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The ethmoidal arteries: a cadaveric study based on cone beam computed tomography and endoscopic dissection
Marco Ferrari1, Luca Pianta2, Andrea Borghesi3
1Unit of Otorhinolaryngology-Head and Neck Surgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Largo Spedali Civili, 1, 25123, Brescia, Italy. 1990marcoferrari@gmail.com.
Surgical and Radiologic Anatomy : SRA
|March 17, 2017
Summary
Cone beam computed tomography (CBCT) accurately identifies ethmoidal arteries (EAs) and their position. However, CBCT has limitations in detecting bony canal dehiscence and the presence of the middle ethmoidal artery.
Area of Science:
- Anatomy
- Radiology
- Otorhinolaryngology
Background:
- Ethmoidal arteries (EAs) are crucial vascular structures in the nasal cavity.
- Variations in EA anatomy can pose surgical risks.
- Accurate preoperative assessment is vital for endoscopic sinus surgery.
Purpose of the Study:
- To detail the anatomical variability of anterior, middle, and posterior ethmoidal arteries (AEA, MEA, PEA).
- To assess the reliability of cone beam computed tomography (CBCT) for preoperative evaluation of EAs.
Main Methods:
- CBCT and endoscopic dissection were performed on 14 cadaver heads.
- Evaluated presence, cranio-caudal and antero-posterior positions, and bony canal dehiscence of AEA, MEA, and PEA.
- Calculated the accuracy of radiological assessment.
Main Results:
- AEA and PEA were consistently identified (100%), while MEA was found in 28.6%.
- CBCT demonstrated high accuracy in identifying EA presence and position, including variable antero-posterior locations.
- Dehiscence was noted in 46.4% (AEA), 12.5% (MEA), and 28.6% (PEA); CBCT had poor accuracy for dehiscence detection but high negative predictive value.
Conclusions:
- CBCT is adequate for identifying and localizing ethmoidal arteries.
- CBCT can effectively rule out the presence of MEA and ethmoidal canal dehiscence.
- The accuracy of CBCT in detecting specific anatomic variants like MEA and dehiscence was limited.
