Journal articles: 'Anterior ethmoidal'

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White, Daniel V., Eric H. Sincoff, and Saleem I. Abdulrauf. "Anterior Ethmoidal Artery: Microsurgical Anatomy and Technical Considerations." Operative Neurosurgery 56, suppl_4 (2005): ONS—406—ONS—410. http://dx.doi.org/10.1227/01.neu.0000156550.83880.d0.

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Abstract OBJECTIVE: Vascular lesions of the anterior cranial fossa can receive significant blood supply from the anterior ethmoidal artery. Embolization of this blood supply exposes the parent vessel, the ophthalmic artery, to possible embolic complications, which can lead to loss of vision. A study of the microsurgical anatomy can help delineate the course of the anterior ethmoidal artery and find the best points for proximal control of the blood supply to these lesions. Clinical cases are presented to illustrate how lesions with prominent anterior ethmoidal artery feeders are best approached through fronto-orbital single-flap craniotomies. METHODS: Eight cadaveric dissections to demonstrate the microsurgical anatomy of the anterior ethmoidal artery were performed to study the relevant anatomy. Two clinical cases are presented that demonstrate clinical application of this anatomy through fronto-orbital single-flap craniotomies. RESULTS: Eight arteries were studied in four cadaveric heads. The dissections show the course of the anterior ethmoidal artery from the ophthalmic artery in the orbit, through the anterior ethmoidal foramen into the ethmoid air cells, to the cribriform plate, where it turns superiorly to become the anterior falx artery. The first surgical case is of a giant tuberculum sellae meningioma that was resected with coagulation and division of the anterior ethmoidal arteries at the anterior ethmoidal foramina at the laminae papyraceae of both medial orbital walls. The second surgical case is of a large deep right frontal arteriovenous malformation that was resected with coagulation and division of the anterior ethmoidal artery at the anterior ethmoidal foramen of the lamina papyracea of the right medial orbital wall. CONCLUSION: The cadaveric dissections and our surgical experience show that the anterior ethmoidal artery has three important sites for surgical access: 1) the anterior ethmoidal foramen at the lamina papyracea of the medial orbital wall; 2) the anterior ethmoid canal at the lateral ethmoid wall; and 3) extradurally, at the cribriform plate. These three sites are best accessed through a fronto-orbital single-flap craniotomy, which can be unilateral or bilateral, depending on the pathological findings. The described orbital-cranial approach in this article is not being advocated to replace the standard pterional and frontal approaches; rather, we suggest it as an option in these complex cases that require early proximal control of the anterior ethmoidal artery feeders.

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Kainz, Josef, and Heinz Stammberger. "The Roof of the Anterior Ethmoid: A Place of Least Resistance in the Skull Base." American Journal of Rhinology 3, no. 4 (1989): 191–99. http://dx.doi.org/10.2500/105065889782009552.

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Because of its special anatomic features the roof of the anterior ethmoid is a preferred area for frontobasal fractures as well as an area of hazard during ethmoid surgery. As clinical experience proves, the most critical area for lesions to occur is in the vicinity of the anterior ethmoidal artery, especially where it leaves the dome of the ethmoid medially to reach the ethmoidal sulcus in the olfactory fossa. Complete ethmoidal specimens were investigated by means of histologic serial sections in the frontal plane. Forty anterior ethmoidal arteries were anatomically prepared. Special features of their topography including connection with the dura, fixation of the dura to the bone of the skull base, and the variations of the thickness of the surrounding bony wall were studied with regard to their surgical relevance. Of utmost importance is the fact that the bone in the vicinity of the ethmoidal sulcus is up to 10 times thinner than the neighboring roof of the ethmoid sinus. Coronal CT scans demonstrating this most critical point with all its many possible variations are found to be invaluable for the preoperative planning of endoscopic or other ethmoid surgery.

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Yamamoto, Hiroki, Kazuhiro Nomura, Hiroshi Hidaka, Yukio Katori, and Naohiro Yoshida. "Anatomy of the posterior and middle ethmoidal arteries via computed tomography." SAGE Open Medicine 6 (January 1, 2018): 205031211877247. http://dx.doi.org/10.1177/2050312118772473.

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Objective: The aim of this study is to investigate the anatomy of the posterior and middle ethmoidal arteries from the viewpoint of an endoscopic sinus surgeon. Methods: Based on 100 computed tomography images, the anatomical position of the posterior ethmoidal artery in relation to the posterior ethmoid cells was classified into five types. The presence of the posterior and middle ethmoidal arteries, their distance from the skull base, and their length exposed in the ethmoid cells were measured. The association of patients’ age and sex, presence of the middle ethmoidal artery, and anatomical type of the posterior ethmoidal artery with the posterior ethmoidal artery distance from the ethmoid roof was analyzed. Results: The posterior ethmoidal artery’s position, relative to the ethmoid cell walls, was most often near the first wall, anterior to the optic canal (92.5%). The posterior ethmoidal artery’s distance from the skull base ranged from 0 to 6.4 mm (mean: 1.2 mm). Older age, longer length of the posterior ethmoidal artery exposed in the ethmoid cells, and absence of the middle ethmoidal artery were positively associated with a longer posterior ethmoidal artery distance from the skull base. Conclusion: Attention should be paid to the posterior and middle ethmoidal arteries.

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Ghosh, P. "Anterior ethmoidal nerve syndrome." Indian Journal of Otolaryngology and Head and Neck Surgery 48, no. 1 (1996): 73–74. http://dx.doi.org/10.1007/bf03048037.

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McDonald, S. E., P. J. Robinson, and D. A. Nunez. "Radiological anatomy of the anterior ethmoidal artery for functional endoscopic sinus surgery." Journal of Laryngology & Otology 122, no. 3 (2007): 264–67. http://dx.doi.org/10.1017/s0022215107008158.

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AbstractAim:This study investigated the extent to which the anterior ethmoidal artery and anterior ethmoidal foramen could be reliably identified on routine coronal sinus computed tomography scans. Where they could be identified, the relationship of these structures with the vertical height of the skull base, and their distance from an anterior landmark, were measured.Methods:Fifty consecutive coronal sinus computed tomography scans were viewed independently by two observers. Scans were reviewed when the observers' opinions differed.Results:Inter-observer concordance was high. The anterior ethmoidal foramen was visualised in 95 per cent of cases bilaterally and in the remaining 5 per cent unilaterally. The anterior ethmoidal artery was visualised in 33 per cent of scans. The anterior ethmoidal foramen was at skull base level in 72 per cent of sides studied, and below it in the remainder. The distance from the lacrimal crest to the anterior ethmoidal foramen was 22.4 mm (mean; standard deviation 3.7).Conclusion:The anterior ethmoidal foramen is a reliable landmark on coronal computed tomography scans of the paranasal sinuses. From this, the position of the anterior ethmoidal artery can be inferred.

