Surgical Anatomy of the Ethmoidal Arteries: A Laboratory Study of 150 Orbits

Abstract

Hemorrhage from the upper portion of the nasal chamber can usually be controlled by ligating the anterior ethmoidal artery at its point of entrance into the anterior ethmoidal foramen. This landmark is usually located in the frontoethmoid suture line, where it can be exposed by elevating the periosteum along the medial wall of the orbit. While elevating this periosteum in his search for the foramen, the surgeon may inadvertently stretch the anterior ethmoidal artery to the point of tearing it. The resultant bleeding may be difficult to control because of the vessel's tendency to retract into the bony canal on one side and into the orbital soft tissue on the other. In an attempt to determine whether anatomical variations within the orbit facilitate or complicate the surgical access to the ethmoidal arteries, or whether other dependable landmarks exist which might facilitate their exposure and ligation, we studied 80 orbits