Analysis of the presence, location and morphometry of the «alveolar antral artery¼ by cone-beam computed tomography in Chilean adults / Análisis de la presencia, ubicación y morfometría de la arteria alvéolo-antral por tomografía computarizada de haz cónico en adultos chilenos

SUMMARY: The posterior superior alveolar artery is responsible for the vascularisation of the mucous which covers the posterior wall of the maxillary sinus, pulp and the periodontal tissues of upper molars. The collateral rami of the infraorbital artery irrigate the mucous of the anterior and lateral walls of the maxillary sinus, as well as the pulp and periodontal tissue of the upper anterior teeth and upper premolars. Both these arteries present intraosseous and extraosseous rami which form an anastomosis in the anterior and lateral walls of the maxillary sinus, called the alveolar antral artery (AAA). The aim of this study was to analyse the presence, location and morphometry of the AAA in a Chilean population, considering sex, side and age, using Cone-Beam computed tomography (CBCT). Forty-two CBCT examinations of Chilean adults were evaluated to analyse the presence, location (extraosseous, intraosseous or subperiosteal) and diameter (<1mm, 1-2 mm, 2-3 mm, >3 mm) of the AAA and the distance from the AAA to the amelocemental limit of the upper second premolar (2PM), permanent upper first molar (1M) and permanent upper second molar (2M) by sex and age range. Pearson's chi-squared test, Student's t-test, ANOVA and Pearson's correlation coefficient were applied, using a significance threshold of 5 %. AAA was found in 75 sides (89.3 %), 38 on the right side (90.5 %) and 37 on the left (88.09 %); extraosseous location was most common. More than 80 % of the arteries presented a diameter between 1 and 2 mm, with no important differences between sexes or age ranges. In younger individuals, the artery was located closer to the vestibular amelocemental limit than in older individuals. Carrying out a proper treatment plan which includes imagenological analysis before surgical procedures is essential to avoid possible haemorrhagic events in the region.

RESUMEN: Arteria alveolar superior posterior es responsable de la vascularización de la mucosa que recubre la pared posterior del seno maxilar, la pulpa y el tejido peridontal en el que se insertan los molares superiores. Las ramas colaterales de la arteria infraorbitaria irrigan la mucosa de las paredes anterior y lateral del seno maxilar, así como la pulpa y el periodonto de los dientes anteriores superiores y los premolares superiores. Ambas arterias presentan ramas intraóseas y extraóseas que forman una anastomosis en las paredes anterior y lateral del seno maxilar, denominada arteria alvéolo antral (AAA). El objetivo de este estudio fue analizar la presencia, localización y morfometría del AAA en una población chilena, considerando sexo, lado y edad, mediante tomografía computarizada Cone-Beam (CBCT). Se evaluaron 42 exámenes CBCT de adultos chilenos para analizar la presencia, ubicación (extraósea, intraósea o subperióstica) y diámetro (<1 mm, 1-2 mm, 2-3 mm,> 3 mm) del AAA. y la distancia del AAA al límite amelocemental del segundo premolar superior (2PM), primer molar superior permanente (1M) y segundo molar superior permanente (2M) por sexo y rango de edad. Se aplicaron la prueba de chi-cuadrado de Pearson, la prueba t de Student, ANOVA y el coeficiente de correlación de Pearson, utilizando un umbral de significancia del 5 %. Se encontró AAA en 75 lados (89,3 %), 38 del lado derecho (90,5 %) y 37 del lado izquierdo (88,09 %); la localización extraósea fue la más común. Más del 80 % de las arterias presentaban un diámetro entre 1 y 2 mm, sin diferencias importantes entre sexos ni rangos de edad. En individuos más jóvenes, la arteria se ubicó más cerca del límite amelocemental vestibular que en individuos mayores. La realización de un adecuado plan de tratamiento que incluya análisis imagenológico antes de los procedimientos quirúrgicos es fundamental para evitar posibles eventos hemorrágicos en la región.

Anastomoses Between Infraorbital Artery And Ophthalmic Artery Within The Orbit

Documentation of contributions from infraorbital artery to branches of the ophthalmic artery are lacking withrespect to the orbit. While there have been sources that suggest anastomoses between the infraorbital artery andophthalmic artery within the orbit, there has been no clear consensus on the location and significance of theseanastomoses. This study aimed to identify and track the course of the infraorbital artery within the orbit and itspossible anastomoses and supply to the orbit. Cadaveric analysis of 19 individuals (38 orbits) revealed acommon pattern of anastomosis between the infraorbital and inferior palpebral arteries (95%; 89% bilaterally)as well as course to the lacrimal sac (91%; 73% bilaterally). These findings demonstrate the significance ofinfraorbital artery supply with respect to the inferior orbit as well as the lacrimal sac, which can prove clinicallyuseful, such as in the context of surgical repair of orbital trauma.