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Hosemann, W., R. Gross, U. Göde, Th Kühnel, and G. Röckelein. "The Anterior Sphenoid Wall: Relative Anatomy for Sphenoidotomy." American Journal of Rhinology 9, no. 3 (1995): 137–44. http://dx.doi.org/10.2500/105065895781873854.

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A total of 53 anatomical specimens of the posterior ethmoid and the adjacent anterior sphenoid sinus wall were examined in reference to the operative guidelines for endonasal sphenoidotomy. Six anatomical points of measurement were defined for clinical orientation, and both the absolute and the relative widths of each third (i.e. of each of three vertical sections) of the pars nasalis and the pars ethmoidalis of the anterior sphenoid sinus wall determined. The choana proved to be the most valuable regional anatomic landmark. In 43 cases (41%), a pervading ethmoidal cell was found, extending superiorly and medically all the way up to the nasal septum. In contrast with certain guidelines reported in the literature, 18% of the specimen (sides) showed a wider pars nasalis in the vertical middle third of the anterior sphenoid sinus wall as compared to the adjacent pars ethmoidalis. The thickness of the bone in the anterior wall was similar in both areas. The present measurements support Wigand's recommendation (1990) that the anterior sphenoid sinus wall be perforated paramedially, 10 mm superiorly to the choana.

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Itayem, Deeyar A., C. Lane Anzalone, James R. White, John F. Pallanch, and Erin K. O’Brien. "Increased Accuracy, Confidence, and Efficiency in Anterior Ethmoidal Artery Identification with Segmented Image Guidance." Otolaryngology–Head and Neck Surgery 160, no. 5 (2019): 818–21. http://dx.doi.org/10.1177/0194599818825454.

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Objective To determine whether using image guidance technology with 3-dimensional image segmentation increases the endoscopic surgeon’s accuracy, efficiency, and confidence in identifying the anterior ethmoidal artery. Methods This is a cross-sectional study of attending physicians and residents at an academic medical center. Because identification of the anterior ethmoidal artery during image-guided surgery can be challenging, we studied the effect of anterior ethmoidal artery image segmentation (ie, partitioning and coloring) on surgeon test performance. A computerized test was administered to 16 surgeons who were asked to identify the anterior ethmoidal artery on multiplanar computed tomographic images and to answer multiple-choice questions. Half the questions showed segmented images of the anterior ethmoidal artery, and half showed images without segmentation. Efficiency and accuracy of identification and subjective surgeon confidence were determined for each question. Descriptive statistics were used to compare test performance for identification of the anterior ethmoidal artery on images with or without segmentation. Results Percentage of correct answers ( P < .001), efficiency ( P < .001), and confidence ( P < .001) in identification of the anterior ethmoidal artery were significantly better with segmented computed tomographic images. Discussion We demonstrated that use of segmented images improves surgeons’ accuracy, confidence, and efficiency for identification of the anterior ethmoidal artery. Implications for Practice We describe how segmentation can allow surgeons to improve the surgical course by increasing their accuracy, confidence, and efficiency in identifying the anterior ethmoidal artery.

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Singh, Bharath, and M. Med. "Combined internal maxillary and anterior ethmoidal arterial occlusion: the treatment of choice in intractable epistaxis." Journal of Laryngology & Otology 106, no. 6 (1992): 507–10. http://dx.doi.org/10.1017/s0022215100120006.

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AbstractWhilst it is generally accepted that the standard management for anterior or benign epistaxis is either cautery or anterior nasal packing, that of posterior or intractable epistaxis remains controversial. Various modalities of treatment, ranging from posterior nasal packing to arterial ligation and embolization, have been advocated but none have been unanimously accepted as the treatment of choice.The purpose of this paper was to determine the efficacy of internal maxillary arterial ligation versus combined internal maxillary arterial ligation and anterior ethmoid arterial coagulation in intractable epistaxis.Over a six year period, from 1985 to 1990,454 patients were admitted and treated for epistaxis. Forty-seven patients were diagnosed as having intractable epistaxis on the basis that the epistaxis failed to settle on anterior nasal packing. They were moved to the next step in management, which was combined anterior and posterior nasal packing. There were 30 failures, one was found to have choriocarcinoma of the maxilla, and was treated wtih cytotoxics, and the other 29 were moved to the next step, which was arterial ligation. Fifteen patients had internal maxillary arterial ligation, and 14 combined internal maxillary arterial ligation and anterior ethmoidal arterial coagulation.Large windows were created in both the anterior and posterior walls of the maxillary sinuses and all identifiable branches of the internal maxillary artery were dissected out carefully and two medium size ligating clips were placed over the main trunk, the sphenopalatine and the descending palatine branches. Single clips were placed on all other identifiable branches. Coagulation of the anterior ethmoidal artery was performed with a bipolar cautery. There were three (20 per cent) failures in the internal maxillary arterial ligation group and none in the combined internal maxillary arterial ligation and anterior ethmoidal arterial coagulation group. Furthermore, the three failures were successfully treated with anterior ethmoidal arterial coagulation. The conclusion is that combined internal maxillary and anterior ethmoidal arterial occlusion is the treatment of choice in intractable epistaxis.

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Douglas, S. A., and D. Gupta. "Endoscopic assisted external approach anterior ethmoidal artery ligation for the management of epistaxis." Journal of Laryngology & Otology 117, no. 2 (2003): 132–33. http://dx.doi.org/10.1258/002221503762624594.

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Anterior ethmoidal artery ligation is a well-established surgical procedure in the management of epistaxis. We describe a procedure of anterior ethmoidal artery ligation via minimal access external surgery with the use of a rigid endoscope. This is, as far as we are aware, the first description of an external approach endoscopic anterior ethmoidal artery ligation.

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Moon, Hyoung-Jin, Hyun-Ung Kim, Jeung-Gweon Lee, In Hyuk Chung, and Joo-Heon Yoon. "Surgical Anatomy of the Anterior Ethmoidal Canal in Ethmoid Roof." Laryngoscope 111, no. 5 (2001): 900–904. http://dx.doi.org/10.1097/00005537-200105000-00027.

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Wong, Danny K. C., Angus Shao, Raewyn Campbell, and Richard Douglas. "Anterior Ethmoidal Artery Emerging Anterior to Bulla Ethmoidalis: An Abnormal Anatomical Variation in Waardenburg's Syndrome." Allergy & Rhinology 5, no. 3 (2014): ar.2014.5.0094. http://dx.doi.org/10.2500/ar.2014.5.0094.

