{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T21:57:12Z","timestamp":1773179832883,"version":"3.50.1"},"reference-count":14,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2022,12,12]],"date-time":"2022-12-12T00:00:00Z","timestamp":1670803200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Laryngol. Otol."],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0022215122002523_sec_a1\"><jats:title>Background<\/jats:title><jats:p>In severe refractory epistaxis, the anterior ethmoidal artery may need to be ligated. Previously described endonasal or transorbital approaches are not always effective, or they have suboptimal aesthetic outcomes. This paper describes a safe and effective surgical technique, with a consistent landmark allowing quick identification.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215122002523_sec_a2\"><jats:title>Technical description<\/jats:title><jats:p>A transcaruncular incision is made, oriented medially in the direction of the medial orbital wall towards the level of the nasion. Once onto bone, a subperiosteal plane is developed and an endoscope is used to dissect posteriorly at the level of the nasion, until the anterior ethmoidal artery is identified, and subsequently ligated.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215122002523_sec_a3\" sec-type=\"conclusions\"><jats:title>Conclusion<\/jats:title><jats:p>The nasion is an easy, constant landmark to use for ligation of the anterior ethmoidal artery in refractory epistaxis. The traditional method of identifying the anterior ethmoidal artery is not applicable or constant enough for use during the transorbital approach. The described technique avoids injury to surrounding structures and has a satisfactory aesthetic outcome.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0022215122002523","type":"journal-article","created":{"date-parts":[[2022,12,12]],"date-time":"2022-12-12T09:46:17Z","timestamp":1670838377000},"page":"1054-1057","source":"Crossref","is-referenced-by-count":5,"title":["How we do it: using the nasion as a landmark for identifying the anterior ethmoidal artery"],"prefix":"10.1017","volume":"137","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6679-3339","authenticated-orcid":false,"given":"T A","family":"Patel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Lubbe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2022,12,12]]},"reference":[{"key":"S0022215122002523_ref4","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000250778.29957.a1"},{"key":"S0022215122002523_ref7","doi-asserted-by":"publisher","DOI":"10.1001\/archfaci.5.6.483"},{"key":"S0022215122002523_ref2","first-page":"S1","article-title":"Clinical practice guideline: nosebleed (epistaxis)","volume":"162","author":"Tunkel","year":"2020","journal-title":"Otolaryngol Head Neck Surg"},{"key":"S0022215122002523_ref3","doi-asserted-by":"publisher","DOI":"10.1007\/BF03008017"},{"key":"S0022215122002523_ref8","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12648"},{"key":"S0022215122002523_ref6","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000221967.67003.1d"},{"key":"S0022215122002523_ref9","volume-title":"Open Access Atlas of Otolaryngology, Head and Neck Operative Surgery","author":"Fagan","year":"2014"},{"key":"S0022215122002523_ref5","doi-asserted-by":"publisher","DOI":"10.1258\/0022215001904167"},{"key":"S0022215122002523_ref10","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21372"},{"key":"S0022215122002523_ref13","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1055\/s-0040-1713900","article-title":"Endoscopic orbital and periorbital approaches in minimally disruptive skull base surgery","volume":"81","author":"Miller","year":"2020","journal-title":"J Neurol Surg Part B Skull Base"},{"key":"S0022215122002523_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2004.12.014"},{"key":"S0022215122002523_ref11","article-title":"Transorbital neuroendoscopic surgery","volume":"67","author":"Moe","year":"2010","journal-title":"Neurosurgery"},{"key":"S0022215122002523_ref14","doi-asserted-by":"publisher","DOI":"10.1177\/019459989210600136"},{"key":"S0022215122002523_ref12","doi-asserted-by":"publisher","DOI":"10.1007\/s40136-019-00237-x"}],"container-title":["The Journal of Laryngology &amp; Otology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0022215122002523","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T08:12:38Z","timestamp":1693987958000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0022215122002523\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,12]]},"references-count":14,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["S0022215122002523"],"URL":"https:\/\/doi.org\/10.1017\/s0022215122002523","relation":{},"ISSN":["0022-2151","1748-5460"],"issn-type":[{"value":"0022-2151","type":"print"},{"value":"1748-5460","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,12]]}}}