Purpose: To identify the anterior ethmoidal artery (AEA) of a skull specimen on CT prior to transnasal endoscopic surgical management of anterior epistaxis.
Materials and methods: From a medial canthotomy approach, the AEA was located and a marker placed on 9 skull specimens (18 AEA). CT with 2D reformations was then performed. The AEA were then dissected using an endoscopic anterior ethmoidectomy approach. The presence of AEA procidence was recorded.
Results: Correlation between CT and surgical findings allowed identification of 2 criteria predictive of AEA procidence: 1) presence of an ethmoid bulla above the AEA canal 2) AEA canal located below (not within) the ethmoid roof, anterior to the bulla.
Conclusion: High resolution CT depiction of the AEA provides information regarding its accessibility for endoscopic ligation in patients with severe anterior epistaxis as an alternative to external ligation while demonstrating the upper limit of the anterior ethmoid.