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Reference Points for the Assessment of the Course of the Anterior and Posterior Ethmoid Arteries by Multislice CT SA Souza, MMA Souza, RLM Rivero, RQ Guimaraes, LR Wanderley, FT Pacheco, RA Mendonca Disclosures: None PURPOSE 1. To identify the landmarks of the anterior ethmoidal artery (AEA) on the orbital medial wall and on the lateral wall of the olfactory fossa. 2. To describe the approach to the radiologic landmarks of the posterior ethmoidal artery (PEA). APPROACH / METHODS Anterior ethmoidal artery (AEA) course/pathway • orbit • anterior ethmoidal foramen • ethmoid labyrinth • anterior ethmoidal canal • anterior ethmoidal sulcus • olfatory fossa Anterior ethmoidal artery arising from ophtalmic artery Henry Grey (2018) Anterior ethmoidal artery arising from ophtalmic artery https://www.uvm.edu/medicine/surge ry/documents/Skullbasetumorsands urgery2.pdf AEA Anterior ethmoidal foramen Anterior ethmoidal canal Anterior ethmoidal sulcus AEA positioning in sagittal plane APPROACH / METHODS Shortly after the ophthalmic artery enters the orbit, the PEA emerges in its posterior third, usually above the superior oblique muscle. On its intra-orbital course, we observe it follows a superior convex loop and ends up above the oblique muscle. APPROACH / METHODS After its intra-orbital path, the PEA continues towards the frontoethmoidal suture and enters through the posterior ethmoidal canal to cross the ethmoidal labyrinth a few millimetres from the anterior wall of the sphenoid sinus, in the sphenoethmoidal angle. APPROACH / METHODS Its path in the ethmoidal canal is slightly shorter and has a more orientation than that of the AEA horizontal Posterior ethmoidal artery arising from ophtalmic artery Henry Grey (2018) Posterior ethmoidal artery arising from ophtalmic artery https://www.uvm.edu/medicine/surge ry/documents/Skullbasetumorsands urgery2.pdf AEA PEA Anterior and posterior ethmoidal canal frontoethmoidal suture and posterior etmoidal canal PEA positioning in sagittal plane SUMMARY / CONCLUSION The medial notch of the orbit (anterior ethmoidal foramen) and the anterior ethmoidal sulcus on the lateral wall of the olfactory fossa were reliable parameters for identifying the course of the anterior ethmoidal artery. Anterior ethmoidal foramen Anterior ethmoidal sulcus SUMMARY / CONCLUSION There are no well-documented anatomical references to identify the PEA in CT studies: - frontoethmoidal suture and a posterior etmoidal canal can be the landmarks to help surgical planning. Frontoethmoidal suture Posterior etmoidal canal