The Complete Anatomy of the Anterior Ethmoidal Artery: A Meta-Analysis with Implications for Sinus and Skull Base Surgery

Szczepanek, Elżbieta; Toppich, Julia; Ostrowski, Patryk; Bonczar, Michał; Nasser, Ameen; Dziedzic, Martyna; Walocha, Jerzy; Koziej, Mateusz

doi:10.3390/jcm13061695

Open AccessSystematic Review

The Complete Anatomy of the Anterior Ethmoidal Artery: A Meta-Analysis with Implications for Sinus and Skull Base Surgery

by

Elżbieta Szczepanek

^1,2,

Julia Toppich

^1,3,

Patryk Ostrowski

^1,3,*

,

Michał Bonczar

^1,3

,

Ameen Nasser

^1,3

,

Martyna Dziedzic

^1,3,

Jerzy Walocha

^1,3 and

Mateusz Koziej

^1,3,*

¹

Department of Anatomy, Jagiellonian University Medical College Cracow, 31-034 Kraków, Poland

²

Doctoral School in Medical Sciences and Health Sciences, Jagiellonian University Medical College, 31-008 Kraków, Poland

³

Youthoria, Youth Research Organization, 31-127 Kraków, Poland

^*

Authors to whom correspondence should be addressed.

J. Clin. Med. 2024, 13(6), 1695; https://doi.org/10.3390/jcm13061695

Submission received: 13 February 2024 / Revised: 9 March 2024 / Accepted: 13 March 2024 / Published: 15 March 2024

(This article belongs to the Special Issue State of the Art—Treatment of Skull Base Diseases)

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Abstract

Background: The anatomical characteristics of the anterior ethmoidal artery (AEA) exhibit a high degree of variability, especially regarding its topography. Methods: PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Google Scholar were searched to identify all studies that included information regarding the morphometric and topographical characteristics of the AEA. Results: Ultimately, a compilation of 38 studies meeting the predetermined criteria, and possessing comprehensive and pertinent data, were incorporated into the current meta-analysis. In the overall analysis, reports of the AEA being embedded within the skull base or at the level of the skull base producing a bony protrusion were found in 56.91% of cases (95% CI: 43.55–69.80%). The mean diameters of the AEA in the intraorbital and intracranial areas were 0.94 mm and 0.76 mm, respectively. Moreover, the artery coursed most commonly between the second and third lamellae, with a prevalence of 65.82% (95% CI: 55.39–75.56%). Conclusions: The AEA may be at a high risk of iatrogenic injury during various sinus and skull base surgeries, especially if the surgeon performing these procedures is unfamiliar with the vast number of variations this vessel may exhibit. The spatial relationship between this vessel and the skull base is especially variable, and understanding this variability goes hand in hand with intraoperative safety.

Keywords: anterior ethmoidal artery; skull base; sinus; surgery; anatomy

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MDPI and ACS Style

Szczepanek, E.; Toppich, J.; Ostrowski, P.; Bonczar, M.; Nasser, A.; Dziedzic, M.; Walocha, J.; Koziej, M. The Complete Anatomy of the Anterior Ethmoidal Artery: A Meta-Analysis with Implications for Sinus and Skull Base Surgery. J. Clin. Med. 2024, 13, 1695. https://doi.org/10.3390/jcm13061695

AMA Style

Szczepanek E, Toppich J, Ostrowski P, Bonczar M, Nasser A, Dziedzic M, Walocha J, Koziej M. The Complete Anatomy of the Anterior Ethmoidal Artery: A Meta-Analysis with Implications for Sinus and Skull Base Surgery. Journal of Clinical Medicine. 2024; 13(6):1695. https://doi.org/10.3390/jcm13061695

Chicago/Turabian Style

Szczepanek, Elżbieta, Julia Toppich, Patryk Ostrowski, Michał Bonczar, Ameen Nasser, Martyna Dziedzic, Jerzy Walocha, and Mateusz Koziej. 2024. "The Complete Anatomy of the Anterior Ethmoidal Artery: A Meta-Analysis with Implications for Sinus and Skull Base Surgery" Journal of Clinical Medicine 13, no. 6: 1695. https://doi.org/10.3390/jcm13061695

APA Style

Szczepanek, E., Toppich, J., Ostrowski, P., Bonczar, M., Nasser, A., Dziedzic, M., Walocha, J., & Koziej, M. (2024). The Complete Anatomy of the Anterior Ethmoidal Artery: A Meta-Analysis with Implications for Sinus and Skull Base Surgery. Journal of Clinical Medicine, 13(6), 1695. https://doi.org/10.3390/jcm13061695

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The Complete Anatomy of the Anterior Ethmoidal Artery: A Meta-Analysis with Implications for Sinus and Skull Base Surgery

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