Haw, Lim Eng
(2018)
The study of variability of the anterior ethmoidal artery in Hospital Universiti Sains Malaysia.
Masters thesis, Universiti Sains Malaysia.
Abstract
Objective: The aim of this study was to explore the variability of the anterior ethmoidal artery in
Malaysian population by using computed tomography.
Methodology: This was a cross sectional study of 252 computed tomography of the paranasal
sinuses acquired between 1st January 2014 and 31st December 2016. The multiplanar computed
tomography images were reconstructed to axial, coronal and sagittal view at 1 mm slice
thickness. The relationship of the artery with the skull base, the effect of the pneumatization of
ethmoid sinus on this relationship and the distances of the artery from important adjacent
reference points were assessed.
Results: The anterior ethmoidal foramen was seen in 100% of cases, whereas the anterior
ethmoidal canal was only seen in 34.1%. 42.5 % of the anterior ethmoidal artery was found
within the skull base, 20.2% at the skull base and the remaining 37.3% coursed freely below the
skull base. The prevalence of the supraorbital ethmoid cell and the suprabullar cell were 29.8%
and 48.0%, respectively. There was statistically significant association between the presence of
the supraorbital ethmoid cell and the position of the anterior ethmoidal artery at the skull base (p
< 0.001). The mean height of the lateral lamella of the cribriform plate was 3.74 1.01 mm. The
lateral lamella was 1-3 mm in 42.1% and 4-7 mm in 57.9%. With increase in the height of the
lateral lamella, the probability for the anterior ethmoidal artery to course freely within the
ethmoid sinus increases (p = 0.016). The mean distance of the anterior ethmoidal artery from the
skull base was 1.93 2.03 mm, from the orbital floor 21.91 2.47 mm and 49.01 3.53 mm
from the nasal floor.
Conclusion: This study provides a better understanding of the variability of the anterior
ethmoidal artery and its relationship with the skull base. We believe that these details are of
paramount importance as a guide for surgeons to ensure a safe endoscopic sinus surgery.
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