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In endoscopic sinus surgery, the anterior ethmoidal artery (AEA) is usually identified as it traverses obliquely across the fovea ethmoidalis, posterior to the bulla ethmoidalis and anterior to or within the ground lamella's attachment to the skull base. Injury to the AEA may result in hemorrhage, retraction of the AEA into the orbit, and a retrobulbar hematoma. The resulting increase in intraorbital pressure may threaten vision. Waardenburg's syndrome (WS) is a rare congenital, autosomal dominantly inherited disorder, distinguished by characteristic facial features, pigmentation abnormalities, and profound, congenital, sensorineural hearing loss. We present a case of AEAs located anterior to the bulla ethmoidalis in a 36-year-old male with WS and chronic rhinosinusitis. The anatomic abnormality was not obvious on a preoperative computed tomography scan and was discovered intraoperatively when the left AEA was injured, resulting in a retrobulbar hematoma. The hematoma was immediately identified and decompressed endoscopically without lasting complications. The AEA on the right was identified intraoperatively and preserved. The characteristic craniofacial features in WS were probably associated with the abnormal vascular anatomy. Endoscopic sinus surgeons should be aware of these potential anatomic anomalies in patients with abnormal craniofacial development.

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Sah, Bajarang Prasad, ShyamThapa Chettri, Mukesh Kumar Gupta, Shankar Prasad Shah, Deepak Poudel, and Sriti Manandhar. "Radiological correlation between the anterior ethmoidal artery and the supraorbital ethmoid cell in relation to skull base." Annals of Advance Medical Sciecnes 2, no. 1 (2018): A11–15. http://dx.doi.org/10.21276/aams.1892.

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Sava, Cristina Julieta, and Mugurel Constantin Rusu. "Bilateral sinoliths in the ethmoid sinus – a rare Cone Beam CT finding." Romanian Journal of Rhinology 7, no. 25 (2017): 57–59. http://dx.doi.org/10.1515/rjr-2017-0007.

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Abstract Sinoliths are calculi found particularly in paranasal sinuses, the rarest location being the ethmoid air cells. There were previously reported only 4 cases of unilateral large ethmoidal sinoliths (ES), this one being the fifth report. We report here the incidental bilateral evidence in a 34-year-old female patient evaluated in Cone Beam Computed Tomography (CBCT) of minor ES. The left ES, of 1.6 mm2 sagittal size, occupied the suprabullar cell, in front of the ground lamella and behind the anterior ethmoidal canal. The right ES, of 7.6 mm2, was located behind the ground lamella. The radiodensity of each ES was about 1000 HU, their bone quality being thus assessed. This is the first evidence of bilateral and clinically silent ethmoidal sinoliths. Being small-sized and incidentally found, it seems reasonable to consider that ethmoidal sinoliths could have a higher incidence but they are overlooked due to the lack of clinical manifestations.

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Jones, N. S., and T. J. Woolford. "Endoscopic ligation of anterior ethmoidal artery in treatment of epistaxis." Journal of Laryngology & Otology 114, no. 11 (2000): 858–60. http://dx.doi.org/10.1258/0022215001904167.

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Arterial ligation of the anterior ethmoidal artery may be required in cases of persistent epistaxis and conventional techniques involving open surgery carry a recognized morbidity. We describe an endoscopic, intranasal technique for ligation of the anterior ethmoidal artery. This technique was performed in a patient who had a severe epistaxis following nasal trauma. Her epistaxis persisted in spite of anterior and posterior nasal packing. Endoscopy showed the bleeding to originate high and lateral to the middle turbinate. Endoscopic exploration defined the frayed end of the anterior ethmoidal artery. A ligaclip was placed with immediate and persistent arrest of her epistaxis. No further nasal packs or treatment were required.

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Abdullah, Baharudin, Eng Haw Lim, Hazama Mohamad, et al. "Anatomical variations of anterior ethmoidal artery at the ethmoidal roof and anterior skull base in Asians." Surgical and Radiologic Anatomy 41, no. 5 (2018): 543–50. http://dx.doi.org/10.1007/s00276-018-2157-3.

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Manjila, Sunil, Efrem M. Cox, Gabriel A. Smith, et al. "Extracranial ligation of ethmoidal arteries before resection of giant olfactory groove or planum sphenoidale meningiomas: 3 illustrative cases with a review of the literature on surgical techniques." Neurosurgical Focus 35, no. 6 (2013): E13. http://dx.doi.org/10.3171/2013.10.focus13327.

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Object There are several surgical techniques for reducing blood loss—open surgical and endoscopic—prior to resection of giant anterior skull base meningiomas, especially when preoperative embolization is risky or not technically feasible. The authors present examples of an institutional experience using surgical ligation of the anterior and posterior ethmoidal arteries producing persistent tumor blush in partially embolized tumors. Methods The authors identified 12 patients who underwent extracranial surgical ligation of ethmoidal arteries through either a transcaruncular or a Lynch approach. Of these, 3 patients had giant olfactory groove or planum sphenoidale meningiomas. After approval from the institution privacy officer, the authors studied the medical records and imaging data of these 3 patients, with special attention to surgical technique and outcome. The variations of ethmoidal artery foramina pertaining to this surgical approach were studied using preserved human skulls from the Hamann-Todd Osteological Collection at the Museum of Natural History, Cleveland, Ohio. Results The extracranial ligation was performed successfully for control of the ethmoidal arteries prior to resection of hypervascular giant anterior skull base meningiomas. The surgical anatomy and landmarks for ethmoidal arteries were reviewed in anthropology specimens and available literature with reference to described surgical techniques. Conclusions Extracranial surgical ligation of anterior, and often posterior, ethmoidal arteries prior to resection of large olfactory groove or planum sphenoidale meningiomas provides a safe and feasible option for control of these vessels prior to either open or endoscopic resection of nonembolized or partially embolized tumors.

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Li, Lifeng, Nyall R. London, Daniel M. Prevedello, and Ricardo L. Carrau. "Intraconal Anatomy of the Anterior Ethmoidal Neurovascular Bundle: Implications for Surgery in the Superomedial Orbit." American Journal of Rhinology & Allergy 34, no. 3 (2020): 394–400. http://dx.doi.org/10.1177/1945892420901630.

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Background The anterior ethmoidal artery (AEA) branches from the ophthalmic artery in the superomedial intraconal space. The feasibility of management of lesions arising from the superomedial intraconal space via an endoscopic endonasal approach has not been sufficiently explored. Objective To yield a detailed anatomic description of the anterior ethmoidal neurovascular bundle and its variants to serve as the foundation for possible management of lesions in the superomedial intraconal space. Methods Eight cadaveric specimens (16 sides) were dissected using an endonasal approach, tracing the AEA proximally through the superomedial intraconal space. Furthermore, the anatomy of adjacent structures was noted, and distances from the anterior ethmoidal foramen to the origin of the AEA at the ophthalmic artery were measured. Results Supraorbital cells were found in 13/16 sides (81.25%), and a bony dehiscence of the anterior ethmoidal canal was observed in 5/16 sides (31.25%). The nasociliary nerve, ophthalmic artery, superior division of the oculomotor nerve, superior rectus muscle, and levator palpebrae superioris were routinely identified in the superomedial intraconal space. The AEA passed through a corridor between the medial rectus and superior oblique muscles after arising from the ophthalmic artery (lateral to the foramen) in all specimens. The average distance from its origin to the anterior ethmoidal foramen was 5.19 ± 0.98 mm. Conclusion Anatomically, it is feasible to access the superomedial intraconal space via an endoscopic endonasal approach. This study provides the anatomical basis for procedures in the superomedial intraconal space.

