Abdullah Baharudin, Lim Eng Haw, Husain Salina, Snidvongs Kornkiat, Wang De Yun
Department of Otolaryngology-Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia.
Department of Otorhinolaryngology-Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia.
Surg Radiol Anat. 2019 May;41(5):491-499. doi: 10.1007/s00276-018-2165-3. Epub 2018 Dec 12.
Anterior ethmoidal artery (AEA) is at risk of injury in endoscopic sinus surgery due to its location. The aim of this review was to assess the anatomical variations of AEA and their significance.
A literature search was performed on PUBMED, SCOPUS AND EMBASE. The following keywords were used: ethmoidal artery; anterior ethmoidal artery; anterior ethmoidal canal; ethmoid sinus; ethmoid roof; skull base. The search was conducted over a period of 6 months between October 2016 and April 2017.
105 articles were retrieved. 76 articles which were either case reports or unrelated topics were excluded. Out of the 29 full text articles retrieved, 16 articles were selected; 3 were cadaveric dissection, 5 combined cadaveric dissection and computed tomography (CT) and the rest were of CT studies. All studies were of level III evidence and a total of 1985 arteries were studied. Its position at the skull base was influenced by the presence of supraorbital ethmoid cell (SOEC) and length of the lateral lamella of cribriform plate (LLCP). Inter population morphological variations contribute to the anatomical variations.
The average diameter of AEA was 0.80 mm and the intranasal length was 5.82 mm. 79.2% was found between the second and third lamellae, 12.0% in the third lamella, 6% posterior to third lamella and 1.2% in the second lamella. Extra precaution should be taken in the presence of a well-pneumatized SOEC and a long LLCP as AEA tends to run freely below skull base.
由于其位置关系，筛前动脉（AEA）在内镜鼻窦手术中有受伤风险。本综述的目的是评估AEA的解剖变异及其意义。
在PUBMED、SCOPUS和EMBASE上进行文献检索。使用了以下关键词：筛动脉；筛前动脉；筛前管；筛窦；筛顶；颅底。检索在2016年10月至2017年4月的6个月期间进行。
检索到105篇文章。排除76篇病例报告或不相关主题的文章。在检索到的29篇全文文章中，选择了16篇；3篇为尸体解剖，5篇为尸体解剖与计算机断层扫描（CT）相结合，其余为CT研究。所有研究均为III级证据，共研究了1985条动脉。其在颅底的位置受眶上筛房（SOEC）的存在和筛板外侧薄板（LLCP）长度的影响。人群间的形态变异导致了解剖变异。
AEA的平均直径为0.80mm，鼻内长度为5.82mm。79.2%位于第二和第三薄板之间，12.0%在第三薄板内，6%在第三薄板后方，1.2%在第二薄板内。当存在气化良好的SOEC和长的LLCP时应格外小心，因为AEA往往在颅底下方自由走行。
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