Ligadura endoscópica da artéria etmoidal anterior: estudo de dissecção em cadáveres

Abstract

Ant erior ethmoidal artery (AEA) ligation may be necessary in cases of severe epistaxis not controllable with traditional therapy. Endoscopic endonasal ligation of the AEA is not used frequently; there are few studies in the literature for standardization of the endoscopic technique for this vessel. Aim:To demonstrate the feasibility of periorbital AEA ligation in a transethmoidal endoscopic approach. Methods:A prospective study where 50 nasal cavities were dissected. After anterior ethmoidectomy and partial removal of lamina papyracea, the periorbital area was carefully dissected along a subperiosteal plane to identify the AEA. The vessel was exposed within the orbit and dissected.Results: Data on technical difficulties, complications, the learning curve and anatomical variations were gathered. Conclusion:An endonasal endoscopic approach to the AEA within the orbit was shown to be feasible. Identifying the artery is not difficult, and this technique avoids external incisions. This approach appears to be an excellent alternative for approaching the AEA. Further clinical studies are needed to demonstarte the benefits of this technique. Braz J Otorhinolaryngol. 2011;77(1):33-8. ORIGINAL ARTICLE

Endoscopic Study of Ethmoidal Canals in Cadavers, Including a Histological Analysis of Their Contents

“…The PEA and MEA have been described as thinner than the AEA; however, there is a lack of studies that specify the exact size and difference in caliber regarding them. 8 13 14 15 16 17 18 19…”

Changing Trends in the Management of Epistaxis

“…The advances in endoscopic procedures facilitated the development of the endoscopic ligation of this technique. In a recent study [ 43 ], a cadaveric dissection examined the feasibility of the procedure as well as the surgical anatomy of the anterior ethmoid artery, which was correctly identified in 98.5% of cases.…”