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Radiological evaluation of maxillary artery and descending palatine artery in the pterygopalatine fossa by 3D rotational angiography

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Abstract

Purpose

The aim of this study is to evaluate the branching patterns and topographical features of the third part of the maxillary artery (t-MA) and descending palatine artery (DPA) by 3-Dimensional Rotational Angiography (3DRA) images and to define the radiological classification of their variations, based upon the previous cadaveric studies and a review of the literature.

Method

This study was conducted from May 2020 through June 2021. All consecutive adult patients who were examined with 3D-RA were enrolled in the study. The morphological evaluations and measurements of t-MA, DPA and their branches were made on maximum intensity projection images with 10–20 mm slice thickness.

Results

Eighty-five hemifaces, including 58 females and 45 right sides, were evaluated. The diameter of the t-MA was measured as 1.73 ± 0.30 mm. The most common pattern of the t-MA according to its course was loop type (63/85, 74.1%) and according to branching pattern was Type Ib (29/85, 34.1%). The mean diameter of DPA was 1.19 ± 0.20 mm. The DPA presented as a single trunk in 11/85 cases. Type II, which was defined as one lesser palatine artery originating from distal-DPA, was the most common morphological variation (51.8%).

Conclusions

3DRA imaging provides valuable information for vascular anatomical studies. The most common morphological variation related to t-MA, DPA is the distal branching pattern.

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Fig. 1
Fig. 2

modified from Type M (Morton and Khan), the angulation between SPA and DPA is 0–30°. The subgroups were defined according to the location of the bifurcation. Type Ia was proximal (a) and Type Ib was distal (b). Type II: modified from Type T and Type intermediate (Morton and Khan), the angulation between SPA and DPA is 30–120°. The subgroups of Type II were defined according to the dominant branch of bifurcation. If SPA was the terminal branch and larger than DPA, it was Type IIa (Type T) (c) and otherwise, it was Type IIb (Type intermediate) (d). Type III; modified from Type Y (Morton and Khan), the angulation between SPA and DPA is > 120° (e)

Fig. 3
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Authors and Affiliations

  1. Faculty of Medicine, Department of Radiology Topkapı, Bezmialem Vakif University, Adnan Menderes Blv. Fatih, 34093, İstanbul, Turkey

    Ibrahim Ilker OZ & Temel Fatih Yilmaz

  2. Faculty of Dentistry, Department of Periodontology Topkapı, Bezmialem Vakif University, Adnan Menderes Blv. Fatih, 34093, İstanbul, Turkey

    Ahmet Aydogdu

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  1. Ibrahim Ilker OZ
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Contributions

IIOZ: protocol/project development, data collection or management, data analysis, manuscript writing/editing. AA: data analysis, data collection or management, manuscript writing/editing. TFY: data collection or management, data analysis, manuscript writing/editing.

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Correspondence to Ibrahim Ilker OZ.

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OZ, I.I., Aydogdu, A. & Yilmaz, T.F. Radiological evaluation of maxillary artery and descending palatine artery in the pterygopalatine fossa by 3D rotational angiography. Surg Radiol Anat 44, 535–542 (2022). https://doi.org/10.1007/s00276-022-02916-9

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