Endoscopic Ligation of the Anterior Ethmoid Artery

Endoscopic transnasal cauterization of the anterior ethmoidal artery

“…Different authors have shown that when the vessel runs within the bone of the skull base, traditional ethmoidectomy and removal of bone surrounding the artery does not reliably provide adequate access for placement of a vascular clip [13]. Our experience highlights that the AEA is reliably accessible through a safe endoscopic transnasal approach, which exposes the artery as it transitions from the orbit to the ethmoidal cavity.…”

A new technique for management of intercavernous sinus bleeding with titanium clips in transsphenoidal surgery

“…Some modified appliers with variously angled tips have been described in the literature; however, they were designed for aneurysm surgery and are not suitable for transsphenoidal surgery due to their bulky volume, which may impair the surgeon's view. [17][18][19] Furthermore, all the appliers mentioned in the literature have never been used for clipping the intercavernous sinus bleeding in transsphenoidal surgery. Hence we have developed a novel deep pistol-shaped clip applier to overcome or minimize these problems concerning instrument maneuverability in transsphenoidal surgery.…”

Danger points, complications and medico-legal aspects in endoscopic sinus surgery

“…Many authors avoid the monopolar coagulation at the skull base due to possible secondary damage to the meninges [100], [133], [402]. Alternatively, clips are suggested, which, however, are not always effective, due to anatomical reasons [100], [402], [406]. …”