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Chakravarthi, Kosuri Kalyan, Nelluri Venumadhav, and KS Siddaraju. "Congenital malformation of lamina orbitalis ossis ethmoidalis." Asian Journal of Medical Sciences 6, no. 2 (2014): 91–94. http://dx.doi.org/10.3126/ajms.v6i2.10534.

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Background: The thinnest portion of the medial wall of the orbit is Lamina orbitalis ossis ethmoidalis which separates the ethmoidal sinuses from the orbit. Congenital bony malformation of orbit and anatomical variation of ethmoidal sinuses are important in terms of the risk of complication development during endoscopic sinus surgery and to understanding the pathophysiology and spread of sinus disease.Materials and Methods: Accordingly the present study was designed to fi nd out the congenital malformation of medial wall of the orbit in relation to lamina orbitalis ossis ethmoidalis. The study was carried out using 100 dried adult human skulls and twenty six human cadavers irrespective of sex were obtained from the Department of Anatomy - Mayo Institute of Medical Sciences-Barabanki, Department of Anatomy - Melaka Manipal Medical College - Manipal and Department of Anatomy - KMCT Medical College, Manassery - Calicut.Results: In three skulls (2.380%) we noted unilateral unusual hole at the junction of medial wall and roof of orbit with dimensions of 2.3 cm long and 1 cm height in two skulls and another unusual vertical hole at the anterior part of medial wall and roof of orbit with dimensions of 2 cm height and 1 cm width. We also noted few ethmoidal cells extended in to the orbital plate and fovea ethmoidalis of the frontal bone.Conclusion: Congenital defective formation of bony orbit and variable anatomy of paranasal sinuses noted in this study is may be due to the defective formation of Lamina orbitalis ossis ethmoidalis from the lateral part of the nasal capsule near the fronto ethmoidal suture such comprehensive knowledge is necessary to understand the various disorders of this region and to avoid complications during surgical procedures involving this area.DOI: http://dx.doi.org/10.3126/ajms.v6i2.10534Asian Journal of Medical Sciences Vol.6(2) 2015 91-94

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Joshi, Anagha A., Kshitij D. Shah, and Renuka A. Bradoo. "Radiological correlation between the anterior ethmoidal artery and the supraorbital ethmoid cell." Indian Journal of Otolaryngology and Head & Neck Surgery 62, no. 3 (2010): 299–303. http://dx.doi.org/10.1007/s12070-010-0088-3.

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Levchenko, O. V., A. Yu Ovchinnikov, A. A. Kalandari, and M. A. Edzhe. "Transorbital clipping of the ethmoidal arteries as a method of early devascularization in cranioorbital tumors removal." Russian Otorhinolaryngology 19, no. 5 (2020): 106–12. http://dx.doi.org/10.18692/1810-4800-2020-5-106-112.

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Objective: To improve the results of surgical treatment of patients with cranioorbital tumors. For this purpose, for patient with high vascularized tumor of ethmoidal bone, adjacent to the medial wall of the orbit, early devascularization as the first stage and transnasal endoscopic removal of the tumor as the second stage was performed. Tumor devascularization was performed by clipping of anterior and posterior ethmoidal arteries through a transcaruncular endoscopic approach. For this, the incision of the conjunctiva, after infiltration with local anesthetics, was carried out posteriorly from the lacrimal caruncle, continuing it above and below the posterior border of the medial canthal ligament. Then, after dissection of the periosteum posterior to the posterior lacrimal crest, further stages of the surgical intervention are performed under the control of an endoscope with a viewing angle of 0°. Results. Transorbital endoscopic clipping of the ethmoid arteries allowed to significantly reduce the intensity of blood flow in the tumor tissue and perform endoscopic transnasal removal of the tumor with minimal blood loss. Intraoperative blood loss was 100 ml. No complications were recorded. Conclusion. Transorbital endoscopic clipping of the anterior and posterior ethmoidal arteries is an effective and safe method for early devascularization of partially embolized or non-embolized cranioorbital tumors. The technique is promising and requires further development.

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Pradhan, Susan, Suman Phuyal, Dipendra Kumar Shrestha, and Sushil Krishna Shilpakar. "Juvenile variant ossifying fibroma of sinonasal region." Nepal Journal of Neuroscience 17, no. 2 (2020): 77–81. http://dx.doi.org/10.3126/njn.v17i2.30551.

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Juvenile variant ossifying fibroma of sinonasal region is an extremely rare benign fibro-osseous lesion which is locally aggressive. A 21-year-old male presented with significant proptosis of right eye with stony-hard lump in the middle upper aspect of the right orbit and base of the nose. CT scan of head revealed a non-enhancing expansile lesion in right ethmoidal cells consistent with chronic ethmoidal mucocele. However Magnetic Resonance Imaging of brain revealed enhancing lesion in right ethmoid and frontal sinus extending up to anterior cranial fossa. He underwent right frontal craniotomy with surgical excision of tumor wherein cystic brown tumor of frontal and ethmoidal sinus was found. The procedure was supplemented with endoscopic transnasal approach. Histopathology report suggested an ossifying fibroma. This case highlights the importance of clinical, imaging and histopathological features of ossifying fibroma occurring in the sinonasal tract for better diagnosis and treatment through a multidisciplinary approach.

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Moriyama, Hiroshi, Masaya Fukami, Kiyoshi Yanagi, Nobuyoshi Ohtori, and Kensaku Kaneta. "Endoscopic Endonasal Treatment of Ostium of the Frontal Sinus and the Results of Endoscopic Surgery." American Journal of Rhinology 8, no. 2 (1994): 67–70. http://dx.doi.org/10.2500/105065894781874449.

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We discuss a procedure for opening the nasofrontal duct and the postoperative findings in endoscopic endonasal surgery. The route of the anterior ethmoidal artery was also studied. The subjects of this study were 57 patients (105 sides) who had frontal sinus disease. The patients all underwent surgery for chronic sinusitis between 1990 and 1992. Patients undergoing revision surgery were excluded. All patients were operated on by the same surgeon. In each patient, following anterior and posterior ethmoidectomy, the frontal sinus ostial region was opened using a 70 endoscope, while carefully monitoring the anterior ethmoidal artery. The agger nasi was left intact. The cells around the ostium were opened using a curved suction tip and upward bent forceps, and the lamellae were removed to achieve the greatest possible communication with the frontal sinus. In 77 sides (73.4%), the communication between the frontal and ethmoidal sinuses was well maintained. The ostium was patent with edematous mucosa in 18 sides (17.1%). The opened ostium could not be confirmed due to presence of polyp, etc., in 10 sides (9.5%). During surgery, the route of the anterior ethmoidal artery was confirmed in 70.8%; and of these cases, it was located anterior to the third ground lamella in about 50%.

