Hostname: page-component-6766d58669-76mfw Total loading time: 0 Render date: 2026-05-18T07:14:00.835Z Has data issue: false hasContentIssue false
  • English
  • Français

Radiological and clinical correlations of the anterior ethmoidal artery in functional endoscopic sinus surgery

Published online by Cambridge University Press:  03 November 2021

A Gupta ,
S Ghosh  and
A Roychoudhury
A Gupta*
Affiliation:
Consultant ENT, Lok Clinic and Hospital, New Delhi, India
S Ghosh
Affiliation:
Department of ENT and Head Neck Surgery, Vivekananda Institute of Medical Sciences, Ramakrishna Mission Seva Pratishthan, Kolkata, India
A Roychoudhury
Affiliation:
Department of ENT and Head Neck Surgery, Vivekananda Institute of Medical Sciences, Ramakrishna Mission Seva Pratishthan, Kolkata, India
*
Author for correspondence: Dr Abhishek Gupta, A-2-132, Ground Floor, Janakpuri, New Delhi 110058, India E-mail: abhishekgupta.dr@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

To correlate computed tomography findings and endoscopic localisation of the anterior ethmoidal artery during surgery, and to analyse the intranasal landmarks and abnormalities of the artery.

Method

The anterior ethmoidal artery was studied with high-resolution computed tomography and endoscopic surgery in 30 patients undergoing functional endoscopic sinus surgery (group A), and with endoscopic dissection on 30 human cadavers (group B).

Results

The anterior ethmoidal artery was demonstrated on computed tomography in 25 patients and intra-operatively in 12 (group A). It was identified in 26 cadavers (group B). Dehiscence of bony canal and branching was noted in 10.53 per cent of cases. The mean (± standard deviation) intranasal length of the anterior ethmoidal artery was 7.29 (± 1.21) mm, the distance of the artery from the axilla of the middle turbinate was 16.24 (± 2.75) mm, and the mean distance from the ground lamella was 8.97 (± 1.46) mm.

Conclusion

High-resolution computed tomography scanning prior to functional endoscopic sinus surgery is mandatory to identify the anterior ethmoidal artery. Endoscopically, the axilla of the middle turbinate and the ground lamella can serve as dependable reference points to identify the artery. Cadaver dissection improves understanding of anatomy.

Keywords

Anterior Ethmoidal ArteryEndoscopic Sinus Surgery

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 2 , February 2022 , pp. 154 - 157
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

