title: Endoscopic anatomy of the middle ethmoidal artery.
abstract: BACKGROUND
  The purpose of this study was to describe the incidence of the middle ethmoidal artery and its anatomical nuances via an endoscopic endonasal approach.
  
  
  METHODS
  A cadaveric study was performed on 22 adult specimens. First, a frontal sinusotomy and ethmoidectomy were performed via an endoscopic endonasal approach in order to fully expose the anterior skull base. Subsequently, the lamina papyracea and the bone of the canals covering the ethmoidal neurovascular bundles were removed to identify the anterior, middle, and posterior ethmoidal arteries. Presence, laterality, and location of the middle ethmoidal artery were recorded.
  
  
  RESULTS
  A total of 14 middle ethmoidal arteries were identified (10 right and 4 left), among 44 sides (22 specimens), accounting for an incidence of 31.8%. Bilateral middle ethmoidal arteries were found in 3 of 22 specimens (14%). Endonasal endoscopy features of the middle ethmoidal artery were noted.
  
  
  CONCLUSIONS
  This is the first study assessing the anatomical features of the middle ethmoidal arteries from an endonasal endoscopic perspective. The findings of this research have clinical significance in guiding surgeries that involve the medial orbital wall, intractable epistaxis, and anterior skull base pathologies, as well as endoscopic endonasal surgeries.
authors: Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center, The Ohio State University, Columbus, OH; Department of Otolaryngology-Head and Neck Surgery, 1st Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China.
authors: Liang
authors: L
authors: Wang
authors: Ahmed
authors: A
authors: Youseef
authors: Abdul Aziz
authors: AA
authors: Al Qahtani
authors: Ramazan
authors: R
authors: Gun
authors: Daniel M
authors: DM
authors: Prevedello
authors: Bradley A
authors: BA
authors: Otto
authors: Leo
authors: L
authors: Ditzel
authors: Ricardo L
authors: RL
authors: Carrau
mesh_terms: D000328:Adult; D001158:Arteries / Q000033:anatomy & histology* / Q000601:surgery; D002102:Cadaver; D004724:Endoscopy; D005005:Ethmoid Sinus / Q000098:blood supply / Q000601:surgery*; D006801:Humans; D009915:Orbit / Q000033:anatomy & histology* / Q000601:surgery; D019291:Skull Base / Q000033:anatomy & histology* / Q000601:surgery
keywords: endoscopy; ethmoid sinuses; ethmoidal artery; orbit; skull base; surgical anatomy