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Ohnishi, Toshio, and Eiji Yanagisawa. "Endoscopic Anatomy of the Anterior Ethmoidal Artery." Ear, Nose & Throat Journal 73, no. 9 (1994): 634–36. http://dx.doi.org/10.1177/014556139407300905.

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Yue, Wen L. "Anterior Ethmoidal Glycerol Rhizotomy for Vasomotor Rhinitis." Ear, Nose & Throat Journal 74, no. 11 (1995): 764–67. http://dx.doi.org/10.1177/014556139507401108.

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The treatment of vasomotor rhinitis by anterior ethmoidal glycerol rhizotomy (AEGR) was assessed in 78 patients with a follow-up period ranging from 12 to 15 months. The reduction of nasal hypersecretion obtained with AEGR was maintained over six months. At the final assessment, sixty patients (76.9%) reported complete relief of symptoms and are taking no medications; seven (8.9%) were improved with minimal drug therapy required for symptom relief; and 11.9% had poor results with unsatisfactory control even with medication. Nineteen patients required a second treatment because of an initial suboptimal injection or recurrence. Apparently, this method offers those patients with vasomotor rhinitis a valid option for treatment of clinical symptoms, with the additional benefit of experiencing no serious complications when compared with vidian neurectomy.

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Gupta, Rahul, RG Aiyer, VK Pandya, GB Soni, PJ Dhameja, and Mayank Patel. "Etiopathogenesis of Rhinosinusitis in Relation to Ethmoid Anatomy." An International Journal Clinical Rhinology 3, no. 1 (2010): 17–21. http://dx.doi.org/10.5005/jp-journals-10013-1020.

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Abstract Introduction: Rhinosinusitis is one of the most common ENT disorders in the developed and developing world. The quest and identification of factors predisposing to chronic rhinosinusitis is the key for guiding appropriate management. Objectives The purpose of this study was to determine the prevalence of anatomical variations of the ethmoid sinus in patients with rhinosinusitis. This was done to assess and evaluate the significance of the anatomical variations of the ethmoid in the genesis of inflammatory sinus disease. Material and methods We reviewed 50 patients with rhinosinusitis, of which 38(76%) had anatomical variations of ethmoid and the extent of mucosal disease. Results Concha bullosa was found to be the most common anatomic variation and was seen in 25(50%) patients closely followed by variations in the uncinate process, paradoxically bend middle turbinate. The most commonly affected paranasal sinus was maxillary sinus (84%) followed by anterior ethmoidal sinus, posterior ethmoidal sinus, frontal sinus and sphenoid sinus in descending order. Conclusion Anatomical variations of the ethmoid sinuses are important etiological factors in the genesis of inflammatory sinus disease.

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Zinreich, S. J., F. A. Kuhn, N. R. London Jr., D. Kennedy, M. Solaiyappan, and W. Hosemann. "3D CT stereoscopic imaging: an improved anatomical understanding of the anterior ethmoid sinus and frontal sinus drainage pathway." Rhinology Online 3, no. 3 (2020): 202–20. http://dx.doi.org/10.4193/rhin20.061.

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OBJECTIVE: The objective of this presentation is to display a series of new anatomical concepts and terms regarding the frontal si- nus, its drainage pathway and cells vs. spaces of the anterior ethmoid, based on Three-Dimensional Computer X-ray Tomography Stereoscopic Imaging (3DCTSI) and contrast these concepts to those reported in the current literature. METHODS: Given the new anatomic observations provided by 3DCTSI, and the widespread anatomic variations a small sample was initially selected to describe our observations. Six exemplary cases according to the “Classification of Fronto-Ethmoidal cells” by Kuhn, Bent et al., Lee et al., expanded by Wormald et al., and adopted by Ramakrishnan et al., Huang et al., and Void et al. (1-7) were chosen to illustrate our detailed anatomic observations. Additional observations and data of prevalence identified in a larger series will follow. RESULTS and CONCLUSION: Conceptually, the anterior ethmoid “cells” are in essence “spaces” with openings that communicate with the middle meatus and/or the ethmoidal infundibulum. The frontal sinus and frontal recess are a united and continuous three-dimensional, irregularly shaped space, the Frontal Sinus/Recess Space (FSRS). The uncinate process has two segments: the Ethmoidal Uncinate Process (EUP), which encompasses the Infundibular Space of the EUP (IS-EUP), currently known as the Agger Nasi cell; and the Turbinal Uncinate Process (TUP), which borders the Turbinal Infundibulum (TI) medially. The superior attach- ment of the EUP will be detailed in each of the six cases (Table 2). The middle meatus and infundibular passages are the drainage pathways from the frontal sinus and maxillary sinus to the nasal cavity.

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Sjogren, Phayvanh P., Rajendra Waghela, Shaelene Ashby, Richard H. Wiggins, Richard R. Orlandi, and Jeremiah A. Alt. "International Frontal Sinus Anatomy Classification and Anatomic Predictors of Low-Lying Anterior Ethmoidal Arteries." American Journal of Rhinology & Allergy 31, no. 3 (2017): 174–76. http://dx.doi.org/10.2500/ajra.2017.31.4428.

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Background The International Frontal Sinus Anatomy Classification (IFAC) was introduced to more accurately characterize ethmoid and frontal sinus pneumatization patterns. The prevalence of IFAC cells and their anatomic associations have not been described. Objective The goal was to examine the prevalence of IFAC cells and determine radiologic features associated with a low-lying anterior ethmoidal artery (LAEA). Methods Imaging of adult patients who underwent computed tomographies from January 2015 to March 2016 were retrospectively reviewed by using the IFAC classification. We also measured the distance from the skull base to the anterior ethmoidal artery (AEA), the height of the lateral lamella of the cribriform plate, and anterior-posterior diameter from the anterior wall of the frontal sinus to the skull base (APF). Patients with a history of sinus surgery, trauma, malignancy, or congenital anomaly were excluded. Statistical analysis was performed by using Pearson correlation coefficients and χ2 tests. Results A total of 95 patients met the inclusion criteria. There was a significant association between supraorbital ethmoid cells and an LAEA (p < 0.001), with a significant effect size (ϕ = 0.276, p = 0.007). An inverse relationship was observed between Keros type I classification I and an LAEA (p < 0.001), with a significant effect size (ϕ = -0.414, p = 0.000). Significant associations were found between the AEA distance from the skull base and the cribriform lateral lamella height (R = 0.576, p < 0.001). In addition, there was a significant association between the AEA distance from the skull base and the APF (R = 0.497, p < 0.001). Conclusion The presence of a supraorbital ethmoid cell and a wide APF were associated with an LAEA. There was a significant relationship between Keros type I classification and the AEA adjacent to the skull base. Delineation of these anatomic relationships may be helpful during endoscopic sinus surgery to avoid complications.

