J Neurol Surg B Skull Base 2012; 73(05): 352-357
DOI: 10.1055/s-0032-1322798
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Endoscopic Identification of the Pharyngeal (Palatovaginal) Canal: An Overlooked Area

Islam R. Herzallah
1   Department of Otolaryngology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
Sameh Amin
2   Department of Otolaryngology-ENT, Faculty of Medicine, El Fayoum University, Cairo, Egypt
Mona A. El-Hariri
3   Lecturer of Radiodiagnosis, Faculty of Medicine, Zagazig University, Zagazig, Egypt
Roy R. Casiano
4   Rhinology and Endoscopic Fellowship Program, Department of Otolaryngology, University of Miami, Miller School of Medicine, Miami, Florida, United States
› Author Affiliations
Further Information

Publication History

28 October 2011

03 May 2012

Publication Date:
07 August 2012 (online)


Objective The pharyngeal or palatovaginal canal (PC) is a small tunnel that lies between the sphenoid process of the palatine bone and the vaginal process of the sphenoid bone. Currently, little endoscopic information is available about this region.

Design and Setting Endoscopic endonasal cadaveric study.

Subjects and Methods Twenty sides in 10 adult cadaver heads were studied endoscopically. The sphenopalatine foramen (SPF) and the adjacent pterygopalatine fossa were exposed. Dissection medial to the vidian canal demonstrated a tunnel that runs posteromedially in the sphenoid floor. Endoscopic data were documented. Additionally, canal measurements were obtained on 20 sides from coronal CT scans of paranasal sinuses.

Results The PC was identifiable in 85% of the sides, although thickness of its bony wall was variable. The endoscopic relationship of the canal and its artery with other landmarks is described. Radiologically, the diameter of the PC averaged 1.7 mm, and the mean distance from the PC to the vidian canal was 3.78 mm.

Conclusion The current study provides a novel endoscopic identification of an overlooked canal. The pharyngeal artery can be a source of bleeding during extended endoscopic procedures. The PC itself could be a place for finger-like projections of anatomically related neoplasms.

  • References

  • 1 Bolger WE, Borgie RC, Melder P. The role of the crista ethmoidalis in endoscopic sphenopalatine artery ligation. Am J Rhinol 1999; 13: 81-86
  • 2 Lee HY, Kim HU, Kim SS , et al. Surgical anatomy of the sphenopalatine artery in lateral nasal wall. Laryngoscope 2002; 112: 1813-1818
  • 3 Babin E, Moreau S, de Rugy MG, Delmas P, Valdazo A, Bequignon A. Anatomic variations of the arteries of the nasal fossa. Otolaryngol Head Neck Surg 2003; 128: 236-239
  • 4 Schwartzbauer HR, Shete M, Tami TA. Endoscopic anatomy of the sphenopalatine and posterior nasal arteries: implications for the endoscopic management of epistaxis. Am J Rhinol 2003; 17: 63-66
  • 5 Snyderman CH, Goldman SA, Carrau RL, Ferguson BJ, Grandis JR. Endoscopic sphenopalatine artery ligation is an effective method of treatment for posterior epistaxis. Am J Rhinol 1999; 13: 137-140
  • 6 Wormald PJ, Wee DT, van Hasselt CA. Endoscopic ligation of the sphenopalatine artery for refractory posterior epistaxis. Am J Rhinol 2000; 14: 261-264
  • 7 O'Flynn PE, Shadaba A. Management of posterior epistaxis by endoscopic clipping of the sphenopalatine artery. Clin Otolaryngol Allied Sci 2000; 25: 374-377
  • 8 Voegels RL, Thomé DC, Iturralde PP, Butugan O. Endoscopic ligature of the sphenopalatine artery for severe posterior epistaxis. Otolaryngol Head Neck Surg 2001; 124: 464-467
  • 9 Wormald PJ, Athanasiadis T, Rees G, Robinson S. An evaluation of effect of pterygopalatine fossa injection with local anesthetic and adrenalin in the control of nasal bleeding during endoscopic sinus surgery. Am J Rhinol 2005; 19: 288-292
  • 10 Williams PL, Warwick R, Dyson M, Bannister LH , Eds. Gray's Anatomy of the Human Body. 36th ed. New York: Churchill Livingstone; 1980: 300-304
  • 11 Wentges RT. Surgical anatomy of the pterygopalatine fossa. J Laryngol Otol 1975; 89: 35-45
  • 12 Alfieri A, Jho HD, Schettino R, Tschabitscher M. Endoscopic endonasal approach to the pterygopalatine fossa: anatomic study. Neurosurgery 2003; 52: 374-378 , discussion 378–380
  • 13 Mellema JW, Tami TA. An endoscopic study of the greater palatine nerve. Am J Rhinol 2004; 18: 99-103
  • 14 Cavallo LM, Messina A, Gardner P , et al. Extended endoscopic endonasal approach to the pterygopalatine fossa: anatomical study and clinical considerations. Neurosurg Focus 2005; 19: E5
  • 15 Rumboldt Z, Castillo M, Smith JK. The palatovaginal canal: can it be identified on routine CT and MR imaging?. AJR Am J Roentgenol 2002; 179: 267-272
  • 16 Borden NM, Dungan D, Dean BL, Flom RA. Posttraumatic epistaxis from injury to the pterygovaginal artery. AJNR Am J Neuroradiol 1996; 17: 1148-1150
  • 17 Pearson BW, MacKenzie RG, Goodman WS. The anatomical basis of transantral ligation of the maxillary artery in severe epistaxis. Laryngoscope 1969; 79: 969-984
  • 18 Daniels DL, Mark LP, Ulmer JL , et al. Osseous anatomy of the pterygopalatine fossa. AJNR Am J Neuroradiol 1998; 19: 1423-1432
  • 19 Pinheiro-Neto CD, Fernandez-Miranda JC, Rivera-Serrano CM , et al. Endoscopic anatomy of the palatovaginal canal (palatosphenoidal canal): a landmark for dissection of the vidian nerve during endonasal transpterygoid approaches. Laryngoscope 2012; 122: 6-12
  • 20 Onerci TM, Yücel OT, Oğretmenoğlu O. Endoscopic surgery in treatment of juvenile nasopharyngeal angiofibroma. Int J Pediatr Otorhinolaryngol 2003; 67: 1219-1225