic routes of the greater palatine canal as observed by cone beam computed tomography. Dent Res J (Isfahan), 2003;10:155-161.

  • 13. Hwang SH, Seo JH, Joo YH, Kim BG, Cho JH, Kang JM. An anatomic study using three–dimensional reconstruction for pterygopalatine fossa infiltration via the greater palatine canal. Clin Anat, 2001;24:576-582.

  • 14. Bigoni L, Velemínská J, Brůzek J. Three-dimensional geometric morphometric analysis of cranio–facial sexual dimorphism in a Central European sample of known sex. Homo, 2010;61:16-32.

  • 15. Orish CN, Didia BC. Micrometric and micrometric study of sexual dimorphism in foramina of middle crania fossa of adult Nigerians. Int J Morphol, 2010;28:519-524.

  • 16. Takegosh H, Kikuchi S. An anatomic study of the horizontal petrous internal carotid artery: Sex and age differences. Auris Nasus Larynx, 2007;34:297-301.

  • 17. Tomaszewska IM, Kmiotek EK, Pena IZ, Średniawa M, Czyżowska K, Chrzan R, et al. Computed tomography morphometric analysis of the greater palatine canal: a study of 1,500 head CT scans and a systematic review of literature. Anat Sci Int, 2014;90:287-297.

  • 18. Das S, Kim D, Cannon TY, Ebert CS Jr, Senior BA. High – resolution computed tomography analysis of the greater palatine canal. Am J Rhinol, 2006;20:603-608.

  • 19. Soto RA, Cáceres F, Vera C. Morphometry of the greater palatal canal in adult skulls. J Craniofac Surg, 2015;26:1697-1699.

  • 20. McKinney KA, Stadler ME, Wong YT, Shah RN, Rose AS, Zdanski CJ, et al. Transpalatal greater palatine canal injection: Radioanatomic analysis of where to bend the needle for pediatric sinus surgery. Am J Rhinol, 2010;24:385-388.

  • 21. Wang TM, Kuo KJ, Shih C, Ho LL, Liu JC. Assessment of the relative locations of the greater palatine foramen in adult Chinese skulls. Acta Anat, 1998;132:182-186.


Journal + Issues