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This study evaluates the nasal branch of the anterior ethmoidal artery (NbAEA) and the cribroethmoidal groove (CrEGr) as consistent landmarks for endoscopic frontal sinusotomy using cadaver dissections and a retrospective clinical case series. NbAEA and CrEGr were found on all dissected sides and in 100% of patient cases, with no perioperative complications, supporting reliable surgical applicability.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/nasal-branch-of-the-anterior-ethmoidal-artery-and-cribroethmoidal-groove-new-frontal-sinus-landmarks/446145/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/nasal-branch-of-the-anterior-ethmoidal-artery-and-cribroethmoidal-groove-new-frontal-sinus-landmarks/446145.png","ImageObject",300,407,{"name":92,"@type":93},"Taylor Morgan","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-24","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What problem does the study address in expanded frontal sinus surgery?","Question",{"text":112,"@type":113},"Expanded frontal sinusotomies need dependable intraoperative landmarks, but traditional anatomical references may be hard to identify, particularly in tumor or revision contexts.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were NbAEA and CrEGr evaluated?",{"text":117,"@type":113},"The study used medio-lateral anatomical dissections on three fresh cadavers plus a retrospective clinical case series analyzing identification and surgical outcomes.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the key findings regarding landmark reliability and safety?",{"text":121,"@type":113},"NbAEA and CrEGr were identified in all dissected sides and in 100% of cases, and no perioperative complications were recorded.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},446145,1791259953,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":46,"preview_page_count":4},1099523885336,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","The Laryngoscope  \nORIGINAL REPORT  OPEN ACCESS   \nNasal Branch of the Anterior Ethmoidal Artery and Cribroethmoidal Groove: New Frontal Sinus Landmarks  \nAlessandro Vinciguerra1  | Mario Turri-Zanoni1  | Pierfrancesco Bettini2 | Alberto Daniele Arosio3  | Alberto Gandolfi1 | Daniel Balzi3 | Gloria Schiavo1 | Federico Russo1  | Marco Valentini1  | Marco Ferrari4  | Paolo Castelnuovo4  | Philippe Herman5 | Maurizio Bignami3 | Paolo Battaglia1  \n1Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, ASST Lariana, Como, Italy | 2ENT and Audiology Department, University of Ferrara, Ferrara, Italy | 3Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences,  \nUniversity of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy | 4Section of Otorhinolaryngology—Head and Neck Surgery, Department of Neuroscience, University of Padova, Padova, Italy | 5Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisière, Paris, France Correspondence: Alessandro Vinciguerra ([a.vinciguerra.md@gmail.com](a.vinciguerra.md@gmail.com))  \nReceived: 22 June 2025 | Revised: 29 July 2025 | Accepted: 5 August 2025  \nFunding: The authors received no specific funding for this work.  \nKeywords: anterior ethmoidal artery | endoscopic sinus surgery | epistaxis | frontal sinus | skull base surgery  \nABSTRACT  \nObjective: Expanded frontal sinusotomies (DrafIIb/c-III) are essential surgical procedures for managing complex frontal sinus pathologies. However, traditional anatomical landmarks may be difficult to identify, particularly in tumor or revision cases. This manuscript investigates the nasal branch of the anterior ethmoidal artery (NbAEA) and the cribroethmoidal groove (CrEGr) as reliable and consistent landmarks for endoscopic frontal sinusotomies.  \nMethods: This study included anatomical dissections (medio-lateral approach) on three fresh cadavers (six sides) focused on the region anterior to the first olfactory phylum, namely the cribo-frontal area. Additionally, a retrospective clinical case series of patients that underwent centripetal dissection with a medio-lateral approach to the frontal sinus was performed. Identification of NbAEA, CrEGr, and the first olfactory phylum, along with surgical outcomes and complications, was analyzed.  \nResults: The NbAEA and CrEGr were identified in all dissected sides and were located anterior to the first olfactory phylum. Considering the 19 enrolled patients, 13/19 (68.4%) were treated with a bilateral centripetal dissection and Draf III procedure (26 sides); whereas 6/19 patients (31.6%) underwent a unilateral approach with a DrafIIb/c procedure. The NbAEA and CrEGr were identified in all cases (100%) and in only 9/19 cases (47.7%) the first olfactory phylum was additionally exposed, reinforcing the role of these new anatomical landmarks. No perioperative complications were recorded.  \nConclusions: This study supports the clinical significance of NbAEA and CrEGr as reliable anatomical landmarks, and their identification in 100% of cases reinforces their practical applicability in surgical approaches to the frontal sinus.  \nLevel of Evidence: Level 4.  \n1 | Introduction  \nEndoscopic approach to the frontal sinus (FS) is a pivotal procedure in endoscopic endonasal surgery, both in functional and expanded approaches, with significant risk of complications (i.e., CSF leak, iatrogenic stenosis) due to the variable  \nanatomy among individuals [1] . Over the last decades, multiple anatomical landmarks have been described to facilitate the intraoperative FS identification, thus enabling subsequent frontal sinusotomy. Nevertheless, if “functional” frontal sinusotomies, such as Draf I-IIa, depend on individual anatomy and present the surgical concept of maximal functional outcome with the  \nThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction ","cbCaikc8KJfoP6en","https://ap.wps.com/l/cbCaikc8KJfoP6en","pdf",1049345,"English","# Abstract\n## Objective\n## Methods\n## Results\n## Conclusions\n# Introduction\n## Anatomy of the Anterior Ethmoidal Artery","[{\"question\":\"What problem does the study address in expanded frontal sinus surgery?\",\"answer\":\"Expanded frontal sinusotomies need dependable intraoperative landmarks, but traditional anatomical references may be hard to identify, particularly in tumor or revision contexts.\"},{\"question\":\"How were NbAEA and CrEGr evaluated?\",\"answer\":\"The study used medio-lateral anatomical dissections on three fresh cadavers plus a retrospective clinical case series analyzing identification and surgical outcomes.\"},{\"question\":\"What were the key findings regarding landmark reliability and safety?\",\"answer\":\"NbAEA and CrEGr were identified in all dissected sides and in 100% of cases, and no perioperative complications were recorded.\"}]","Nasal Branch of the Anterior Ethmoidal Artery and Cribroethmoidal Groove: New Frontal Sinus Landmarks | PDF",1790714290]