Study of Anthropometric Measurements of the Anterior Ethmoidal Artery using Three-dimensional Scanning on 300 Patients

Abstract

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.

A Simple Clinical Application for Locating the Anterior Ethmoidal Artery Using the Anterior Ethmoidal Foramen and the Anterior Nasal Spine

“…One radiological study located the AEA by measuring the distance of the AEF from the ethmoid bulla and the frontal beak. 1 However, the accurate measurement of these distances during surgery is difficult. The ANS is a consistent anatomic landmark that has been used by surgeons to identify the anterior skull base 18 and the sphenoidal rostrum.…”

“…In the endonasal endoscopic view, finding the ethmoidal foramen is not easy; hence, it is necessary to identify correlations between the AEA and other structures to allow its safe identification. One radiological study located the AEA by measuring the distance of the AEF from the ethmoid bulla and the frontal beak 1. However, the accurate measurement of these distances during surgery is difficult.…”

“…It then reaches the ethmoidal sinus, passing through the bony anterior ethmoidal canal (AEC), finally getting into the olfactory fossa through the lateral lamella of the cribriform plate 5. The AEA exhibits considerable variability in terms of distance from the frontal sinus and the skull base1; it may be closely apposed to the skull base, or it may traverse the ethmoids, either freely or within a bony canal 6,7. Poor recognition of this variation places the artery at risk during ESS, as injury to the AEA may result in severe consequences such as massive hemorrhage, vision loss, periorbital or intraorbital hematoma, and cerebrospinal fluid rhinorrhea, among others 2,8.…”

Deep Learning Framework for Preoperative Recognition of Inverted Papilloma and Nasal Polyp

“…The LSN region, extending from plane of nasal floor (Figure 3, line C) to bottom of orbit (Figure 3, line B) [34], is largely occupied by maxillary sinus (spacious cavities) [35]. The USN region, extending from base of orbit to base of skull (Figure 3, line A) [36] harbors ethmoid, frontal, and sphenoid sinuses (small, irregular air cells) [5,37].…”

“…Near-absence of this assymetry in the training set has prevented accurate ROI detection by the network. The CT slice of Figure 8(b), from a patient with NP, has leaf-like features of IP [36]. This pattern interferes with model results, even if ROI is extracted accurately.…”