Radiological correlation between the anterior ethmoidal artery and the supraorbital ethmoid cell in relation to skull base
Keywords:
Anterior ethmoidal Artery, Supraorbital ethmoidal cell, skull base
Abstract
Background: The anterior ethmoidal artery (AEA) is an important landmark in functional endoscopic sinus surgery. Iatrogenic injury may result in retraction of the artery into the orbit, with intra-orbital bleeding and possible blindness. Computerized Tomography (CT) scans are the gold standard in diagnosing paranasal sinus diseases. These scans are used as road maps while operating on the paranasal sinuses. We undertook this study to determine the reliability of identification of the artery on the coronal CT scan and to determine whether a correlation exists between the pneumatization of the suprabullar recess and the vertical distance of the artery from the base skull. Methods: 80 randomly selected CT scans were studied. The AEA was identified on each side and the vertical distance between the artery and the base skull was measured. The CT scans were divided into two groups based on whether the supraorbital cell was present or absent. These groups were each further subdivided into 3 groups depending on the vertical distance between the anterior ethmoidal artery and the base skull.Result: The AEA was reliably identified in 98.75 % of the cases. When the supraorbital cell was absent, the mean distance between the artery and the base skull was 1.2 mm; while when the cell was present, the mean distance was 4.52 mm which is statistical highly significant (p value < 0.05).Conclusion: The orbital beak and superior oblique muscle are reliable landmarks to identify the anterior ethmoidal artery. There exists a strong correlation between the vertical distance of the artery from the base skull and the presence of the supraorbital ethmoid cell. DOI: 10.21276/AAMS.1892References
1. Stankiewz JA. Complications of endoscopic intranasal ethmoidectomy. Laryngoscope 1987; 97:1270-3.
2. Moon Hyoung-Jin, Hyung-Ung Kim, Jeung-Gweon Lee, In Hyuk Chung. Surgical anatomy of the anterior ethmoidal canal in ethmoid roof. Laryngoscope 2001; 111:900-4.
3. McDonald S E, Robinson P J, Nunez D A. Radiological anatomy of the anterior ethmoidal artery for functional endoscopic sinus surgery. The Journal of Laryngol & Otol 2008; 122:264-67.
4. Ohnishi T, Yanagisawa E. Endoscopic anatomy of the anterior ethmoidal artery. Ear Nose and Throat Journal 1994:634-6.
5. Voegels RL. Cirurgia endoscópica dos seios paranasais. Arquivos de otorrinolaringologia 1997;1(1).
6. Araujo Filho BC, Weber R, Pinheiro Neto CD, Lessa MM, Voegels RL, Butugan O. Endoscopic anatomy of the anterior ethmoidal artery: a cadaveric dissection study. Rev Bras Otorrinolaringol. (Engl Ed). 2006 ;72(3):303-8.
7. Pandolfo I, Vinci S, Salamone I, Granata F, Mazziotti S. Evaluation of the anterior ethmoidal artery by 3D dual volume rotational digital subtraction angiography and native multidetector CT with multiplanar reformations. Initial findings. Eur Radiol. 2007;17(6):1584-90.
8. Joshi AA, Shah KD, Bradoo RA. Radiological correlation between the anterior ethmoidal artery and the supraorbital ethmoid cell. Indian J Otolaryngol Head Neck Surg (July–September 2010) 62(3) (Rhinology):299–303.
9. Ohnishi T., Tachibana T., Kaeko Y. et al. (1993) High-risk areas in endoscopic sinus surgery and prevention of complications. Laryngoscope 103, 1181–1185
10. 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 Jun;31(3):187-91.
11. Chung SK, Dhong HJ, Kim HY. Computed tomography anatomy of the anterior ethmoid canal. Am J Rhinol 2001; 15:77–81.
12. Souza SA, Souza MM, Gregório LC, Ajzen S. Anterior ethmoidal artery evaluation on coronal CT scans. Braz J Otorhinolaryngol. 2009 Jan-Feb;75(1):101-6.
2. Moon Hyoung-Jin, Hyung-Ung Kim, Jeung-Gweon Lee, In Hyuk Chung. Surgical anatomy of the anterior ethmoidal canal in ethmoid roof. Laryngoscope 2001; 111:900-4.
3. McDonald S E, Robinson P J, Nunez D A. Radiological anatomy of the anterior ethmoidal artery for functional endoscopic sinus surgery. The Journal of Laryngol & Otol 2008; 122:264-67.
4. Ohnishi T, Yanagisawa E. Endoscopic anatomy of the anterior ethmoidal artery. Ear Nose and Throat Journal 1994:634-6.
5. Voegels RL. Cirurgia endoscópica dos seios paranasais. Arquivos de otorrinolaringologia 1997;1(1).
6. Araujo Filho BC, Weber R, Pinheiro Neto CD, Lessa MM, Voegels RL, Butugan O. Endoscopic anatomy of the anterior ethmoidal artery: a cadaveric dissection study. Rev Bras Otorrinolaringol. (Engl Ed). 2006 ;72(3):303-8.
7. Pandolfo I, Vinci S, Salamone I, Granata F, Mazziotti S. Evaluation of the anterior ethmoidal artery by 3D dual volume rotational digital subtraction angiography and native multidetector CT with multiplanar reformations. Initial findings. Eur Radiol. 2007;17(6):1584-90.
8. Joshi AA, Shah KD, Bradoo RA. Radiological correlation between the anterior ethmoidal artery and the supraorbital ethmoid cell. Indian J Otolaryngol Head Neck Surg (July–September 2010) 62(3) (Rhinology):299–303.
9. Ohnishi T., Tachibana T., Kaeko Y. et al. (1993) High-risk areas in endoscopic sinus surgery and prevention of complications. Laryngoscope 103, 1181–1185
10. 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 Jun;31(3):187-91.
11. Chung SK, Dhong HJ, Kim HY. Computed tomography anatomy of the anterior ethmoid canal. Am J Rhinol 2001; 15:77–81.
12. Souza SA, Souza MM, Gregório LC, Ajzen S. Anterior ethmoidal artery evaluation on coronal CT scans. Braz J Otorhinolaryngol. 2009 Jan-Feb;75(1):101-6.
Published
2018-03-04
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