{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T20:17:00Z","timestamp":1789676220003,"version":"4.0.1"},"reference-count":100,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:sec>\n                    <jats:title>Object<\/jats:title>\n                    <jats:p>There are several surgical techniques for reducing blood loss\u2014open surgical and endoscopic\u2014prior to resection of giant anterior skull base meningiomas, especially when preoperative embolization is risky or not technically feasible. The authors present examples of an institutional experience using surgical ligation of the anterior and posterior ethmoidal arteries producing persistent tumor blush in partially embolized tumors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The authors identified 12 patients who underwent extracranial surgical ligation of ethmoidal arteries through either a transcaruncular or a Lynch approach. Of these, 3 patients had giant olfactory groove or planum sphenoidale meningiomas. After approval from the institution privacy officer, the authors studied the medical records and imaging data of these 3 patients, with special attention to surgical technique and outcome. The variations of ethmoidal artery foramina pertaining to this surgical approach were studied using preserved human skulls from the Hamann-Todd Osteological Collection at the Museum of Natural History, Cleveland, Ohio.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The extracranial ligation was performed successfully for control of the ethmoidal arteries prior to resection of hypervascular giant anterior skull base meningiomas. The surgical anatomy and landmarks for ethmoidal arteries were reviewed in anthropology specimens and available literature with reference to described surgical techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Extracranial surgical ligation of anterior, and often posterior, ethmoidal arteries prior to resection of large olfactory groove or planum sphenoidale meningiomas provides a safe and feasible option for control of these vessels prior to either open or endoscopic resection of nonembolized or partially embolized tumors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2013.10.focus13327","type":"journal-article","created":{"date-parts":[[2013,12,1]],"date-time":"2013-12-01T03:33:23Z","timestamp":1385868803000},"page":"E13","source":"Crossref","is-referenced-by-count":28,"title":["Extracranial ligation of ethmoidal arteries before resection of giant olfactory groove or planum sphenoidale meningiomas: 3 illustrative cases with a review of the literature on surgical techniques"],"prefix":"10.3171","volume":"35","author":[{"given":"Sunil","family":"Manjila","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efrem M.","family":"Cox","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel A.","family":"Smith","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Corriveau","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nipun","family":"Chhabra","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head & Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freedom","family":"Johnson","sequence":"additional","affiliation":[{"name":"Otolaryngology-Head & Neck Surgery, MetroHealth Hospital, Case Western Reserve University, Cleveland, Ohio; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert T.","family":"Geertman","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0350013","series-title":"Braz J Otorhinolaryngol","first-page":"303","article-title":"Endoscopic anatomy of the anterior ethmoidal artery: a cadaveric dissection study","volume":"72","author":"Araujo Filho","year":"2006"},{"key":"b2-0350013","series-title":"Neurosurgery","first-page":"1306","article-title":"Is there a benefit of preoperative meningioma embolization?","volume":"47","author":"Bendszus","year":"2000"},{"key":"b3-0350013","series-title":"Otolaryngol Head Neck Surg","first-page":"323","article-title":"Traumatic optic neuropathy after posterior ethmoidal artery ligation for epistaxis","volume":"126","author":"Brouzas","year":"2002"},{"key":"b4-0350013","series-title":"Surg Radiol Anat","first-page":"29","article-title":"The intraorbital arrangement of the anterior and posterior ethmoidal foramina","volume":"17","author":"Caliot","year":"1995"},{"key":"b5-0350013","series-title":"Clin Radiol","first-page":"1034","article-title":"Evaluation of the anterior and posterior ethmoidal canal by computed tomography","volume":"59","author":"Cankal","year":"2004"},{"key":"b6-0350013","series-title":"Neurosurg Rev","first-page":"195","article-title":"Olfactory groove meningiomas: a retrospective study on 59 surgical cases","volume":"35","author":"Ciurea","year":"2012"},{"key":"b7-0350013","series-title":"Otolaryngol