New landmarks in endonasal surgery: from nasal bone to anterior cribriform plate including branches of anterior ethmoidal artery and nerve and terminal nerve

Autor:	Clément Escalard, Vincent Patron, Sylvain Moreau, Martin Hitier, Emmanuèle Lechapt, Lise-Marie Roussel, Didier Goux, Vincent Beaudouin, Eric Maubert
Rok vydání:	2020
Předmět:	Male Natural Orifice Endoscopic Surgery medicine.medical_specialty Dura mater Ophthalmic Nerve Cribriform plate Ophthalmic Artery 03 medical and health sciences 0302 clinical medicine Anterior ethmoidal artery medicine.artery Cadaver otorhinolaryngologic diseases medicine Foramen Humans Immunology and Allergy Nasal Bone 030223 otorhinolaryngology Aged Skull Base Frontal sinus business.industry Dissection Nasal bone Surgery Ethmoid Bone Skull medicine.anatomical_structure 030228 respiratory system Otorhinolaryngology Female Anterior ethmoidal nerve business
Zdroj:	International Forum of Allergy & Rhinology. 10:395-404
ISSN:	2042-6984 2042-6976
DOI:	10.1002/alr.22480
Popis:	Background Despite the development of anterior skull base surgery, the anatomy of the nasal bone and anterior cribriform plate remains unclear. A recent study confirmed 2 distinct foramina in the anterior part of cribriform plate: the ethmoidal slit (ES) and the cribroethmoidal foramen (CF). The aim of this study was to specify their content, their anatomic relationship to the frontal sinus and skull base, and their potential value in skull base surgery. Methods Dissections were performed on 36 cadaver heads. Macro- and microscopic examinations were carried out. Microcomputed tomography scans contrasted with osmium were performed to identify vessels and nerves. Histology with neural, meningeal, or luteinizing hormone-releasing hormone immunomarkers was performed on the content of the foramina. Finally, endonasal surgical dissections were carried out. Results The ES and the CF were observed in all cases. They measured a mean of 4.2 and 1.6 mm, respectively. The ES contained dura mater, arachnoid tissues, lymphatics, and the terminal nerve. The CF contained the anterior ethmoidal nerve and artery. This foramen continued forward with the cribroethmoidal groove, which measured a mean of 2.5 mm. This groove was under the frontal sinus and in front of the skull base. We also described a "cribroethmoidal canal" and a "nasal bone foramen." Conclusion The clinical applications of this new anatomic description concern both cribriform plate and frontal sinus surgeries. Identifying the terminal nerve passing through the ES is a step forward in understanding pheromone recognition in humans.
Databáze:	OpenAIRE
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