Exploring the Anatomical Spatial Relationships affecting the Anterior and Posterior Ethmoid Foramina (AEF & PEF) using 3‐D Geometric Morphometric Technique

Abstract

Close relationships between ethmoid and maxillary sinuses, and orbital cavities have long challenged ENT surgeons. Identification of ethmoid vasculature (EV) in or adjacent to the frontal ethmoid suture line is critical in preventing intracranial entry and orbital hemorrhage during surgery. This study investigated influence of body size on spatial relationships among anterior ethmoid foramen (AEF) and posterior ethmoid foramen (PEF; which transmit arterial branches to ethmoid sinuses and meninges) and posterosuperior‐most point on the maxillary sinus roof (MSR). Ten hemi‐heads were harvested from donor bodies at SUNY Downstate. Each specimen was dissected to expose orbital cavity boundaries, infraorbital foramen, MSR, and zygomaticomaxillary suture. Landmark coordinate data were collected using a Microscribe digitizer & scaled (Procrustes scaling). Centroid size (sum of squared distances from each landmark to centroid) was used for size standardization. Results showed strong & negative correlations (p<0.05) between centroid size & distance between 1) AEF & PEF, 2) points on the orbital rim and the AEF and PEF, and 3) lateral‐most point on the orbital rim & MSR. Orbital width & height were similarly correlated with size (p<0.05) while no significance was revealed in MSR distance from the medial orbital wall. Orbital size appears to be the determining factor in changing relative positions of AEF & PEF.Grant Funding Source : SUNY Downstate Medical Center