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.