Anterior ethmoidal notch
Citation, DOI, disclosures and article data
At the time the article was created Henry Knipe had no recorded disclosures.
View Henry Knipe's current disclosuresAt the time the article was last revised Jeevan K Karuppannan had no financial relationships to ineligible companies to disclose.
View Jeevan K Karuppannan's current disclosuresThe anterior ethmoidal notch contains the anterior ethmoidal artery and has significant rates of anatomic variation that is seen during functional endoscopic sinus surgery (FESS).
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Gross anatomy
The anterior ethmoidal notch lies in the medial wall of the superomedial orbit, adjacent to the anterior ethmoid air cells.
Radiographic features
CT
the notch can be identified bilaterally in 95-100% of patients on coronal reformats, and when not seen bilaterally is present unilaterally 1
Related pathology
During FESS the anterior ethmoidal artery is considered "protected" if the notch is adjacent to the fovea ethmoidalis or lateral lamella. The anterior ethmoidal artery is at increased risk of injury during FESS if there are pneumatized supraorbital anterior ethmoid air cells (occurs in ~30% of patients) 1.
References
- 1. William T. O’Brien, Sr, Stefan Hamelin, Erik K. Weitzel. The Preoperative Sinus CT: Avoiding a “CLOSE” Call with Surgical Complications. (2016) Radiology. 281 (1): 10-21. doi:10.1148/radiol.2016152230 - Pubmed
- 2. Ding J, Sun G, Lu Y, Yu BB, Li M, Li L, Li GY, Peng ZH, Zhang XP. Evaluation of anterior ethmoidal artery by 320-slice CT angiography with comparison to three-dimensional spin digital subtraction angiography: initial experiences. (2012) Korean journal of radiology. 13 (6): 667-73. doi:10.3348/kjr.2012.13.6.667 - Pubmed
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