title: [Endoscopic ligation of the anterior ethmoidal artery: a cadaver dissection study].
abstract: Anterior ethmoidal artery (AEA) ligation may be necessary in cases of severe epistaxis not controllable with traditional therapy. Endoscopic endonasal ligation of the AEA is not used frequently; there are few studies in the literature for standardization of the endoscopic technique for this vessel.
  
  
  OBJECTIVE
  To demonstrate the feasibility of periorbital AEA ligation in a transethmoidal endoscopic approach.
  
  
  METHODS
  A prospective study where 50 nasal cavities were dissected. After anterior ethmoidectomy and partial removal of lamina papyracea, the periorbital area was carefully dissected along a subperiosteal plane to identify the AEA. The vessel was exposed within the orbit and dissected.
  
  
  RESULTS
  Data on technical difficulties, complications, the learning curve and anatomical variations were gathered.
  
  
  CONCLUSIONS
  An endonasal endoscopic approach to the AEA within the orbit was shown to be feasible. Identifying the artery is not difficult, and this technique avoids external incisions. This approach appears to be an excellent alternative for approaching the AEA. Further clinical studies are needed to demonstarte the benefits of this technique.
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP. bcaf@terra.com.br
authors.forename: Bernardo Cunha
authors.initials: BC
authors.lastname: Araujo Filho
authors.forename: Carlos Diógenes
authors.initials: CD
authors.lastname: Pinheiro-Neto
authors.forename: Henrique Faria
authors.initials: HF
authors.lastname: Ramos
authors.forename: Richard Louis
authors.initials: RL
authors.lastname: Voegels
authors.forename: Luiz Ubirajara
authors.initials: LU
authors.lastname: Sennes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000033:anatomy & histology; D002102:Cadaver; D004210:Dissection / Q000379:methods*; D004724:Endoscopy / Q000379:methods* / Q000592:standards; D005005:Ethmoid Sinus / Q000098:blood supply* / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000601:surgery*; D011446:Prospective Studies