Anatomical variations of anterior ethmoidal artery at the ethmoidal roof and anterior skull base in Asians

2018 ◽  
Vol 41 (5) ◽  
pp. 543-550 ◽  
Author(s):  
Baharudin Abdullah ◽  
Eng Haw Lim ◽  
Hazama Mohamad ◽  
Salina Husain ◽  
Mohd Ezane Aziz ◽  
...  
Keyword(s):  
Skull Base ◽  
Anatomical Variations ◽  
Anterior Skull Base ◽  
Ethmoidal Artery ◽  
Anterior Ethmoidal Artery

scholarly journals Study of variants of anterior ethmoidal artery on computed tomography of paranasal sinuses

2018 ◽  
Vol 5 (1) ◽  
pp. 19
Author(s):  
S. B. Amarnath ◽  
P. Suresh Kumar
Keyword(s):  
Computed Tomography ◽  
Skull Base ◽  
Paranasal Sinuses ◽  
Congenital Anomalies ◽  
Anatomical Landmark ◽  
Frontal Recess ◽  
Severe Epistaxis ◽  
History Of ◽  
Ethmoidal Artery ◽  
Anterior Ethmoidal Artery

<p class="abstract"><strong>Background:</strong> The anterior ethmoidal artery (AEA) is an anatomical landmark, its position is important for recognizing structures of difficult access (frontal sinus) and to define skull base in surgery.Additionally, visualizing this artery makes it possible to identify and treat causes of severe epistaxis. The aims and objectives of the study were to determine the reliability of identification of the AEA on the coronal CT scan, to study the variability in the pneumatisation of the suprabullar recess and the course of the AEA and to determine whether a correlation exists between the pneumatisation of the suprabullar recess and the distance of the AEA from the base skull.</p><p class="abstract"><strong>Methods:</strong> This study conducted among 200 Patients attending to ENT OPD, Yashoda hospital, Secunderabad with history of headache, nose block who underwent CT-PNS. Patients with age above 18 years without any congenital anomalies of face, without opacification in frontal recess or anterior ethmoidal cells, without nasal surgeries or trauma were included in the present study. All the 200 CT-PNS were studied in detail by using PACS and DICOM software.  </p><p class="abstract"><strong>Results:</strong> In this study AEA was present in 100% of cases on both sides. In this study AEA was seen in skull base in 50.75% of cases, among this 51% was on right side, remaining was on left side.</p><p class="abstract"><strong>Conclusions:</strong> CT-PNS coronal sections are helpful in assessment of AEA position pre-operatively. AEF and AES act as important landmarks for the identification of AEA in CT-PNS.</p>

Anterior Ethmoidal Artery: A Computed Tomography Analysis and New Classifications

2020 ◽  
Author(s):  
Mohammad Waheed El-Anwar ◽  
Alaa Omar Khazbak ◽  
Diaa Bakry Eldib ◽  
Hesham Youssef Algazzar
Keyword(s):  
Computed Tomography ◽  
Skull Base ◽  
Frontal Sinus ◽  
Ethmoidal Artery ◽  
Anterior Ethmoidal Artery ◽  
The Mean ◽  
Type 3 ◽  
Sinus Ostium

Abstract Objective to determine the anterior ethmoidal artery (AEA) anatomy and variations by computed tomography (CT) in adult and their relations to and presents new AEA classifications. Methods One hundred and fifty paranasal CT scans (300 sides) were included. Axial images were acquired with multiplanar reformates to obtain delicate details in coronal and sagittal planes. Results One hundred and forty-four AEAs canal (48%), 293 AEAs foramen (97.7%), and 229 AEAs sulcus could be detected (76.3%). The mean AEA intranasal length was 6.7 ± 1.27 mm (range: 4.24–10.6 mm). The mean angle between AEA and lamina papyracea was 105.49 ± 9.28 degrees (range: 76.41–129.76 degrees). Of them, 95.8% AEAs had an angle with lamina >90 degrees, while 4.2% had angle <90 degrees. The mean angle between AEA and lateral lamella of cribriform plate was 103.95 ± 13.08 degrees (range: 65.57–141.36 degrees). Of them, 87.5% AEAs had an angle >90 degrees and 12.5% had an angle <90 degrees. The mean distance between AEA and skull base was 1.37 ± 1.98 mm (range: 0–8.35 mm). The AEA types in relation to skull base was type 1 (0–2 mm from skull base; 64.6%), type 2 (2–4 mm; 22.2%), type 3 (4–6 mm; 11.1%), and type 4 (>6 mm; 2.1%). The mean distance between the AEA and frontal sinus ostium was 9.17 ± 4.72 mm (range: 0–25.36 mm). AEA classification according to distance from AEA to frontal sinus ostium was 17.4% type 1 (<5 mm), 41.7% type 2 (5–10 mm), 31.9% type 3 (10–15 mm), and 9% type 4 (>15 mm). Conclusion Provided AEA details improve surgeons' awareness of AEA variations in the endoscopic field and can help residents in training.

scholarly journals Variability of the Anterior Ethmoid Artery in Endoscopic Sinus Surgery

2020 ◽  
pp. 014556132095048
Author(s):  
Mohamed A. Taha ◽  
Christian A. Hall ◽  
Harry E. Zylicz ◽  
Margaret B. Westbrook ◽  
William T. Barham ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Skull Base ◽  
Statistical Significance ◽  
Sinus Surgery ◽  
Preoperative Imaging ◽  
Computed Tomography Scans ◽  
Ethmoidal Artery ◽  
Anterior Ethmoidal Artery ◽  
The Right ◽  
Anterior Ethmoid Artery

