The site of the Media Sphera Publishers contains materials intended solely for healthcare professionals.
By closing this message, you confirm that you are a certified medical professional or a student of a medical educational institution.

Login
EN
+7 (495) 482-4118
+7 (495) 482-0604
+8 800 250-18-12
  • (toll-free number for subscriptions)
    Mon-Fri from 10 a.m. to 6 p.m.

  • © 1998-2025
+7 (495) 482-43-29
EN
All journals
Journal
Year
Year
Search result: 0

Gol'bin D.A.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Shkarubo M.A.

Burdenko Neurosurgical Institute, Moscow, Russia

Lasunin N.V.

FGBU "NII neĭrokhirurgii im. N.N. Burdenko" RAMN, Moskva

Cherekaev V.A.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Grigor'eva N.N.

FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva

Serova N.K.

NII neĭrokhirurgii im. N.N. Burdenko RAMN, Moskva

Tarkhnishvili G.S.

Khimki Forensic Medical Examination Unit of the Moscow Region Forensic Medical Examination Bureau, Moscow Region, Russia

An anatomical study on the applicability of direct endoscopic exclusion of the ethmoid arteries for devascularization of the anterior skull base structures

Authors:

Gol'bin D.A., Shkarubo M.A., Lasunin N.V., Cherekaev V.A., Grigor'eva N.N., Serova N.K., Tarkhnishvili G.S.

More about the authors

Journal: Burdenko's Journal of Neurosurgery. 2019;83(1): 29‑39

DOI: 10.17116/neiro20198301129

Read: 3108 times

Download PDF (RU)
Download PDF
Contact the author
Table of contents

AN ANATOMICAL STUDY ON THE APPLICABILITY OF DIRECT ENDOSCOPIC EXCLUSION OF THE ETHMOID ARTERIES FOR DEVASCULARIZATION OF THE ANTERIOR SKULL BASE STRUCTURES
AN ANATOMICAL STUDY ON THE APPLICABILITY OF DIRECT ENDOSCOPIC EXCLUSION OF THE ETHMOID ARTERIES FOR DEVASCULARIZATION OF THE ANTERIOR SKULL BASE STRUCTURES

To cite this article:

Gol'bin DA, Shkarubo MA, Lasunin NV, Cherekaev VA, Grigor'eva NN, Serova NK, Tarkhnishvili GS. An anatomical study on the applicability of direct endoscopic exclusion of the ethmoid arteries for devascularization of the anterior skull base structures. Burdenko's Journal of Neurosurgery. 2019;83(1):29‑39. (In Russ., In Engl.)
https://doi.org/10.17116/neiro20198301129

Подписка 2025 Журнал «Вопросы нейрохирургии» имени Н.Н. Бурденко (Burdenko's Journal of Neurosurgery)
 
МСФ на ЯМ
Использование инфографики авторами научных работ
Close metadata
Recommended articles:
Endo­scopic methods of treatment of benign stenosis of the trachea. Endo­scopic Surgery. 2024;(5):59-65
Early dete­ction of gastrointestinal cancer: oppo­rtunities for the deve­lopment of endo­scopic services in the Russian Fede­ration. Russian Journal of Evidence-Based Gastroenterology. 2024;(4):69-80
The first expe­rience of using an auto­graft from the wide fascia of the thigh for closing oroantral fistula. Stomatology. 2025;(1):17-22
Transluminal extraction of intramural duodenal wall calculus after videolaparoscopic cholecystectomy. Endo­scopic Surgery. 2025;(2):50-55
Evaluating the effi­cacy of the Kyoto classification of gastritis in diagnosing Heli­cobacter pylori infe­ction. Russian Journal of Evidence-Based Gastroenterology. 2025;(1):29-38
Diagnosis and treatment of three synchronous early squamous cell carcinomas of the esophagus: case report. Russian Journal of Evidence-Based Gastroenterology. 2025;(1):104-110
Endo­scopic cystogastrostomy in children (clinical series). Russian Journal of Evidence-Based Gastroenterology. 2025;(1):111-117
Modern methods of diagnosis and endo­scopic treatment Zenker’s dive­rticulum. Endo­scopic Surgery. 2025;(3):36-43
Functional dyspepsia: approaches to diagnosis and treatment in the context of Russian clinical practice. Russian Journal of Evidence-Based Gastroenterology. 2025;(2):43-49
Complications in diagnostic and therapeutic endo­scopic procedures on the lower gastrointestinal tract. Collegial discussion of info­rmed consent by the Asso­ciation of Quality Care Expe­rts. Russian Journal of Evidence-Based Gastroenterology. 2025;(2):94-105
Abstract:

The anterior skull base structures are the site of initial growth of histologically different tumors. The difficulties in their removal are often associated with significant vascularization, which may limit the amount of resection due to abundant intraoperative blood loss. Midline tumors are primarily fed by the ethmoid arteries that are not accessible to embolization. The aim of this work was a comparative experimental study of various direct approaches to the ethmoid arteries. Material and methods. The study was conducted on anatomical specimens of 12 cadaveric heads of deceased people without pathology of the anterior skull base structures, orbits, nasal cavity, and paranasal sinuses (24 sides). In all specimens, the internal and external carotid arteries were stained with silicone. During anatomical dissection, four surgical approaches for exclusion of the ethmoid arteries were studied: 1) transorbital approach to the arteries using a bicoronal incision; 2) endoscopic retro-caruncular approach; 3) endoscopic endonasal transethmoidal approach to the ethmoid artery canals; 4) endoscopic endonasal transethmoidal transorbital approach to the ethmoid arteries in the orbit. Results. We described a surgical technique for exclusion of the ethmoid arteries using the approaches and analyzed their advantages and disadvantages. We formulated an algorithm for choosing the method for direct endoscopic exclusion of the ethmoid arteries, depending on the surgical approach chosen for removal of the tumor and features of the tumor extracranial spread. Conclusion. The decision on tumor devascularization is based on assessment of tumor blood supply (CT angiography or MR angiography data). Our study demonstrated the advantages and disadvantages of various approaches to the ethmoid arteries for their exclusion in order to early devascularize anterior skull base tumors. All these approaches are less traumatic and characterized by a good cosmetic and functional outcome.

Keywords:

skull base tumor
anterior cranial fossa
endoscopy
ethmoid arteries
devascularization
surgical approach

Authors:

Gol'bin D.A.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Shkarubo M.A.

Burdenko Neurosurgical Institute, Moscow, Russia

Lasunin N.V.

FGBU "NII neĭrokhirurgii im. N.N. Burdenko" RAMN, Moskva

Cherekaev V.A.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Grigor'eva N.N.

FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva

Serova N.K.

NII neĭrokhirurgii im. N.N. Burdenko RAMN, Moskva

Tarkhnishvili G.S.

Khimki Forensic Medical Examination Unit of the Moscow Region Forensic Medical Examination Bureau, Moscow Region, Russia

Close metadata

References:

  1. Solero CL, Giombini S, Morello G. Suprasellar and olfactory meningiomas. Report on a series of 153 personal cases. Acta Neurochir (Wien). 1983;67(3-4): 181-194.
  2. Mirimanoff R, Dosoretz DE, Linggood RM, Ojemann RG, Martuza RL. Meningioma: analysis of recurrence and progression following neurosurgical resection. J Neurosurg. 1985;62(1):18-24. https://doi.org/10.3171/jns.1985.62.1.0018
  3. Al-Mefty O. Tuberculum sella and olfactory groove meningiomas. In: Sekhar LN, Janecka IP, eds. Surgery of Cranial Base Tumors. New York: Raven Press; 1993:507-519.
  4. Aguiar PH, Almeida N. Surgery of olfactory groove meningiomas. In: Ramina R, Henrique P, Agiular P, Tatagiba M, eds. Samii’s essentials in neurosurgery. Berlin-Heidelberg: Springer-Verlag, 2008;67-77.
  5. Spektor S, Valarezo J, Fliss DM, Gil Z, Cohen J, Goldman J, Umansky F. Olfactory groove meningiomas from neurosurgical and ear, nose, and throat perspectives: approaches, techniques, and outcomes. Neurosurgery. 2005;57(4 Suppl.):268-280.
  6. Hentschel SJ, DeMonte F. Olfactory groove meningiomas. Neurosurg Focus. 2003;14(6):e4.
  7. Rosen CL, Ammerman JM, Sekhar LN, Bank WO. Outcome analysis of preoperative embolization in cranial base surgery. Acta Neurochir (Wien). 2002;144(11):1157-1164. https://doi.org/10.1007/s00701-002-0965-y
  8. Barzaghi LR, Spina A, Gagliardi F, Boari N, Mortini P. Trans-frontal-sinus-subcranial approach to olfactory groove meningiomas: surgical results, clinical and functional outcome in a consecutive series of 21 patients. World Neurosurg. 2017;101:315-324. https://doi.org/10.1016/j.wneu.2017.02.039
  9. Manjila S, Cox EM, Smith GA, Corriveau M, Chhabra N, Johnson F, Geertman RT Extracranial ligation of ethmoidal arteries before resection of giant olfactory groove or planum sphenoidale meningiomas: 3 illustrative cases with a review of the literature on surgical techniques. Neurosurg Focus. 2013;35(6):E13. https://doi.org/10.3171/2013.10.FOCUS13327
  10. Rosen MR, Rabinowitz MR, Farrell CJ, Schaberg MR, Evans JJ. Septal transposition: a novel technique for preservation of the nasal septum during endoscopic endonasal resection of olfactory groove meningiomas. Neurosurg Focus. 2014;37:E6. https://doi.org/10.3171/2014.7.FOCUS14308
  11. Pepper JP, Hecht SL, Gebarski SS, Lin EM, Sullivan SE, Marentette LJ. Olfactory groove meningioma: discussion of clinical presentation and surgical outcomes following excision via the subcranial approach. Laryngoscope. 2011;121(11):2282-2289. https://doi.org/10.1002/lary.22174
  12. Lund VJ. Malignant sinus tumors. In: Kennedy D, Hwang P, eds. Rhinology. Diseases of the nose, sinuses, and skull base. New York, NY: Thieme medical publishers, Inc., 2012:409-424.
  13. Wagenmann M, Schipper J. The transnasal approach to the skull base. From sinus surgery to skull base surgery. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2011;10:Doc08. https://doi.org/10.3205/cto000081
  14. Oostra A, van Furth W, Georgalas C. Extended endoscopic endonasal skull base surgery: from the sella to the anterior and posterior cranial fossa. ANZ J Surg. 2012;82(3):122-130. https://doi.org/10.1111/j.1445-2197.2011.05971.x
  15. Lehmberg J. Endoscopic transnasal surgery for pure intradural lesions—balance between advantages and disadvantages. Acta Neurochir (Wien). 2011;153(1):10-11. https://doi.org/10.1007/s00701-010-0789-0
  16. Lee JH, ed. Meningiomas. Diagnosis, treatment, and outcome. London: Springer-Verlag; 2009. https://doi.org/10.1007/978-1-84628-784-8
  17. Nania A, Granata F, Vinci S, Pitrone A, Barresi V, Morabito R, Settineri N, Tomasello F, Alafaci C, Longo M. Necrosis score, surgical time, and transfused blood volume in patients treated with preoperative embolization of intracranial meningiomas. Analysis of a single-centre experience and a review of literature. Clin Neuroradiol. 2014;24(1):29-36. https://doi.org/10.1007/s00062-013-0215-0
