Lisbona Alquezar María Pilar, Fernández Liesa Rafael, Lorente Muñoz Asís, Pérez Delgado Laura, Herrera Tolosana Silvia, Tejero-Garcés Galve Gloria, Guallar Larpa María, Ortiz García Alberto
Servicio de Otorrinolaringología, Hospital Universitario Miguel Servet, Zaragoza, España.
Acta Otorrinolaringol Esp. 2010 May-Jun;61(3):202-8. doi: 10.1016/j.otorri.2010.01.002. Epub 2010 Mar 30.
The anterior ethmoidal artery (AEA) has a trajectory with multiple anatomical variations. In addition, there are no clear references to locate it, so it is easy to produce an iatrogenic lesion. The goal of this study was to carry out a bibliographical review to analyse variants and endoscopic reference reports in the scientific literature.
A review in Medline and Embase data bases was carried out, looking for AEA-related anatomical and radiological studies. After the revision, the principal study results, together with several distances and angles useful for locating the AEA, are presented in this study.
There were 13 main articles that analysed a total of 1388 AEA. It was absent from 2 to 14%. It was identifiable in computed tomography (CT) between 95 and 100%. It was located between the second and third ethmoidal lamella in 74.2% and at the skull base level in 66.6%. Ethmoidal sinuses pneumatisation was related to AEA location at the skull base. Between 83 and 85.3%, it was found at the suprabullar recess.
CT is useful for presurgery planning. AEA are more frequent between the second and third lamella and at skull level. Ethmoidal pneumatisation and Keros grades could be predictive factors for AEA relationship with the skull base level. The AEA, the axilla of the middle turbinate and the superomedial edge of the nose are in a straight line, being a simple and useful reference in endoscopic sinus surgery.
筛前动脉（AEA）走行存在多种解剖变异。此外，目前尚无明确的定位参考，因此容易产生医源性损伤。本研究的目的是进行文献综述，分析科学文献中AEA的变异及内镜参考报道。
对Medline和Embase数据库进行检索，查找与AEA相关的解剖学和放射学研究。经筛选后，本研究呈现了主要研究结果以及一些有助于定位AEA的距离和角度。
共有13篇主要文章分析了总计1388条AEA。其缺如率为2%至14%。在计算机断层扫描（CT）中其可识别率为95%至100%。74.2%位于第二和第三筛骨薄板之间，66.6%位于颅底水平。筛窦气化与AEA在颅底的位置有关。83%至85.3%位于泡上隐窝。
CT有助于术前规划。AEA在第二和第三薄板之间以及颅底水平更为常见。筛窦气化和凯罗斯分级可能是AEA与颅底水平关系的预测因素。AEA、中鼻甲腋部和鼻的上内侧缘在一条直线上，是鼻内镜手术中简单且有用的参考标志。