Head Neck Surg","first-page":"664","article-title":"The Draf III mucosal grafting technique: a prospective study","volume":"146","author":"Conger","year":"2012"},{"key":"b8-0350013","series-title":"J Neurooncol","first-page":"239","article-title":"Surgical treatment of anterior basal meningiomas","volume":"29","author":"DeMonte","year":"1996"},{"key":"b9-0350013","series-title":"J Laryngol Otol","first-page":"132","article-title":"Endoscopic assisted external approach anterior ethmoidal artery ligation for the management of epistaxis","volume":"117","author":"Douglas","year":"2003"},{"key":"b10-0350013","series-title":"J Craniofac Surg","first-page":"280","article-title":"The anatomic landmarks of ethmoidal arteries for the surgical approaches","volume":"17","author":"Erdogmus","year":"2006"},{"key":"b11-0350013","series-title":"Laryngoscope","first-page":"986","article-title":"Z-plasty modification of the Lynch incision","volume":"99","author":"Esclamado","year":"1989"},{"key":"b12-0350013","series-title":"Acta Otolaryngol","first-page":"1074","article-title":"Endoscopic transnasal cauterization of the anterior ethmoidal artery","volume":"131","author":"Felippu","year":"2011"},{"key":"b13-0350013","series-title":"Laryngoscope","first-page":"1263","article-title":"Endoscopic anterior ethmoidal artery ligation: a cadaver study","volume":"116","author":"Floreani","year":"2006"},{"key":"b14-0350013","series-title":"Orbit","first-page":"93","article-title":"Radiological classification of anterior skull base anatomy prior to performing medial orbital wall decompression","volume":"25","author":"Gauba","year":"2006"},{"key":"b15-0350013","series-title":"Radiographics","first-page":"177","article-title":"Failed endoscopic sinus surgery: spectrum of CT findings in the frontal recess","volume":"29","author":"Huang","year":"2009"},{"issue":"1","key":"b16-0350013","series-title":"Neurosurg Focus","first-page":"E3","article-title":"Expanded endonasal approach: the rostrocaudal axis. 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view of the posterior ethmoid artery","volume":"83","author":"Yanagisawa","year":"2004"},{"key":"b1-0350013","series-title":"Braz J Otorhinolaryngol","first-page":"303","article-title":"Endoscopic anatomy of the anterior ethmoidal artery: a cadaveric dissection study","volume":"72","author":"Araujo Filho","year":"2006"},{"key":"b2-0350013","series-title":"Neurosurgery","first-page":"1306","article-title":"Is there a benefit of preoperative meningioma embolization?","volume":"47","author":"Bendszus","year":"2000"},{"key":"b3-0350013","series-title":"Otolaryngol Head Neck Surg","first-page":"323","article-title":"Traumatic optic neuropathy after posterior ethmoidal artery ligation for epistaxis","volume":"126","author":"Brouzas","year":"2002"},{"key":"b4-0350013","series-title":"Surg Radiol Anat","first-page":"29","article-title":"The intraorbital arrangement of the anterior and posterior ethmoidal foramina","volume":"17","author":"Caliot","year":"1995"},{"key":"b5-0350013","series-title":"Clin Radiol","first-page":"1034","article-title":"Evaluation of the anterior and posterior ethmoidal canal by computed tomography","volume":"59","author":"Cankal","year":"2004"},{"key":"b6-0350013","series-title":"Neurosurg Rev","first-page":"195","article-title":"Olfactory groove meningiomas: a retrospective study on 59 surgical cases","volume":"35","author":"Ciurea","year":"2012"},{"key":"b7-0350013","series-title":"Otolaryngol Head Neck Surg","first-page":"664","article-title":"The Draf III mucosal grafting technique: a prospective study","volume":"146","author":"Conger","year":"2012"},{"key":"b8-0350013","series-title":"J Neurooncol","first-page":"239","article-title":"Surgical treatment of anterior basal meningiomas","volume":"29","author":"DeMonte","year":"1996"},{"key":"b9-0350013","series-title":"J Laryngol Otol","first-page":"132","article-title":"Endoscopic assisted external approach 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study","volume":"116","author":"Floreani","year":"2006"},{"key":"b14-0350013","series-title":"Orbit","first-page":"93","article-title":"Radiological classification of anterior skull base anatomy prior to performing medial orbital wall decompression","volume":"25","author":"Gauba","year":"2006"},{"key":"b15-0350013","series-title":"Radiographics","first-page":"177","article-title":"Failed endoscopic sinus surgery: spectrum of CT findings in the frontal recess","volume":"29","author":"Huang","year":"2009"},{"issue":"1","key":"b16-0350013","series-title":"Neurosurg Focus","first-page":"E3","article-title":"Expanded endonasal approach: the rostrocaudal axis. 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