Anatomic variation of alveolar antral artery

The alveolar antral artery (AAA) was unanimously encountered in a few available studies with an intraosseous course to anastomose with the infraorbital artery. We report here two cases in which dissection revealed an extraosseous placement of this artery, between the lateral wall of the maxillary sinus and the Schneiderian membrane. The frequency of occurrence of the intraosseous anastomosis should be so modified from 100% to < 100%. This arterial course over the Schneiderian membrane is important during surgical procedures: if it is identified preoperatively it can be avoided, or ligaturated, if not, it may be accidentally severed and uncomfortable haemorrhage may disturb the surgical procedure. In the first case reported here hybrid morphology of the AAA was also found, demonstrating that arterial anatomy should be considered with caution, on a case-by-case basis.