Endoscopic Localization of the Anterior and Posterior Ethmoid Arteries

Abstract

Specific endoscopic anatomic relationships and measurements have been presented for the anterior and posterior ethmoid arteries.

Management of orbital complications in endoscopic sinus surgery

“…The anterior ethmoid artery can be within the ethmoid sinus mesentery in 20-40% of cases and most commonly occurs when there is presence of a pneumatized supraorbital ethmoid air cell. The location of the anterior ethmoid artery is by the basal lamella, whereas the posterior ethmoid artery is by the anterior face of the sphenoid sinus [5 ]. It is important to detect whether the anterior or posterior ethmoid arteries are in the ethmoid mesentery (Fig.…”

Endoscopic transnasal cauterization of the anterior ethmoidal artery

“…For these reasons the AEA is an important structure to identify during endoscopic sinus surgery or other endoscopic skull base procedures, in order to stop bleeding by epistaxis, tumors, trauma, etc. Accidental injuries to the AEA can cause bleeding into the ethmoidal cavities, and retrobulbar hematoma may develop, which in turn can have profound ophthalmologic consequences [8]. For these reasons, its surgical ligature and/or cauterization is necessary in many cases.…”

“…The AEA is usually situated within a thinwalled bony canal that lies along the skull base and runs perpendicular to the plane of the nasal septum, at the level of the horizontal part of the frontal bone direction [8] (Figures 4,5,6).…”

“…Occasionally, this canal can be dehiscent or lowlying, and therefore the artery may be susceptible to injury during endoscopic sinus surgery [8]. Previous studies highlighted that the anterior ethmoidal canal is found to be dehiscent or low-lying in between 14% and 43% of cases [5,8].…”

Orbital Complications Associated with the Treatment of Chronic Rhinosinusitis

“…4). 9 An injured ethmoidal artery may retract into the orbital cavity and cause a rapidly expanding retrobulbar hematoma that can result in blindness if not quickly recognized. In addition, one must recognize and be familiar with implications of variations of ethmoidal pneumatization.…”