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Head and Neck
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
The hard palate is a conglomerate of many structures making up the roof of the oral cavity and these structures also seamlessly contribute to nearby regions. These include the incisive foramen located just posterior to the incisors teeth, alveolar processes superior and adjacent to the teeth and palatine process of the maxilla, the horizontal plate, perpendicular plate, greater palatine foramen, and lesser palatine foramen of the palatine bone, located posterior to the maxilla and the hamulus of the medial plate of the pterygoid process, the lateral plate of the pterygoid process, the scaphoid fossa, and the pterygoid canal of the sphenoid bone located superior and slightly posterior to the maxilla and palatine bones (Plate 3.9). As you can see, the hard palate is made up of many bony parts. The hard palate is also the structure typically subject to facial clefting birth defects (see Branchial arches at the beginning of Chapter 3).
Anatomy and Embryology of the Mouth and Dentition
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
The hard palate derives its blood supply principally from the greater palatine artery, a branch of the third part of the maxillary artery. The greater palatine artery descends (with its accompanying nerve) in the palatine canal. In the canal, it gives off two or three lesser palatine arteries that are transmitted through lesser palatine canals to supply the soft palate and tonsil (anastomosing with the ascending palatine branch of the facial artery). The greater palatine artery emerges on to the oral surface of the palate at the greater palatine foramen and runs in a curved groove near the alveolar border of the hard palate to the incisive canal. It ascends this canal and anastomoses with septal branches of the nasopalatine artery.
Local resection and reconstruction of oral carcinomas and lip cancer
Published in John Dudley Langdon, Mohan Francis Patel, Robert Andrew Ord, Peter Brennan, Operative Oral and Maxillofacial Surgery, 2017
Similar to the other resections described in this chapter, a 1-cm margin is outline. Typically, this will involve the greater palatine foramen. This area is then outlined with the needle-point diathermy. First, the medial aspect is incised to bone. This is followed by the next incision which is adjacent to the alveolus. The anterior margin is then incised to bone. At this time, a periosteal elevator can be used to elevate the tumour off the palatal bone. Hopefully the greater palatine vessels are still intact and then can be clipped with hemo-liga clips or ligated. If this is not the case, then the foramen can be cauterized to control for bleeding. The specimen is then dissected posteriorly to the soft palate. Here is it elevated off the palatal muscles. The specimen is oriented before being sent to the pathologist. The defect can be closed with a buccal fat pad, a healing stent is also a good option, and local flaps may also be used.
Comparison between combined regional nasal block and general anesthesia versus general anesthesia with dexmedetomidine during endoscopic sinus surgery
Published in Egyptian Journal of Anaesthesia, 2023
Moustafa Atef Moustafa Hamouda, Nahed E. Salama, Samia A. Hassan, Eman M. Aboseif, Rehab A. Abdelrazik
SPGB Group: immediately after induction of general anesthesia, regional nasal block by SPGB, which was done by via a transoral approach using 2 ml of a mixture of lidocaine (2%) and bupivacaine (0.5%) for each side. The ganglion was blocked at the greater palatine foramen. A curved dental needle passes through the greater palatine foramen (GPF) in the posterior portion of the hard palate. This should be just medial to the gum line opposite the third molar tooth to reach the superior aspect of the pterygopalatine fossa (Figure 1) [7].