Morphometrics of the Anatomical Lacrimal‐Ethmoid Relationship: Examination of Racial Variation for Maxillectomy Surgical Procedures

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The medial maxillectomy operation is an aggressive surgical procedure directed at total en bloc extirpation of tumors that involve the ethmoid labyrinth and medial orbital wall. It is the procedure of choice for sinonasal tumors that extend to the cribriform plate, fovea ethmoidalis, and orbit. Determining the location of the ethmoidal blood vessels in or adjacent to the frontal ethmoid suture line is critical in preventing intracranial entry and orbital hemorrhage during surgery. Typically, a generic estimate of the distance from the lacrimal fossa to the frontal‐ethmoid suture is used to identify the anterior ethmoid artery (AEA) regardless of race. This morphometric study examines variation of the distance between dacryon to ethmoidal foramina in four continentally‐distinct human population groups (Inuit, German, West African, and Singaporean) (n=20). An urban population was also included to determine the variance of the measures (n=27). Results showed statistically significant differences between the African and Inuit groups (p < 0.05) while the Singaporeans and Africans clustered together as a whole. Given the high variance found in the measured distances between lacrimal and ethmoid craniofacial landmarks, consideration of polyethnic affinities may be essential to the correct calculation of surgical resection parameters.