Endoscopic transnasal cauterization of the anterior ethmoidal artery

OBJECTIVES: The aim of this study was to provide the anatomic rationale for endoscopic cauterization of the AEA and to present our surgical approach to AEA in the treatment of severe nasal bleeding. METHODS: A retrospective study reviewed 300 endoscopic transnasal AEA cauterizations, over a 20-year period from 1991 to July 2010, at the Instituto Felippu, Sao Paolo, Brazil. All surgeries were carried out under general anesthesia and with the help of a rigid 30° endoscope. RESULTS: The AEA was identified in all the patients treated. In 299 patients we found the AEA located at the level of the horizontal portion of the frontal bone into the anterior ethmoidal canal; in 88 (29.4%) of these patients the canal bone was partially open and in 211 (70.6%) it was completely closed. In only one patient, we found a dehiscent AEA. No patients presented short-term failure and/or long-term failure. CONCLUSIONS: In our experience, the technique described can be applied independently according to the specific patient's anatomy and disease, allowing simple, easy, and safe identification of the anterior ethmoidal artery (AEA).