Asymmetry of the anterior ethmoidal artery in relation to the anterior skull base: a population-based study of 500 arteries

Bernard Beraldin; Gustavo Rassier Isolan; Lucas Rodrigues Mostardeiro; Vagner Antonio Rodrigues Silva; Joel Lavinsky

doi:10.1016/j.bjorl.2024.101412

Asymmetry of the anterior ethmoidal artery in relation to the anterior skull base: a population-based study of 500 arteries

Braz J Otorhinolaryngol. 2024 Mar 1;90(3):101412. doi: 10.1016/j.bjorl.2024.101412. Online ahead of print.

Authors

Bernard Beraldin¹, Gustavo Rassier Isolan², Lucas Rodrigues Mostardeiro³, Vagner Antonio Rodrigues Silva⁴, Joel Lavinsky⁵

Affiliations

¹ Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil. Electronic address: bernardberaldin1501@gmail.com.
² Faculdade Evangélica Mackenzie do Paraná, CEANNE Brasil, Porto Alegre, RS, Brazil.
³ Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.
⁴ Universidade de Campinas (Unicamp), Faculdade de Ciências Médicas (FCM), Departamento de Otorrinolaringologia, Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil.
⁵ Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-graduação em Cirurgia, Porto Alegre, RS, Brazil.

Abstract

Objective: To analyze variability in the distance between the Anterior Ethmoidal Artery (AEA) and the anterior Skull Base (SB), as well as the frequency of lateral asymmetry in a Latin American population using computed tomography.

Methods: A total of 250 computed tomography scans of paranasal sinuses in coronal reconstruction (500 AEAs) were analyzed. After determining the image with the best anatomical view of the artery, the distance between its midpoint and the ethmoidal roof was measured, and the images were independently interpreted by 2 physicians.

Results: Of the 500 AEAs, 279 (55.8%) adhered to or passed through the SB at a distance of 0mm. A total of 221 AEAs (44.2%) were at some distance from the SB, of which 107 (48.4%) were on the right side, ranging from 1.18 to 6.75mm, and 114 (51.5%) were on the left side, ranging from 1.15 to 6.04mm. The overall mean distance between the AEA and SB was 1.22 (SD=1.57) mm, increasing to 2.77 (SD=1.14) when the arteries adhered to the SB were excluded. Seventy-six individuals (30.4%) had a lateral distance variation > 1mm.

Conclusion: Our study includes the largest sample of AEA analyzed with computed tomography scans of paranasal sinuses. There was some distance between the AEA and SB in almost half the patients, and we found a high rate of lateral variability >1mm.

Level of evidence: Level 3.

Keywords: Computed tomography; Epistaxis; Paranasal sinuses; Skull base.