TY - JOUR
T1 - Supraorbital ethmoid cell
T2 - A consistent landmark for endoscopic identification of the anterior ethmoidal artery
AU - Jang, David W.
AU - Lachanas, Vasileios A.
AU - White, Lauren C.
AU - Kountakis, Stilianos E.
N1 - Publisher Copyright:
© American Academy of Otolaryngology - Head and Neck Surgery Foundation 2014.
PY - 2014/12/4
Y1 - 2014/12/4
N2 - Objective. To demonstrate that the supraorbital ethmoid cell (SOEC) is a consistent and reliable landmark in identification of the anterior ethmoidal artery (AEA).Study Design. Retrospective radiographic study.Setting. Tertiary care rhinology practice.Subjects and Methods. The computed tomography (CT) scans for 78 consecutive patients were evaluated for the presence of SOECs, degree of pneumatization, and location of the AEA in relation to fixed anatomic structures. Forty-one patients with normal SOECs were identified and compared with a group of 15 patients with pathological expansion of the SOEC secondary to inflammatory disease. The CT findings were correlated with endoscopic findings.Results. The incidence of SOECs was 53%. Compared to normal SOECs, expanded SOECs had significantly greater pneumatization laterally (9.3 vs 18.5 mm, respectively; P < .0001) and AEAs that were significantly farther from the skull base (1.3 vs 6.6 mm, respectively; P <.0001). The distance between the AEA and the nasal beak was similar between the 2 groups (P = .1). More importantly, 68 of 68 sides with normal SOECs (100%) demonstrated the AEA within or in continuity with the posterior border of the SOEC opening. In patients with pathological expansion, the AEA remained within the posterior border of the SOEC opening in 19 of 19 sides (100%), despite significant expansion of the cell superolaterally.Conclusion. This is the first study to demonstrate a consistent landmark to identify the AEA even in cases of distorted anatomy of the frontal recess. Identifying the SOEC is a practical and reliable technique for minimizing the risk of injury to the AEA during frontal recess surgery.
AB - Objective. To demonstrate that the supraorbital ethmoid cell (SOEC) is a consistent and reliable landmark in identification of the anterior ethmoidal artery (AEA).Study Design. Retrospective radiographic study.Setting. Tertiary care rhinology practice.Subjects and Methods. The computed tomography (CT) scans for 78 consecutive patients were evaluated for the presence of SOECs, degree of pneumatization, and location of the AEA in relation to fixed anatomic structures. Forty-one patients with normal SOECs were identified and compared with a group of 15 patients with pathological expansion of the SOEC secondary to inflammatory disease. The CT findings were correlated with endoscopic findings.Results. The incidence of SOECs was 53%. Compared to normal SOECs, expanded SOECs had significantly greater pneumatization laterally (9.3 vs 18.5 mm, respectively; P < .0001) and AEAs that were significantly farther from the skull base (1.3 vs 6.6 mm, respectively; P <.0001). The distance between the AEA and the nasal beak was similar between the 2 groups (P = .1). More importantly, 68 of 68 sides with normal SOECs (100%) demonstrated the AEA within or in continuity with the posterior border of the SOEC opening. In patients with pathological expansion, the AEA remained within the posterior border of the SOEC opening in 19 of 19 sides (100%), despite significant expansion of the cell superolaterally.Conclusion. This is the first study to demonstrate a consistent landmark to identify the AEA even in cases of distorted anatomy of the frontal recess. Identifying the SOEC is a practical and reliable technique for minimizing the risk of injury to the AEA during frontal recess surgery.
KW - anterior ethmoidal artery
KW - endoscopic sinus surgery
KW - frontal recess
KW - supraorbital ethmoid cell
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U2 - 10.1177/0194599814551124
DO - 10.1177/0194599814551124
M3 - Article
C2 - 25257902
AN - SCOPUS:84914148459
SN - 0194-5998
VL - 151
SP - 1073
EP - 1077
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
IS - 6
ER -