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May 16, 2024
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Abstract

Introduction: The anterior ethmoidal artery (AEA) is an important anatomical structure during
endoscopic sinus surgery (ESS) due to the risk of injury. Preoperative identification of landmarks
correlating with AEA location could help reduce complications. This study aims to determine
anatomical variations affecting the AEA course concerning the skull base.
Methods: A retrospective review was conducted of 50 patients who underwent ESS.
Preoperative coronal CT scans were analysed for supraorbital ethmoid cells (SOEC), suprasellar
cells (SBC), and Keros classification of olfactory fossa depth. Radiological AEA location relative
to the skull base was recorded. Intraoperative videos were reviewed to correlate findings with
radiology.
Results: SOEC were present on 24 right and 28 left sides. SBC were present in 39 right and 33
left sides. The most common Keros types were right type 1 (31) and left type 1 (27).
Radiologically, AEA was within the skull base on 32 right and 27 left sides. Intraoperative
correlation showed a higher incidence of AEA below the skull base with SOEC/SBC presence and
more profound Keros types. The relationship between anatomical variations and AEA location
was statistically significant (p<0.05).
Conclusion: This study demonstrates that anatomical variations, including SOEC, SBC, and
Keros classification, influence the course of the AEA relative to the skull base. Preoperative
identification using these landmarks on CT may help surgeons localise and protect the AEA during
ESS, thus reducing the risks of injury. More extensive prospective studies are needed to validate
these findings.

Keywords

Radiological study Endoscopic sinus surgery Anatomical landmark, Anterior ethmoidal artery

Article Details

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Copyright (c) 2024 University of Thi-Qar Journal Of Medicine

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

References

  1. Abdullah B, Lim EH, Husain S, Snidvongs K, Wang DY. Anatomical variations of anterior
  2. ethmoidal artery and their significance in endoscopic sinus surgery: a systematic review. Surgical
  3. and Radiologic Anatomy. 2019 May.
  4. Yuresh Naidoo and P.J. Wormald. Endoscopic and Open Anterior/ Posterior Ethmoid Artery
  5. Ligation. In: CHIU AG, PALMER JN, ADAPPA ND, editors. Atlas of endoscopic sinus and skull
  6. base surgery. Second edition. | Philadelphia, PA: Elsevier; 2019. P.25-26.
  7. Dustin M Dalgorf and Richard J. Harvey. ANATOMY OF THE NOSE AND PARANASAL
  8. SINUSES. In: Watkinson JC, Clarke RW, editors. Scott-Brown's otorhinolaryngology and head
  9. and neck surgery: Volume 1: Basic sciences, endocrine surgery, rhinology. EIGHTH EDITION.
  10. CRC Press; 2018 Jun 12. P. 974-975
  11. Devyani Lal, James A. Stankiewicz. Primary Sinus Surgery. In: Flint PW, Francis HW,
  12. Haughey BH, Lesperance MM, Lund VJ, Robbins KT, Thomas JR, editors. Cummings
  13. Otolaryngology Head and Neck Surgery. Seventh edition. Philadelphia, PA 19103-2899:
  14. Copyright © 2021 by Elsevier Inc. P. 677-678.
  15. Devyani Lal, James A. Stankiewicz. Primary Sinus Surgery. In: Flint PW, Francis HW,
  16. Haughey BH, Lesperance MM, Lund VJ, Robbins KT, Thomas JR, editors. Cummings
  17. Otolaryngology Head and Neck Surgery. Seventh edition. Philadelphia, PA 19103-2899:
  18. Copyright © 2021 by Elsevier Inc. P. 684-686.
  19. Devyani Lal, James A. Stankiewicz. Primary Sinus Surgery. In: Flint PW, Francis HW,
  20. Haughey BH, Lesperance MM, Lund VJ, Robbins KT, Thomas JR, editors. Cummings
  21. Otolaryngology Head and Neck Surgery. Seventh edition. Philadelphia, PA 19103-2899:
  22. Copyright © 2021 by Elsevier Inc. P. 684.
  23. Almushayti ZA, Almutairi AN, Almushayti MA, Alzeadi HS, Alfadhel EA, AlSamani AN.
  24. Evaluation of the Keros Classification of Olfactory Fossa by CT Scan in Qassim Region. Cureus.
  25. Feb 19;14(2).
  26. Bonasia S, Smajda S, Ciccio G, Robert T. Anatomic and Embryologic Analysis of the Dural
  27. Branches of the Ophthalmic Artery. American Journal of Neuroradiology. 2021 Mar
  28. ;42(3):414416.
  29. Majid Khan, S. James Zinreich, Nafi Aygun. Imaging of Nose and Sinuses. . In: Flint PW,
  30. Francis HW, Haughey BH, Lesperance MM, Lund VJ, Robbins KT, Thomas JR, editors.
  31. Cummings Otolaryngology Head and Neck Surgery. Seventh edition. Philadelphia, PA
  32. : Copyright © 2021 by Elsevier Inc. P. 616.
  33. Philip R. Chapman. NOSE AND SINUS.In: Koch BL,Hamilton BE, Hudgins PA, Harnsberger
  34. HR, editors. Diagnostic imaging Head and Neck. Third Edition. 1600 John F. Kennedy Blvd. Ste
  35. Philadelphia, PA 19103-2899: Elsevier; 2017. P. 666-667.
  36. Baban MI, Hadi M, Gallo S, Zocchi J, Turri-Zanoni M, Castelnuovo P. Radiological and
  37. clinical interpretation of the patients with CSF leaks developed during or after endoscopic sinus
  38. surgery. European Archives of Oto-Rhino-Laryngology. 2017 Jul;274(7):2827-35.
  39. Li M, Sharbel DD, White B, Y. Tadros S, Kountakis SE. Reliability of the supraorbital ethmoid
  40. cell vs Keros classification in predicting the course of the anterior ethmoid artery. InInternational
  41. Forum of Allergy & Rhinology 2019 Jul (Vol. 9, No. 7, pp. 821-824).
  42. Joshi AA, Shah KD, Bradoo RA. Radiological correlation between the anterior ethmoidal
  43. artery and the supraorbital ethmoid cell. Indian Journal of Otolaryngology and Head & Neck
  44. Surgery. 2010 Sep;62(3):299-303.
  45. Simmen D, Raghavan U, Briner HR, Manestar M, Schuknecht B, Groscurth PJ, Jones NS. The
  46. surgeon’s view of the anterior ethmoid artery. Clin otolaryngol. 2006 Jun 1;31(3):187-91.
  47. Poteet PS, Cox MD, Wang RA, Fitzgerald RT, Kanaan A. Analysis of the relationship between
  48. the location of the anterior ethmoid artery and Keros classification. Otolaryngology– Head and
  49. Neck Surgery. 2017 Aug;157(2):320-4.
  50. Umar NF, Aziz ME, Mat Lazim N, Abdullah B. The Effects of Suprabullar Pneumatization on
  51. the Orientation of Its Surrounding Anatomical Structures Relevant to the Frontal Drainage
  52. Pathway. Diagnostics. 2021 Dec 27;12(1):52

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