Endoscopic Anatomy of Middle Ethmoidal Artery
Background: To describe the incidence of middle ethmoidal artery and its anatomical nuances via endoscopic endonasal approach.
Methods: A cadaveric study was performed on 22 adult specimens. First, a frontal sinusotomy and ethmoidectomy were performed via an endoscopic endonasal approach (EEA) to fully expose the anterior skull base. Subsequently, the lamina papyracea and the bone of the canals covering the ethmoidal neurovascular bundles were removed to identify the anterior, middle, and posterior ethmoidal arteries. Presence, laterality and location of middle ethmoidal artery were recorded.
Results: Fourteen middle ethmoidal arteries were identified (10 right and 4 left), among 44 sides (22 specimens); thus, accounting for an incidence of 31.8%. Bilateral middle ethmoidal arteries were found in 3 of 22 specimens (14%). Endonasal endoscopy features of the middle ethmoidal artery were noted.
Conclusions: This is the first study assessing the anatomical features of the middle ethmoidal arteries from an endonasal endoscopic perspective. The findings of this research have clinical significance in guiding surgeries that involve the medial orbital wall, intractable epistaxis, and anterior skull base pathologies, as well as the endoscopic endonasal surgeries.