Abstract
Introduction
The maxillary artery (MA) is a key structure at risk of injury in numerous Oral and
Maxillofacial surgical (OMS) procedures. Knowledge of safe distances from this vessel
to surgically familiar bony landmarks could improve patient safety and prevent catastrophic
haemorrhage
Methods
Distances between MA and bony landmarks on the maxilla and mandible were measured
using CT angiograms on 100 patients (200 facial halves).
Results
The vertical height of the pterygomaxillary junction (PMJ) was 16 ± 3mm. The MA enters
the pterygomaxillary fissure (PMF) 29 ± 3 mm from the most inferior point of the PMJ.
The mean shortest distance between the MA and medial surface of mandible was 2 ± 2mm
(with the vessel directly contacting the mandible in 17% of cases). The branchpoint
(bifurcation of the superficial temporal artery (STA) and MA) was directly in contact
with the mandible in 5% of cases. The average distances between this bifurcation point
and the medial pole of the condyle were 20 ± 5mm and 22 ± 5mm, respectively.
Conclusion
A horizontal plane through the sigmoid notch perpendicular to the posterior border
of the mandible is a good approximation of the trajectory of the MA. The branchpoint
is usually within 5mm of this line and inferior in 70% of cases. Surgeons should take
note that both the branchpoint and the MA contact the surface of the mandible in a
significant number of cases.
Keywords
Abbreviations:
BP (branch point (ECA terminates to STA and MA)), CT (Computed Tomography), ECA (external carotid artery), ICA (internal carotid artery), LP (lateral pterygoid), MA (maxillary artery), PBM (posterior border mandible), PMF (pterygomaxillary fissure), PMJ (pterygomaxillary junction), PPF (pterygopalatine fossa), SN (sigmoid notch), STA (superficial temporal artery), TP (tragal pointer), TOF-MRA (Time of flight-Magnetic Resonance Angiography)To read this article in full you will need to make a payment
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Article info
Publication history
Accepted:
November 1,
2022
Received in revised form:
October 15,
2022
Received:
July 20,
2022
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
© 2022 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