Evaluación de la arteria alveolo-antral mediante tomografía volumétrica en población mexicana y su relación con levantamiento del piso del seno maxilar / CBCT evaluation of the alveolar antral artery in a mexican cohort and its relationship to maxillary sinus floor lifting

Introducción: El conocimiento de la anatomía de la región maxilar debe ser esencial para el cirujano antes de realizar levantamiento del seno maxilar para evitar complicaciones. La arteria alveolo antral forma una anastomosis intraósea con la arteria infraorbitaria a nivel de la pared antero lateral del seno maxilar, aproximadamente a una distancia de entre 18.9 y 19.6 mm desde el reborde alveolar maxilar. La arteria alveolo antral es la encargada de dar vascularidad a la membrana mucosa del seno maxilar, pared antero lateral del seno y tejido perióstico subyacente.Objetivo: Describir y establecer la frecuencia, diámetro y localización dela anastomosis entre la arteria infraorbitaria y la arteria alveolar posterior superior, llamada arteria alveolo antral y su relación con la cresta ósea alveolar en una población mexicana. Material y métodos: Se realizaun protocolo de estudio observacional, descriptivo y transversal en una población de 1,116 pacientes derecho habientes del Instituto de Seguridad Social y Servicios para los Trabajadores del Estado (ISSSTE), en el oriente de la Ciudad de México, mediante la revisión de estudios de tomografía volumétrica computarizada. Resultados: Se encuentra la anastomosis arterial en el 90 por ciento de los estudios revisados, correspondiente a 1,005 estudios de tomografía.

Introduction: In order to avoid complications, it is essential for surgeonsto have a detailed knowledge of the anatomy of the superior maxillarybone prior to performing any sinus lift procedure. The alveolarantral artery forms an intraosseous anastomosis with the infraorbitalartery at the level of the anterolateral wall of the maxillary antrum at anapproximate distance of between 18.9 and 19.6 mm from the maxillaryalveolar ridge. The alveolar antral artery is responsible for providingvascularity to the mucous membrane of the maxillary sinus, the anteriorlateral wall of the sinus, and the underlying periosteal tissue. Objective:To analyze and establish the frequency, diameter, and locationof the anastomosis between the infraorbital artery and the posteriorsuperior alveolar artery known as the alveolar antral artery, and itsrelationship to the alveolar bone crest in a Mexican cohort. Materialand methods. We conducted a cross-sectional observational descriptivestudy involving a cohort comprised of 1,116 patients of the Institute forSocial Security and Services for State Workers (ISSSTE) on the eastside of Mexico City. The study consisted of a review of CBCT studies.Results: The arterial anastomosis was found in 90% of the 1,005 CBCTstudies reviewed, based on which the following values were determinedfor the distance between the alveolar ridge and the canal of the alveolarantral artery: for the fi rst premolar, 18.24 mm; second premolar,17.35 mm; fi rst molar, 16.96 mm, and for the second molar, 18.75 mm.Conclusions: We established the average measurements for the locationof the vascular bundle in question and the measurements neededto safeguard it along its course, which is important for the preservationand osseointegration of bone grafts placed during maxillary sinus liftprocedures, thus providing a margin of safety not previously reportedin the literature for a Mexican cohort.

Recurrent epistaxis from a post-traumatic infraorbital artery pseudoaneurysm

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To present a rare case of post-traumatic recurrent epistaxis in an elderly woman.<br /><strong>METHODS:</strong><br />  <strong>Design:</strong> Case Report<br /> <strong> Setting:</strong> Tertiary Private Hospital<br /><strong>  Patient:</strong> One<br /><strong>RESULT:</strong> A  93-year-old  woman  had  multiple  admissions  for  recurrent  life  threatening  nose-bleeding  that  was  not  controlled  until  a  post-traumatic pseudoaneurysm  of  the  infraorbital artery was diagnosed and embolized.<br />CONCLUSION: The diagnosis of pseudoaneurysm should be considered in such cases, and treatment involving surgeons and interventional radiologists should be initiated to minimize morbidity and mortality.</p>

A Case of Abrupt Termination of the Facial Artery with Unusual Multiple Arterial Anastomoses: Clinical Implications in the Head and Neck.

Having up-to-date knowledge of the variability in facial artery topography is an essential starting point in performing certain surgical and radiological procedures on the head and neck (e.g. oromucosal reconstruction flaps, transarterial embolization). We report a unique case with: (1) the left facial artery truncating as an atypical inferior labial artery, (2) the left anterolateral face being perfused by unusual arterial collaterals derived from the right superior labial, left infraorbital and left dorsal nasal arteries, (3) the transverse facial artery not being one of the perfusing collaterals, and (4) the right submental artery piercing the mylohyoid muscle and entering the oral cavity. The embryologic basis of this atypical vascular pattern is discussed. Discovery of a highly atypical facial artery highlights the importance of performing a thorough pre-operative vascular evaluation to prevent iatrogenic injuries and complications before any surgical or therapeutic procedure.

Arterial arcade of the maxillary sinus related to sinus bone graft in korean population ; A preliminary study using computed topographies

AIM: The aim of this study was to investigate the arterial arcade of maxillary sinus by determining the distance between the alveolar crest and the inferior border of the vessels in Korean population. MATERIALS AND METHODS: 76 patients and 87 available sinuses were determined by CT scan (Implagraphy, Vatech, Seoul, Korea). The distance between alveolar crest and inferior border of the vessel was determined considering the tooth area of posterior maxilla. RESULTS: The lowest distance was observed on first molar area and the average distance is 16.9 mm. DISCUSSIONS: it is important in sinus lift surgery that the vessels not to be damaged and that the anastomosis is situated in the lateral wall of maxillary sinus, which has to be exposed to gain access to the maxillary sinus. The knowledge of arterial arcade of maxillary sinus is important to perform the sinus floor elevation procedure effectively.