Footnotes

Dr A Gupta takes responsibility for the integrity of the content of the paper

References

Messerklinger, W. Endoscopy of the Nose. Baltimore: Urban & Schwarzenberg, 1978;1–18Google Scholar
Han, JK, Becker, SS, Bomeli, SR, Gross, CW. Endoscopic localization of anterior and posterior ethmoidal arteries. Ann Otol Rhinol Laryngol 2008;117:931–5CrossRefGoogle Scholar
Woolford, TJ, Jones, NS. Endoscopic ligation of anterior ethmoidal artery in treatment of epistaxis. J Laryngol Otol 2000;114:858–60Google ScholarPubMed
Walker, A, Surda, P, Hopkins, C. Improving paranasal sinus computed tomography reporting prior to functional endoscopic sinus surgery – an ENT-UK panel perspective. J Laryngol Otol 2017;131:280–2CrossRefGoogle ScholarPubMed
Sharp, HR, Crutchfield, L, Rowe, JM, Mitchell, DB. Major complications and consent prior to endoscopic sinus surgery. Clin Otolaryngol Allied Sci 2001;26:33–8CrossRefGoogle ScholarPubMed
Pernas, FG, Coughlin, AM, Hughes, SE, Riascos, R, Maeso, PA. A novel use of a landmark to avoid injury of the anterior ethmoidal artery during endoscopic sinus surgery. Am J Rhinol Allergy 2011;25:54–7CrossRefGoogle ScholarPubMed
Keros, P. On the practical value of differences in the level of the lamina cribrosa of the ethmoid [in German]. Z Laryngol Rhinol Otol 1962;41:809–13Google ScholarPubMed
Moon, HJ, Kim, HU, Lee, JG, Chung, IH, Yoon, JH. Surgical anatomy of the anterior ethmoidal canal in ethmoid roof. Laryngoscope 2001;111:900–4CrossRefGoogle ScholarPubMed
Ohnishi, T, Yanagisawa, E. Endoscopic anatomy of the anterior ethmoidal artery. Ear Nose Throat J 1994;73:634–6CrossRefGoogle ScholarPubMed
Lang, J, Schafer, K. Ethmoidal arteries: origin, course, regions supplied and anastomoses [in German]. Acta Anat (Basel) 1979;104:183–97CrossRefGoogle ScholarPubMed
Ding, J, Sun, G, Lu, Y, Yu, BB, Li, M, Li, L et al. Evaluation of anterior ethmoidal artery by 320-slice CT angiography with comparison to three-dimensional spin digital subtraction angiography: initial experiences. Korean J Radiol 2012;13:667–73CrossRefGoogle ScholarPubMed
Gotwald, TF, Menzler, A, Beauchamp, NJ, Zur, ND, Zinreich, SJ. Paranasal and orbital anatomy revisited: identification of the ethmoid arteries on coronal CT scans. Crit Rev Comput Tomogr 2003;44:263–78CrossRefGoogle ScholarPubMed
Souza, SA, Souza, MM, Gregório, LC, Ajzen, S. Anterior ethmoidal artery evaluation on coronal CT scans. Braz J Otorhinolaryngol 2009;75:101–6CrossRefGoogle ScholarPubMed
Basak, S, Karaman, CZ, Akdilli, A, Mutlu, C, Odabasi, O, Erpek, G. Evaluation of some important anatomical variations and dangerous areas of the paranasal sinuses by CT for safer endonasal surgery. Rhinology 1998;36:162–7Google ScholarPubMed
Lannoy, PL, Schults, P, Riehm, S, Atallah, L, Veillon, F, Debry, C. The anterior ethmoidal artery: radioanatomical comparison and its application in endonasal surgery. Acta Otolaryngol 2007;127:618–22CrossRefGoogle Scholar
Erdogmus, S, Govsa, F. The anatomic landmarks of ethmoidal arteries for surgical approaches. J Craniofac Surg 2006;17:280–5CrossRefGoogle ScholarPubMed
Simmen, D, Raghavan, U, Briner, HR, Manestar, M, Schuknecht, B, Groscurth, P et al. The surgeon's view of the anterior ethmoid artery. Clin Otolaryngol 2006;31:187–91Google ScholarPubMed
Wang, L, Youseef, A, Al Qahtani, AA, Gun, R, Prevedello, DM, Otto, BA et al. Endoscopic anatomy of the middle ethmoidal artery. Int Forum Allergy Rhinol 2014;4:164–8CrossRefGoogle ScholarPubMed
Araujo, BC, Weber, R, Pinheiro, CD, Lessa, MM, Voegels, RL, Butugan, O. Endoscopic anatomy of the anterior ethmoidal artery: a cadaveric dissection study. Braz J Otorhinolaryngol 2006;72:303–8Google Scholar
Lee, WC, Ming, PK, Hasselt, CA. New guidelines for endoscopic localization of the anterior ethmoidal artery: a cadaveric study. Laryngoscope 2000;110:1173–8CrossRefGoogle ScholarPubMed
Lisbona, MP, Fernandez, LR, Lorente, MA, Perez, DL, Herrera, TS, Tejero, GG et al. Anterior ethmoid artery at ethmoidal labyrinth: bibliographical review of anatomical variants and references for endoscopic sinus surgery [in Spanish]. Acta Otorrinolaryngol Esp 2010;61:202–8Google Scholar
Lund, VJ, Stammberger, H, Nicolai, P, Castelnuovo, P, Beal, T, Beham, A et al. European position paper on endoscopic management of tumours of the nose, paranasal sinuses and skull base. Rhinol Suppl 2010;22:1–143Google ScholarPubMed