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Yang, You-xiong, Qin-kang Lu, Jian-chun Liao, and Rui-shan Dang. "Morphological Characteristics of the Anterior Ethmoidal Artery in Ethmoid Roof and Endoscopic Localization." Skull Base 19, no. 05 (2009): 311–17. http://dx.doi.org/10.1055/s-0028-1115323.

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Cavada, Marina N., Carolyn A. Orgain, Raquel Alvarado, Raymond Sacks, and Richard J. Harvey. "Septal Perforation Repair Utilizing an Anterior Ethmoidal Artery Flap and Collagen Matrix." American Journal of Rhinology & Allergy 33, no. 3 (2018): 256–62. http://dx.doi.org/10.1177/1945892418816959.

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Background Nasal septal perforation repair remains a challenge with no standard technique for repair recognized. Objective To describe the combination of an anterior ethmoidal artery flap with a collagen matrix inlay as a successful technique for nasal septal perforation repair. Methods A case series of consecutive patients who underwent nasal septal perforation repair with an anterior ethmoidal artery flap with an inlay collagen graft was conducted. Demographic data, preoperative features of the perforation (size, location, and presence of chondritis), and postoperative outcomes were analyzed; closure rate, mucosalization rate (of the contralateral side at 21 and 90 days), and complications (crusting, bleeding, obstruction, infection, and rehospitalization <30 days) were documented. Results Thirteen patients (age: 49 ± 15 years, 30.8% women) were assessed. The perforation size was 1.6 ± 0.9 cm (range: 0.3–3.5 cm) and located 1.2 ± 0.5 cm (range: 0.5–2.0 cm) posterior to the columella. Chondritis was present in 69.2%. The closure rate was 100% (95% confidence interval [CI]: 77%–100%) at both 21 and 90 days. One patient required a free mucosa graft to an area of persistent crusting on the contralateral side (7.7%). Complications were low; bleeding 0%, obstruction 7.7% (requiring corticosteroid injection of anterior ethmoidal artery flap), and 0% infection/rehospitalization. Conclusion Anterior ethmoidal artery flap with an inlay collagen matrix is a reliable technique to repair nasal septal perforation. This technique, with robust vascularity and wide angle of rotation, enables the closure of perforations both large (<50% total septum) and with anterior locations.

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Budu, Vlad Andrei, Silviu Crăc, Alexandra Gheorghe, and I. Bulescu. "Anterior ethmoidal artery – implications in endoscopic endonasal surgery." ORL.ro 1, no. 46 (2020): 21. http://dx.doi.org/10.26416/orl.46.1.2020.2840.

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Souza, Soraia Ale, Marcia Maria Ale de Souza, Luís Carlos Gregório, and Sergio Ajzen. "Anterior Ethmoidal Artery Evaluation on Coronal CT Scans." Brazilian Journal of Otorhinolaryngology 75, no. 1 (2009): 101–6. http://dx.doi.org/10.1016/s1808-8694(15)30839-9.

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Quintana, Leonidas M. "Ethmoidal Arteries and Vascularized Anterior Skull Base Lesions." World Neurosurgery 84, no. 4 (2015): 881–83. http://dx.doi.org/10.1016/j.wneu.2015.06.025.

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Felippu, Alexandre, Renzo Mora, and Luca Guastini. "Endoscopic transnasal cauterization of the anterior ethmoidal artery." Acta Oto-Laryngologica 131, no. 10 (2011): 1074–78. http://dx.doi.org/10.3109/00016489.2011.593548.

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Losken, H. Wolfgang, Warwick M. M. Morris, and J. W. Earle. "Unilateral Exophthalmos Caused by an Anterior Ethmoidal Meningoencephalocele." Plastic and Reconstructive Surgery 89, no. 4 (1992): 742–45. http://dx.doi.org/10.1097/00006534-199204000-00028.

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Floreani, Stephen R., Salil B. Nair, Michael C. Switajewski, and Peter-John Wormald. "Endoscopic Anterior Ethmoidal Artery Ligation: A Cadaver Study." Laryngoscope 116, no. 7 (2006): 1263–67. http://dx.doi.org/10.1097/01.mlg.0000221967.67003.1d.

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Marianetti, Tito Matteo, Giulio Gasparini, Alessandro Moro, et al. "Nasal and Ethmoidal Alterations in Anterior Synostotic Plagiocephaly." Journal of Craniofacial Surgery 22, no. 2 (2011): 509–13. http://dx.doi.org/10.1097/scs.0b013e31820871d6.

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Delavari, Nader, David Staffenberg, and Howard Riina. "Transpalpebral Incision for Resection of an Ethmoidal Dural Arteriovenous Fistula: 2-Dimensional Operative Video." Operative Neurosurgery 19, no. 6 (2020): E606. http://dx.doi.org/10.1093/ons/opaa213.

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Abstract Ethmoidal dural arteriovenous fistulas are vascular malformations with arterial supply from the anterior ethmoidal artery and ultimate drainage into the sagittal sinus.1-3 They are characterized by a high risk of hemorrhage. Microsurgical disconnection of the fistula represents a safe and robust treatment option. Endovascular treatment requires catheterization of the ophthalmic artery and carries a risk of visual deficits. The supraorbital craniotomy provides an excellent corridor to the anterior skull base and is well suited for the treatment of ethmoidal dural arteriovenous fistulas. The supraorbital craniotomy may be performed through a transpalpebral “eyelid” incision. The transpalpebral incision allows for a well-hidden scar and does not have any associated hair loss, as can be seen with the eyebrow incision. The patient consented to the procedure and being videotaped.

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Takahashi, Yasuhiro, Hiroyuki Kinoshita, Takashi Nakano, Ken Asamoto, Akihiro Ichinose, and Hirohiko Kakizaki. "Anatomy of Anterior Ethmoidal Foramen, Medial Canthal Tendon, and Lacrimal Fossa for Transcutaneous Anterior Ethmoidal Nerve Block in Japanese Individuals." Ophthalmic Plastic and Reconstructive Surgery 30, no. 5 (2014): 431–33. http://dx.doi.org/10.1097/iop.0000000000000215.

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Ranjan, Alok, and Thomas Joseph. "Giant aneurysm of anterior ethmoidal artery presenting with intracranial hemorrhage." Journal of Neurosurgery 81, no. 6 (1994): 934–36. http://dx.doi.org/10.3171/jns.1994.81.6.0934.

