Cone Beam Computed Tomographic Analysis of Anatomical Variations of Greater Palatine Canal and Foramen in Relation to Gender in South Indian Population

The greater palatine canal (GPC) extends through thepterygopalatine fossa (PPF), which then diverges to enter  the hard palate at respective foramina. It houses the descendingpalatine artery (a branch of the third division of the maxillary artery) and greater and lesser palatine nerves (branches of the maxillary division of the trigeminal nerve) and their posterior inferio-lateral nasal branches. The canal helps direct access to the PPF, including the sphenopalatine ganglion, pterygopalatine ganglion, infraorbital nerve, internal maxillary artery, and the pterygoid venous plexus . The anatomy ofthe GPC is of interest to dentists, oral maxillofacial surgeons, and otolaryngologists performing procedures in this area (e.g., administration of local anesthesia, dental implant placement,orthognathic Le Fort osteotomies, and .Clinical textbooks on anesthesia locates the GPF in relation to the molar teeth. However, in a comparison one finds variation in the reported locations. Accordingly the position is
cited as opposite the second molar, opposite the third molar or anywhere between the second and third molar. Variations in the location of GPF may pose difficulties in the local and regional anesthesia of the trigeminal maxillary division. In addition, difficulties may occur in identifying the emergence of the greater palatine artery within the oral cavity, which represents important information in the surgery of palatal free vascular flaps, cleft palate, or maxillary sinus. A good knowledge of the anatomy and average length of the GPC is crucial in order to avoid possible complicationssuch as penetration of the orbit and nasal cavity, protopsis, blindness from vasoconstriction of the ophthalmic artery and/ or intracranial spread of infection, intravascular injection, penetration of the nasopharynx, damage to neural tissue, and failed anesthesia. 3D images of cone beam computed tomography (CBCT) are becoming more readily available for use in maxillofacial applications and provides better image
quality of teeth and their surrounding structures, compared with conventional CT scan.
Accordingly the position is
cited as opposite the second molar, opposite the third molar or anywhere between the second and third molar. Variations in the location of GPF may pose difficulties in the local and regional anesthesia of the trigeminal maxillary division. In addition, difficulties may occur in identifying the emergence of the greater palatine artery within the oral cavity, which represents important information in the surgery of palatal free vascular flaps, cleft palate, or maxillary sinus. A good knowledge of the anatomy and average length of the GPC is crucial in order to avoid possible complicationssuch as penetration of the orbit and nasal cavity, protopsis, blindness from vasoconstriction of the ophthalmic artery and/ or intracranial spread of infection, intravascular injection, penetration of the nasopharynx, damage to neural tissue, and failed anesthesia. 3D images of cone beam computed tomography (CBCT) are becoming more readily available for use in maxillofacial applications and provides better image

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