anterior ethmoidal artery

The anterior ethmoid artery is a branch of the ophthalmic artery. It supplies the anterior and middle ethmoidal sinuses, frontal sinus, the lateral nasal wall and the nasal septum (see nasal cavity).

Gross anatomy

It traverses the anterior ethmoidal foramen with the anterior ethmoidal nerve (which is the continuation of the nasociliary nerve) before entering the anterior cranial fossa where it gives off meningeal and nasal branches. The nasal branches continue into the nasal cavity to supply the nasal septum where it contributes to the Kiesselbach’s plexus in addition to supplying the lateral nasal wall.

Radiographic features

The anterior ethmoidal artery is identified via identification of the anterior ethmoidal notch. This notch is reportedly seen in 95-100% of subjects.

Practical points

Location of the anterior ethmoidal artery should be reported by the radiologist on pre-operative studies. If the anterior ethmoidal notch is abutting the lateral lamella or the fovea ethmoidalis, the artery is considered protected during functional endoscopic sinus surgery as it is as the level of the skull base. If a supraorbital cell is seen above the anterior ethmoidal notch, or if the artery is located below the skull base, it is considered at risk.

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