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✓ This forty-five-year-old woman presented with a history suggestive of an intracranial hemorrhage. Clinical examination indicated mild right pyramidal signs and neck stiffness. Computerized tomography demonstrated contrast enhancement in the region of a left frontal intraparenchymal hematoma with an adjacent subdural hematoma. Angiography revealed the presence of a giant aneurysm on the left anterior ethmoidal artery. Surgical evacuation of the hematoma with excision of the aneurysm and coagulation of the feeding artery was achieved. Postoperative recovery was uneventful. Vascular lesions of the anterior ethmoidal artery and the rarity of a giant aneurysm at this site are discussed.

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Zinreich, S. J., F. A. Kuhn, D. Kennedy, et al. "Supplements and refinements to current classifications and nomenclature of the fronto-ethmoidal transition region by systematic analysis with 3D CT microanatomy." Rhinology Online 4, no. 4 (2021): 165–80. http://dx.doi.org/10.4193/rhinol/21.039.

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Objective: The microanatomy of the fronto-ethmoidal transition region has been addressed in several classifications. CT stereoscopic imaging (3DCTSI) provides improved display and delineates three defined complex “spaces”, the Frontal Sinus/Frontal Recess Space, the Infundibular Space of the Ethmoid Uncinate Process, and the Ethmoid Bulla Space (FSRS, IS-EUP, EB), none of which were adequately described with the “cell” terminology. We present details on the 3D microanatomy, variability, and prevalence of these spaces. Methods: 3D stereoscopic imaging displays (3DCTSI) were created from 200 datasets. The images were analyzed and categorized by a radiologist (SJZ), and consultant otolaryngologists, focusing on 3D microanatomy of the fronto-ethmoidal transition, the frontal recess/frontal sinus, and drainage pathways, in comparison to established anatomical classification systems. Results: The anterior ethmoid is subdivided into seven groups with the following core properties and prevalence: 1. The horizontal roof of the IS-EUP is attached to the superior half of the frontal process of the maxilla (19%); 2. The IS-EUP extends into the frontal recess (6.5%); 3. The IS-EUP extends into the frontal recess and the frontal sinus (18.5%); 4. A bulla is seen in the medial frontal sinus (3%); 5. The ethmoid bulla and supra bullar space extend into the frontal sinus (7%); 6. Lamellae extend into the FSRS antero-superiorly (25%); 7. FSRS expansion expands below the upper half of the frontal process of the maxilla (FSRS) (21%). Conclusion: 3-D analysis of the detailed anatomy provides important new anatomic information with the increased focus on precision surgery in the region.

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Huang, J., A.-R. Habib, D. Mendis, et al. "An artificial intelligence algorithm that differentiates anterior ethmoidal artery location on sinus computed tomography scans." Journal of Laryngology & Otology 134, no. 1 (2019): 52–55. http://dx.doi.org/10.1017/s0022215119002536.

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AbstractObjectiveDeep learning using convolutional neural networks represents a form of artificial intelligence where computers recognise patterns and make predictions based upon provided datasets. This study aimed to determine if a convolutional neural network could be trained to differentiate the location of the anterior ethmoidal artery as either adhered to the skull base or within a bone ‘mesentery’ on sinus computed tomography scans.MethodsCoronal sinus computed tomography scans were reviewed by two otolaryngology residents for anterior ethmoidal artery location and used as data for the Google Inception-V3 convolutional neural network base. The classification layer of Inception-V3 was retrained in Python (programming language software) using a transfer learning method to interpret the computed tomography images.ResultsA total of 675 images from 388 patients were used to train the convolutional neural network. A further 197 unique images were used to test the algorithm; this yielded a total accuracy of 82.7 per cent (95 per cent confidence interval = 77.7–87.8), kappa statistic of 0.62 and area under the curve of 0.86.ConclusionConvolutional neural networks demonstrate promise in identifying clinically important structures in functional endoscopic sinus surgery, such as anterior ethmoidal artery location on pre-operative sinus computed tomography.

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Bortoli, Vinicius, Rafael Martins, and Krystal Negri. "Study of Anthropometric Measurements of the Anterior Ethmoidal Artery using Three-dimensional Scanning on 300 Patients." International Archives of Otorhinolaryngology 21, no. 02 (2017): 115–21. http://dx.doi.org/10.1055/s-0037-1598598.

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Introduction The anterior ethmoidal artery (AEA) is one of the main arteries that supply both the nasal mucosa and the ethmoid sinuses. The AEA shows variability regarding its distance from adjacent structures. Several studies have developed techniques to identify the AEA. Objective This study aimed to compare the measurements from the AEA to the ethmoid bulla and to the frontal beak by using computed tomography of the face, while identifying their intraindividual and interindividual variations. Methods We analyzed 300 CT scans of the face performed at the CT scan Center at Hospital. The average age of subjects was 36 ± 15.1 years (range 4–84). Results We found that the average distance from the AEA to the ethmoid bulla was 17.2 ± 1.8 mm and the distance from the AEA to the frontal beak was 15.1 ± 2.2 mm. Regarding the average distance from the AEA to the frontal beak (AEA-frontal beak), there was a difference between the right and left sides, with the former being 0.4 mm higher on average than the latter. Among the age groups, there was a significant difference of distances between the AEA and the ethmoid bulla (AEA-ethmoid bulla), which were shorter in the ≤ 12 years group. There was a positive and significant correlation between both measurements analyzed, with low values (high) of AEA-ethmoid bulla distance corresponding to low values (high) of AEA-frontal beak distance. Conclusion The measurements obtained adds anatomical knowledge that can serve as a parameter in frontal and ethmoid sinus surgery.

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Asanau, Alexander, Andrei P. Timoshenko, Paul Vercherin, Christian Martin, and Jean-Michel Prades. "Sphenopalatine and Anterior Ethmoidal Artery Ligation for Severe Epistaxis." Annals of Otology, Rhinology & Laryngology 118, no. 9 (2009): 639–44. http://dx.doi.org/10.1177/000348940911800907.

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Objectives: We describe the surgical treatment of severe epistaxis and evaluate the recurrence of bleeding in a nonrandomized retrospective trial. Methods: We performed a retrospective study comparing bilateral endoscopic ligation of the sphenopalatine artery alone (ELSPA) and bilateral endoscopic ligation of the sphenopalatine artery with concomitant bilateral external ligation of the anterior ethmoidal artery (ELSPEA) in the management of persistent epistaxis. Clinical and hematologic information, preoperative and surgical care, and short- and long-term outcomes were analyzed. The main outcome measure was recurrence of epistaxis in the short- and long-term follow-up periods. Results: Forty-five patients were enrolled in the study. There were 20 patients in group A (ELSPA) and 25 in group B (ELSPEA). Three patients in group A and no patients in group B had long-term (more than 2 weeks after surgery) re-bleeding. The difference between the two groups was not statistically significant (p > 0.05). Conclusions: We conclude that ELSPA and ELSPEA are effective, well-tolerated, reliable procedures if performed by an experienced surgeon. Their failure can be explained by anatomic lateral nasal wall variations and perioperative technical difficulties. They can be appropriate methods to treat severe recurrent epistaxis refractory to repeated nasal packing.

