title: Three-dimensional evaluation of the danger zone of ethmoidal foramens on the frontoethmoidal suture line on the medial orbital wall.
abstract: BACKGROUND
  It is clear that the importance of the ethmoidal foramen (EF) is based on its vascular contents. The frontoethmoidal suture (FS) line is recommended as more reliable navigational landmark for identifying the EF.
  
  
  METHODS
  The vertical orientation between the EF and the FS line was studied in 188 orbits using a computer software program.
  
  
  RESULTS
  146 anterior EFs (77.7 %) and 42 anterior EFs (22.3 %) were situated in the FS line as intrasutural and extrasutural, respectively. 146 posterior EFs (77.25 %) and 8 posterior EFs (4.25 %) were presented as intrasutural and extrasutural, respectively. Although accessory EFs were detected in 25.5 % specimen exhibited an extrasutural location. Majority of the EFs (1-4 EFs) were situated on the FS line. The mean distances from the FS and the anterior EF, the posterior EF and the accessory EF were measured as 2.1 ± 0.5, 2.0 ± 1.5 and 2.3 ± 1.2 mm, respectively. The range of the distances from the FS to the anterior EF, posterior EF and accessory EF were -1.2 to 3.32 , -1.02 to 5.76 and -1.1 to 3.65 mm, respectively.
  
  
  CONCLUSIONS
  The ranges of EF changed within 1-6 mm. As the FS is not a single point, it is more suitable to make the incision 7 mm above the suture line. The data from this study to help the orbital surgeons explain and avoid unexpected hemorrhage during the orbital procedures such as posttraumatic orbital reconstruction, orbital tumor resections, anterior skull base reconstruction, and orbital decompression surgery.
authors.affiliation: Department of Anatomy, Faculty of Dentristry, Kirikkale University, Kirikkale, Turkey.
authors.forename: Zuhal
authors.initials: Z
authors.lastname: Kazak
authors.affiliation: Department of Anatomy, Faculty of Medicine, Ege University, 35100, Izmir, Turkey.
authors.forename: Servet
authors.initials: S
authors.lastname: Celik
authors.affiliation: Department of Anatomy, Faculty of Medicine, Ege University, 35100, Izmir, Turkey.
authors.forename: Mehmet Asim
authors.initials: MA
authors.lastname: Ozer
authors.affiliation: Department of Anatomy, Faculty of Medicine, Ege University, 35100, Izmir, Turkey. figen.govsa@ege.edu.tr.
authors.forename: Figen
authors.initials: F
authors.lastname: Govsa
mesh_terms: D005004:Ethmoid Bone / Q000033:anatomy & histology*; D006801:Humans; D021621:Imaging, Three-Dimensional; D009915:Orbit / Q000033:anatomy & histology*
keywords: Anterior ethmoidal artery; Anterior ethmoidal foramen; Epistaxis; Frontoethmoidal suture; Intraorbital hematoma; Posterior ethmoidal artery; Posterior ethmoidal foramen