Has anyone ever actually seen a case of ethmoid artery injury and retraction leading to a post septal hematoma? my FESS guys say it is actually extremely rare, does everyone comment on aeration of the anterior and posterior ethmoid artery canals routinely?
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I have never seen this complication personally. Our FESS guys would agree with yours. While they do occasionally have complications related to injury of one of the ethmoidal arteries (maybe once a year or so), the injuries occur in a medial enough location that the artery can be controlled. They haven’t had a case in recent memory of arterial retraction and resultant post septal hematoma as a complication of FESS performed here, although they have had one or two of these complications referred emergently from outside. In general, if I do see aeration around either of the ethmoidal artery canals, I will comment on it.
Rick, I have never seen imaging after this type of injury and am not aware of any cases at our institution or from the outside. I do not typically comment on aeration around the canals in my reports.