  18. Quinones-Hinojosa A, ed. Schmidek and Sweet operative neurosurgical techniques. Indications, methods, and results. 6th edition. Philadelphia: Saunders; 2012.
  19. Macpherson P. The value of pre-operative embolisation of meningioma estimated subjectively and objectively. Neuroradiology. 1991;33(4):334-337. https://doi.org/10.1007/BF00587818
  20. Dean BL, Flom RA, Wallace RC, Khayata MH, Obuchowski NA, Hodak JA, Zabramski JM, Spetzler RF. Efficacy of endovascular treatment of meningiomas: evaluation with matched samples. AJNR. 1994;15(9):1675-1680.
  21. Arustamyan SR. Superselective embolization of extraintracranial tumors: PhD thesis. M. 2002. (In Russ.).
  22. Bendszus M, Rao G, Burger R, Schaller C, Scheinemann K, Warmuth-Metz M, Hofmann E, Schramm J, Roosen K, Solymosi L. Is there a benefit of preoperative meningioma embolization? Neurosurgery. 2000;47(6):1306-1312. https://doi.org/10.1227/00006123-200108000-00050
  23. Terada T, Kinoshita Y, Yokote H, Tsuura M, Itakura T, Komai N, Nakamura Y, Tanaka S, Kuriyama T. Preoperative embolization of meningiomas fed by ophthalmic branch arteries. Surg Neurol. 1996;45(2):161-166. https://doi.org/10.1016/S0090-3019(96)80010-3
  24. Turner T, Trobe JD, Deveikis JP. Sequential branch retinal artery occlusions following embolization of an intracranial meningioma. Arch Ophthalmol. 2002;120(6):857-860.
  25. Kunikata H, Tamai M. Cilioretinal artery occlusions following embolization of an artery to an intracranial meningioma. Graefe’s Arch Clin Exp Ophthalmol. 2006;244(3):401-403. https://doi.org/10.1007/s00417-005-0054-z
  26. Hufendiek K, Hufendiek K, Finkenzeller T, Helbig H, Framme C. Acute visual loss after preoperative embolization of an ethmoidal metastasis. Int Ophthalmol. 2012;32(2):165-169. https://doi.org/10.1007/s10792-012-9525-5
  27. Güldner C, Diogo I, Windfuhr J, Bien S, Teymoortash A, Werner JA, Bremke M. Analysis of the fossa olfactoria using cone beam tomography (CBT). Acta Otolaryngol. 2011;131(1):72-78. https://doi.org/10.3109/00016489.2010.506653
  28. Kazak Z, Celik S, Ozer MA, Govsa F. Three-dimensional evaluation of the danger zone of ethmoidal foramens on the frontoethmoidal suture line on the medial orbital wall. Surg Radiol Anat. 2015;37(8):935-940. https://doi.org/10.1007/s00276-015-1429-4
  29. Celik S, Ozer MA, Kazak Z, Govsa F. Computer-assisted analysis of anatomical relationships of the ethmoidal foramina and optic canal along the medial orbital wall. Eur Arch Oto-Rhino-Laryngology. 2014;272(11):3483-3490. https://doi.org/10.1007/s00405-014-3378-7
  30. Cecchini G. Anterior and posterior ethmoidal artery ligation in anterior skull base meningiomas: a review on microsurgical approaches. World Neurosurgery. 2015;84(4):1161-1165. https://doi.org/10.1016/j.wneu.2015.06.005
  31. Lynch RC. The technique of a radical frontal sinus operation which has given me the best results. Laryngoscope. 1921;31(1):1-5. https://doi.org/10.1288/00005537-192101000-00001
  32. Weddell G, MacBeth RG, Sharp HS, Calvert CA. The surgical treatment of severe epistaxis in relation to the ethmoidal arteries. Br J Surg. 1946;33(132):387-392. https://doi.org/10.1002/bjs.18003313219
  33. Esclamado RM, Cummings CW. Z-plasty modification of the Lynch incision. Laryngoscope. 1989;99(9):986-987. https://doi.org/10.1288/00005537-198909000-00015
  34. Graham SM, Thomas RD, Carter KD, Nerad JA. The transcaruncular approach to the medial orbital wall. Laryngoscope. 2002;112(6):986-989. https://doi.org/10.1097/00005537-200206000-00009
  35. Caseido E, Herrera A, Carrau RL, Snyderman CH, Kassam AB, Prevedello DM, Gardner PA, Fernandez-Miranda JC, Morera V. How to manage lateral sphenoid cerebrospinal fluid leaks. In: Stamm A, ed. Transnasal endoscopic skull base and brain surgery. Tips and pearls. New York: Thieme medical publishers Inc. 2011;332-336.
