Anterior ethmoidal notch
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the notch can be identified bilaterally in 95-100% of patients on coronal reformats, and when not seen bilaterally is present unilaterally 1
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.