الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
In current study, we compared between radiological and surgical measurements from fixed landmarks to the SPF to select the most significant reliable landmark(s) for localization of the SPF to be a guide for rapid TESPAL.
Our study is composed of 24 patients divided into two equal groups according to sex were prepared for sinonasal surgeries. We selected fixed landmarks to the SPF and we measured distances from these landmarks on C.Ts before surgeries. These landmarks are: maxillary line, anterior head of middle turbinate, basal lamella, nasal floor and the choanal arch. We selected these landmarks for their consistent and reliable identification during nasal endoscopy and CT examination.
We measured distances from the selected anatomic landmarks to the SPF radiologically and surgically in all patients.
According to our measures, we found that measures were same radiologically and surgically for maxillary line, anterior head of middle turbinate and nasal floor with non-significant difference between radiological measures and surgical measures. So, radiological measures for these three landmarks are the most reliable measures which can be taken as a guide for rapid localization and estimation of the SPF in cases of refractory posterior epistaxis for rapid TESPAL.
For the choanal arch measures were same in 11 patients of totally 24 patients, but were different between radiological measures and surgical measures in the other 13 patients but still a non-significant difference.
For the basal lamella, the radiological measures were totally different from surgical measures (highly significant difference). So, the radiological measurement of the distance from the basal lamella to the SPF is not a reliable measure to be taken as a guide for proper surgical localization of the SPF.
Based on our measurements, we proposed using the expected distances from the simple endoscopic reliable landmarks to the SPF to triangulate the most likely location of the SPA. The reliable radiographic measurements described in this study can be used to guide incision placement and elevate a smaller flap directly onto the foramen or coagulate directly on top of it.
The anatomic landmarks in this study were chosen for easy identification during nasal endoscopy and their expected presence even in the setting of previous surgery or trauma. Distances were greater in male patients for most measurements, consistent with the larger mean nasal cavity dimensions typically seen in men.