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., Ravikumar. "Endoscopic anatomy of anterior ethmoidal artery: A cadaveric study." MedPulse International Journal of ENT 14, no. 2 (2020): 22–26. http://dx.doi.org/10.26611/10161424.

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Lisbona Alquezar, María Pilar, Rafael Fernández Liesa, Asís Lorente Muñoz, et al. "Anterior ethmoidal artery at ethmoidal labyrinth: Bibliographical review of anatomical variants and references for endoscopic surgery." Acta Otorrinolaringologica (English Edition) 61, no. 3 (2010): 202–8. http://dx.doi.org/10.1016/s2173-5735(10)70035-1.

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Avcı, Emel, Erinç Aktüre, Hakan Seçkin, et al. "Level I to III craniofacial approaches based on Barrow classification for treatment of skull base meningiomas: surgical technique, microsurgical anatomy, and case illustrations." Neurosurgical Focus 30, no. 5 (2011): E5. http://dx.doi.org/10.3171/2011.3.focus1110.

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Object Although craniofacial approaches to the midline skull base have been defined and surgical results have been published, clear descriptions of these complex approaches in a step-wise manner are lacking. The objective of this study is to demonstrate the surgical technique of craniofacial approaches based on Barrow classification (Levels I–III) and to study the microsurgical anatomy pertinent to these complex craniofacial approaches. Methods Ten adult cadaveric heads perfused with colored silicone and 24 dry human skulls were used to study the microsurgical anatomy and to demonstrate craniofacial approaches in a step-wise manner. In addition to cadaveric studies, case illustrations of anterior skull base meningiomas were presented to demonstrate the clinical application of the first 3 (Levels I–III) approaches. Results Cadaveric head dissection was performed in 10 heads using craniofacial approaches. Ethmoid and sphenoid sinuses, cribriform plate, orbit, planum sphenoidale, clivus, sellar, and parasellar regions were shown at Levels I, II, and III. In 24 human dry skulls (48 sides), a supraorbital notch (85.4%) was observed more frequently than the supraorbital foramen (14.6%). The mean distance between the supraorbital foramen notch to the midline was 21.9 mm on the right side and 21.8 mm on the left. By accepting the middle point of the nasofrontal suture as a landmark, the mean distances to the anterior ethmoidal foramen from the middle point of this suture were 32 mm on the right side and 34 mm on the left. The mean distance between the anterior and posterior ethmoidal foramina was 12.3 mm on both sides; the mean distance between the posterior ethmoidal foramen and distal opening of the optic canal was 7.1 mm on the right side and 7.3 mm on the left. Conclusions Barrow classification is a simple and stepwise system to better understand the surgical anatomy and refine the techniques in performing these complex craniofacial approaches. On the other hand, thorough anatomical knowledge of the midline skull base and variations of the neurovascular structures is crucial to perform successful craniofacial approaches.

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Biswas, D., S. K. Ross, A. Sama, and A. Thomas. "Non-sphenopalatine dominant arterial supply of the nasal cavity: an unusual anatomical variation." Journal of Laryngology & Otology 123, no. 6 (2008): 689–91. http://dx.doi.org/10.1017/s0022215108003058.

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AbstractObjective:We present a rare and clinically relevant anomaly of the sphenopalatine artery in relation to its blood supply of the nasal mucosa, with implications for the management of epistaxis.Method:Case report and review of the world literature, using Medline through Pub Med (1950–2005), EMBASE (1980–2005) and Ovid (1958–2005), searching for papers using a combination of terms including ‘spheno-palatine artery’, ‘anterior ethmoidal artery’ and ‘epistaxis’.Results:In the presented case of refractory epistaxis, endoscopic and subsequent endovascular management failed to identify a significant supply from the sphenopalatine arteries bilaterally. The main supply was found to be from the anterior ethmoidal arteries.Conclusion:After a detailed search, the authors failed to locate any similar case in the English literature.

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Enomoto, Hitomi, Hiroshi Goto, and Mikio Murase. "Subarachnoid Hemorrhage Due to a Cerebral Aneurysm at the Anastomotic Site between the Frontoorbital Artery and the Anterior Ethmoidal Artery: A Case Report." Neurosurgery 17, no. 2 (1985): 335–37. http://dx.doi.org/10.1227/00006123-198508000-00018.

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Halbach, Van V., Randall T. Higashida, Grant B. Hieshima, Charles B. Wilson, Stanley L. Barnwell, and Christopher F. Dowd. "Dural Arteriovenous Fistulas Supplied by Ethmoidal Arteries." Neurosurgery 26, no. 5 (1990): 816–23. http://dx.doi.org/10.1227/00006123-199005000-00014.

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Abstract Eight patients with dural arteriovenous fistulas (DAVFs) located on the floor of the anterior cranial fossa and supplied by enlarged ethmoidal branches of the ophthalmic artery are described. Five patients showed the classical symptom of intracerebral hemorrhage (all five had ipsilateral frontal lobe hematomas and one also had an associated a subdural hematoma). Two patients exhibited atypical symptoms of proptosis, chemosis, elevated intraocular pressure, and loss of vision secondary to an ethmoidal DAVF, which drained posteriorly to the cavernous sinus. The eighth patient exhibited proptosis and chemosis secondary to a cavernous sinus DAVF and was incidentally found to have an asymptomatic ethmoidal DAVF. One additional patient had two separate dural fistulas: one located on the cribriform plate and the second located in the posterior fossa. Seven of the eight patients were cured by surgical excision of the fistula site; in the remaining patient spontaneous obliteration followed a surgical procedure for a cavernous DAVF. DAVFs involving the floor of the anterior cranial fossa usually present with hemorrhage, but can present with ocular symptoms or be entirely asymptomatic and are effectively treated by surgical excision of the fistula site.

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Nepal, Pankaj Raj, Karuna Tamrakar Karki, and Dinesh Kumar Thapa. "Ethmoidal dural Arteriovenous Fistula- A case report." Journal of Brain and Spine Foundation Nepal 1, no. 1 (2020): 33–35. http://dx.doi.org/10.3126/jbsfn.v1i1.32231.

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Ethmoidal dural arteriovenous fistulas (dAVF) are a rare type of dAVF present in the anterior cranial fossa. There are usually fed by the ethmoidal artery and drains into superior sagittal sinus. Due to its high flow nature, they are considered a challenging case for surgery and usually present with frontal lobe hematoma or seizure. Here, is a similar case report of a 52-year-old gentleman who presented with sequel of frontal lobe hematoma and was managed surgically with clipping of feeder and excision of fistula.

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Journal articles on the topic 'Anterior ethmoidal'

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