[Anterior ethmoidal artery at ethmoidal labyrinth: Bibliographical review of anatomical variants and references for endoscopic surgery].
BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Lisbona Alquezar
María Pilar
MP
Servicio de Otorrinolaringología, Hospital Universitario Miguel Servet, Zaragoza, España. mplisbona@hotmail.com
Fernández Liesa
Rafael
R
Lorente Muñoz
Asís
A
Pérez Delgado
Laura
L
Herrera Tolosana
Silvia
S
Tejero-Garcés Galve
Gloria
G
Guallar Larpa
María
M
Ortiz García
Alberto
A
D001158:Arteries / Q000033:anatomy & histology; D004724:Endoscopy; D005005:Ethmoid Sinus / Q000098:blood supply* / Q000601:surgery*; D006801:Humans