  36. White DV, Sincoff EH, Abdulrauf SI. Anterior ethmoidal artery: microsurgical anatomy and technical considerations. Neurosurgery. 2005;56(4 suppl): 406-410. https://doi.org/10.1227/01.NEU.0000156550.83880.D0
  37. Douglas SA, Gupta D. Endoscopic assisted external approach anterior ethmoidal artery ligation for the management of epistaxis. J Laryngol Otol. 2003;117:132-133. https://doi.org/10.1258/002221503762624594
  38. Cornelis MMK, Lubbe DE. Precaruncular approach to the medial orbit and landmarks for anterior ethmoidal artery ligation: a cadaveric study. Clin Otolaryngol. 2016;41(6):777-781. https://doi.org/10.1111/coa.12648
  39. Woolford TJ, Jones NS. Endoscopic ligation of anterior ethmoidal artery in treatment of epistaxis. J Laryngol and Otol. 2000;114:858-860. https://doi.org/10.1258/0022215001904167
  40. Solares CA, Luong A, Batra PS. Technical feasibility of transnasal endoscopic anterior ethmoid artery ligation: assessment with intraoperative CT imaging. Am J Rhinol Allergy. 2009;23(6):619-621. https://doi.org/10.2500/ajra.2009.23.3364
  41. Filho BCA, Pinheiro-Neto CD, Ramos HF, Voegels RL, Sennes LU. Endoscopic ligation of the anterior ethmoidal artery: a cadaver dissection study. Braz J Otorhinolaryngol. 2011;77(1):33-38. https://doi.org/10.1590/S1808-86942011000100006
  42. Yeh S, Yen MT, Foroozan R. Orbital apex syndrome after ethmoidal artery ligation for recurrent epistaxis. Ophthal Plast Reconstr Surg. 2004;20(5):392-394. https://doi.org/10.1097/01.IOP.0000139524.87938.18
  43. Brouzas D, Charakidas A, Androulakis M, Moschos M. Traumatic optic neuropathy after posterior ethmoidal artery ligation for epistaxis. Otolaryngol Head Neck Surg. 2002;126(3):323-325. https://doi.org/10.1067/mhn.2002.122387
  44. Al-Mefty O. Supraorbital-pterional approach to skull base lesions. Neurosurgery. 1987;21(4):474-477. https://doi.org/10.1227/00006123-198710000-00006
  45. Barker L, Naveed H, Adds PJ, Uddin JM. Supraorbital notch and foramen. Ophthal Plast Reconstr Surg. 2013;29(1):67-70. https://doi.org/10.1097/IOP.0b013e318279fe41
  46. Martins C, Yasuda A, Campero A, Ulm AJ, Tanriover N, Rhoton A. Microsurgical anatomy of the dural arteries. Neurosurgery. 2005;56(4 suppl). https://doi.org/10.1227/01.NEU.0000144823.94402.3D
  47. McDermott MW, Rootman J, Durity FA. Subperiosteal, subperiorbital dissection and division of the anterior and posterior ethmoid arteries for meningiomas of the cribriform plate and planum sphenoidale: technical note. Neurosurgery. 1995;36(6):1215-1219. https://doi.org/10.1227/00006123-199506000-00027
  48. Ung TH, Waziri AE, Ramakrishnan VR. Preoperative ethmoid artery ligation facilitates resection of large sub-frontal meningiomas. Am J Otolaryngol. 2014;35(3):424-426. https://doi.org/10.1016/j.amjoto.2014.01.003
Contact the author
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.

Email Confirmation

An email was sent to test@gmail.com with a confirmation link. Follow the link from the letter to complete the registration on the site.

Email Confirmation

Contact us
If you have any questions, complaints or suggestions, please use this feedback form.
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.
Submit Application

You can become an author of one of our magazines, send a request and we will consider it in during the day.

Name
Phone
E-mail
Message
Login
Registration
E-mail
Password
Forgot Password?

Log in to the site using your account in one of the services

Password recovery
E-mail
Login
Register

We use cооkies to improve the performance of the site. By staying on our site, you agree to the terms of use of cооkies. To view our Privacy and Cookie Policy, please. click here.