Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, Nelson R. Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban, 4001, KwaZulu-Natal, South Africa.
Department of Human Biology and Integrated Pathology, School of Medicine, Faculty of Health Sciences, Nelson Mandela University-Missionvale Campus, Gqeberha, 6059, Eastern Cape, South Africa.
Surg Radiol Anat. 2023 May;45(5):545-554. doi: 10.1007/s00276-023-03122-x. Epub 2023 Mar 20.
The anterior ethmoidal artery is a major surgical landmark that is susceptible to iatrogenic injury during surgery of the anterior ethmoidal sinus, frontal sinus, and skull base. The present study aimed to define the location of the anterior ethmoidal artery in relation to specific anatomical landmarks using radiological imaging and endoscopic dissection.
Eighty-six anterior ethmoidal arteries were assessed using computed tomography scans (bilateral analyses) and forty anterior ethmoidal arteries were assessed using cadaveric specimens (bilateral analyses). The skull base, anterior nasal spine, anterior axilla of the middle turbinate, and nasal axilla were morphometrically analysed to determine their reliability as anterior ethmoidal artery landmarks.
Distances to the skull base, anterior nasal spine, and nasal axilla displayed statistically significant differences between sexes and sides (p < 0.05). All landmarks demonstrated excellent reliability as anatomical landmarks for the localisation of the anterior ethmoidal artery, radiologically and endoscopically (ICC values ranged from 0.94 to 0.99).
The middle turbinate axilla was the most reliable landmark, due to the lack of statistically significant differences according to sex and laterality, and the high inter-rater agreement between measurements. Anatomical knowledge of variations and relationships observed in the present study can be applied to surgeries of the anterior ethmoidal sinus, frontal sinus, and skull base to improve localisation of the anterior ethmoidal artery, preoperatively and intraoperatively, and avoid iatrogenic injury of the vessel.
筛前动脉是在前筛窦、额窦和颅底手术中易受医源性损伤的重要手术标志。本研究旨在通过影像学和内镜解剖来确定筛前动脉与特定解剖标志的位置关系。
使用计算机断层扫描（双侧分析）评估了 86 条筛前动脉，使用尸体标本（双侧分析）评估了 40 条筛前动脉。对颅底、前鼻棘、中鼻甲前腋和鼻腋进行形态学分析，以确定它们作为筛前动脉标志的可靠性。
颅底、前鼻棘和鼻腋与性别和侧别之间的距离存在统计学差异（p<0.05）。所有标志在影像学和内镜下作为筛前动脉定位的解剖标志均具有良好的可靠性（ICC 值范围为 0.94 至 0.99）。
由于性别和侧别无统计学差异，以及测量值之间的高组内一致性，中鼻甲腋是最可靠的标志。本研究中观察到的变异和关系的解剖学知识可应用于前筛窦、额窦和颅底手术，以改善术前和术中筛前动脉的定位，避免血管的医源性损伤。
