Anatomy of the posterior septal artery with surgical implications on the vascularized pedicled nasoseptal flap

Abstract

BACKGROUND: The purpose of this study was to define the anatomic characteristics of the posterior septal artery related to the design of the vascularized pedicled nasoseptal flap. METHODS: The course and branching pattern of the posterior septal artery and its relationship with landmarks and other regional arteries were studied in 26 vascular latex-injected head sides. RESULTS: The posterior septal artery is divided into 2 septal branches within the sphenoidal segment, which occurred either close to the sphenopalatine foramen (65.4%) or at the posterior border of the nasal septum (34.6%). The inferior branch was frequently dominant (61.5%). The dominant branch was always below the axial plane of the sphenoid ostium. On the posterior nasal septum, the inferior branch may run downward before coursing anteroinferiorly. CONCLUSION: We identify 2 high-risk areas for the design of the vascularized PNSF, namely, at the inferior aspect of the sphenoid ostium and the junction of the posterior nasal septum and the choana arch.