Introduction: The anterior ethmoidal artery (AEA) demonstrates anatomic variability relative to its descent from the anterior skull base. Our study’s objective was to assess for correlation of AEA descent and laterality, in addition to correlation of AEA descent and the presence of supraorbital ethmoid cells (SOEC) and concha bullosae (CB). Method: A retrospective study was performed at a tertiary rhinology center from January 2019 to January 2020. Noncontrast maxillofacial computed tomography scans were examined independently by 2 fellowship trained rhinologists. The vertical distance from both left and right AEAs to the ipsilateral skull base were compared and correlated with the presence of ipsilateral SOEC and CB. Results: Computed tomography scans from 50 subjects were included. Mean age was 50.68 years (40% females). The distance of AEA to the skull base was greater on the left when compared to the right (62% vs 48%) ( P < .05). The left AEA had an average descent of 2.84 mm versus 1.78 mm on the right ( P < .05). An SOEC was present in 56% of cases. Thirty-eight percent of subjects had both SOEC and AEA descent on the right, while 52% of subjects had both on the left. This reached a statistical significance on both sides ( P < .05). Concha bullosa was present in 35% of cases, with both AEA descent and CB present in 16% on the right, and 32% on the left. Conclusion: The AEA displays variability in vertical descent from the skull base, with greater variability on the left. These findings implore vigilance with evaluation of preoperative imaging and during sinus surgery, especially in the presence of SOEC and CB.

Surgical Relevance of Pediatric Anterior Clinoid Process Maturation for Anterior Skull Base Approaches

2020 ◽  
Author(s):  
Robert C Rennert ◽  
Michael G Brandel ◽  
Jeffrey A Steinberg ◽  
Joel R Martin ◽  
David D Gonda ◽  
...  
Keyword(s):  
Skull Base ◽  
Age Groups ◽  
Anatomical Variations ◽  
Anterior Skull Base ◽  
High Resolution Computed Tomography ◽  
Anterior Clinoid Process ◽  
Patients Âgés ◽  
Optic Strut ◽  
Computed Tomography Scans ◽  
Remodeling Pattern

Abstract BACKGROUND Removal of the anterior clinoid process (ACP) can expand anterior skull base surgical corridors. ACP development and anatomical variations are poorly defined in children. OBJECTIVE To perform a morphometric analysis of the ACP during pediatric maturation. METHODS Measurements of ACP base thickness (ACP-BT), midpoint thickness (ACP-MT), length (ACP-L), length from optic strut to ACP tip (ACP-OS), pneumatization (ACP-pneumo), and the presence of an ossified carotico-clinoid ligament (OCCL) or interclinoid ligament (OIL) were made from high-resolution computed-tomography scans from 60 patients (ages 0-3, 4-7, 8-11 12-15, 16-18, and &gt;18 yr). Data were analyzed by laterality, sex, and age groups using t-tests and linear regression. RESULTS There were no significant differences in ACP parameters by laterality or sex, and no significant growth in ACP-BT or ACP-MT during development. From ages 0-3 yr to adult, mean ACP-L increased 49%, from 7.7 to 11.5 mm. The majority of ACP-L growth occurred in 2 phases between ages 0-3 to 8-11 and ages 16-18 to adult. Conversely, ACP-OS was stable from ages 0-3 to 8-11 but increased by 63% between ages 8-11 to adult. Variations in ACP morphology (OCCL/OIL/ACP-pneumo) were found in 15% (9/60) of scans. OCCL and OIL occurred in patients as young as 3 yrs, whereas ACP-pneumo was not seen in patients younger than 11 yrs. CONCLUSION The ACP demonstrates stable thickness and a complex triphasic elongation and remodeling pattern with development, the understanding of which may facilitate removal in patients &lt;12. Clinically relevant ACP anatomic variations can occur at any age.

International Frontal Sinus Anatomy Classification and Anatomic Predictors of Low-Lying Anterior Ethmoidal Arteries

2017 ◽  
Vol 31 (3) ◽  
pp. 174-176 ◽  
Author(s):  
Phayvanh P. Sjogren ◽  
Rajendra Waghela ◽  
Shaelene Ashby ◽  
Richard H. Wiggins ◽  
Richard R. Orlandi ◽  
...  
Keyword(s):  
Skull Base ◽  
Effect Size ◽  
Frontal Sinus ◽  
Pearson Correlation ◽  
Correlation Coefficients ◽  
Anterior Wall ◽  
Sinus Surgery ◽  
Type I ◽  
Ethmoidal Artery ◽  
Anterior Ethmoidal Artery

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.

The Roof of the Anterior Ethmoid: A Place of Least Resistance in the Skull Base

1989 ◽  
Vol 3 (4) ◽  
pp. 191-199 ◽  
Author(s):  
Josef Kainz ◽  
Heinz Stammberger
Keyword(s):  
Skull Base ◽  
Preoperative Planning ◽  
Frontal Plane ◽  
Ethmoid Sinus ◽  
Ct Scans ◽  
Critical Area ◽  
Serial Sections ◽  
Ethmoidal Artery ◽  
Anterior Ethmoidal Artery ◽  
Ethmoidal Arteries

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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