title: Pre-caruncular approach to the medial orbit and landmarks for anterior ethmoidal artery ligation: a cadaveric study.
abstract: OBJECTIVE
  In epistaxis and skull base surgery, the anterior ethmoidal artery sometimes needs to be ligated. We describe a novel, quick and scar-free surgical technique to ligate this artery with salient landmarks allowing rapid identification.
  
  
  METHODS
  Twenty medial orbital walls from 10 randomly selected fresh-frozen, non-formalinised cadaver heads were examined. Dissection was performed by a pre-caruncular external approach to expose the AEA in all cases.
  
  
  RESULTS
  The Horner's muscle and nasion, two salient landmarks, have been identified for use during the pre-caruncular approach.
  
  
  CONCLUSIONS
  The pre-caruncular approach is a novel combined open and endoscopic surgical approach to the anterior ethmoidal artery. It is a simple, quick and scar-free technique. The identification of the artery is easy when using the two anatomic landmarks we describe in our study, that is Horner's muscle and the nasion.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck surgery, University of Cape Town, Cape Town, South Africa.
authors.forename: M M K
authors.initials: MM
authors.lastname: Cornelis
authors.affiliation: Department of Otorhinolaryngology, Head and Neck surgery, University of Cape Town, Cape Town, South Africa.
authors.forename: D E
authors.initials: DE
authors.lastname: Lubbe
mesh_terms: D002102:Cadaver; D004210:Dissection; D004844:Epistaxis / Q000601:surgery*; D005005:Ethmoid Sinus / Q000098:blood supply / Q000601:surgery*; D005260:Female; D006801:Humans; D008026:Ligation; D008297:Male; D009915:Orbit / Q000601:surgery*