The AEA branches are from the ophthalmic artery in the superomedial intraconal space. Existing researchers have not sufficiently explored the feasibility of managing lesions from the superomedial intraconal area via an endoscopic endonasal approach.

Researchers did this study to yield a detailed anatomic description of the anterior ethmoidal neurovascular bundle and its variants to serve as the foundation for possible management of lesions in the superomedial intraconal space.

Eight cadaveric specimens were dissected using an endonasal approach, tracing the AEA proximally through the superomedial intraconal space. The adjacent structures’ anatomy was noted, and distances from the anterior ethmoidal foramen to the AEA’s origin at the ophthalmic artery were measured.

Supraorbital cells were found on 13 sides. Bony dehiscence of the anterior ethmoidal canal was observed in 5. The nasociliary nerve, ophthalmic artery, superior division of the oculomotor nerve, rectus muscle, and levator palpebrae superioris were routinely identified in the superomedial intraconal space.

The study concluded that anatomically, it is feasible to access the superomedial intraconal space via an endoscopic endonasal approach. This study provides the anatomical basis for procedures in the superomedial intraconal area.

Reference: https://journals.sagepub.com/doi/full/10.1177/1945892420901630

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