Surgical Anatomy of the Orbit in Human Cadavers–An Endoscopic Pictorial Documentation

Background The aim of our study was a pictorial documentation of the anatomical structures of the orbit. Methods We performed a transmaxillary endoscopic approach in nine formalin-fixed human heads. We identified and documented the anatomy of the inferior part of the orbit. Results The first intraorbital anatomical landmark was the inferior rectus muscle, from which important structures medially and laterally could be identified. Anatomical structures and their relation to each other were documented and presented as illustrative figures. Conclusion Knowledge of the topographic anatomy of the inferior part of the orbit could be sufficiently imparted by our illustrations. The presented transmaxillary approach allowed a wide overview of the anatomical structures located in the inferior part of the orbit. Our pictorial documentation may provide neurosurgeons more safety and the opportunity to become familiar with the endoscopic anatomy.

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Compartmental Endoscopic Surgical Anatomy of the Inferior Intraconal Orbital Space

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0037-1604405 ◽

2017 ◽

Vol 79 (02) ◽

pp. 189-192 ◽

Cited By ~ 7

Author(s):

Alice Maxfield ◽

Christopher Brook ◽

Marcel Miyake ◽

Benjamin Bleier

Keyword(s):

Rectus Muscle ◽

Anatomical Study ◽

Surgical Anatomy ◽

Oblique Muscle ◽

Inferior Rectus ◽

Inferior Oblique Muscle ◽

Safe Technique ◽

Orbital Space ◽

Neurovascular Structures ◽

Inferior Rectus Muscle

Objectives This study aims to define the endoscopic anatomy of inferior intraconal space, in terms of its neurovascular structures and relationship to fixed anatomic landmarks. Design A cadaveric anatomical study was conducted. Setting This study was conducted at an academic cranial base center. Participants Cadaveric subjects have been investigated. Main Outcome Measures After dissection of the inferior intraconal space, the number and position of ophthalmic artery (OA) and oculomotor nerve (OMN) branches to the inferior rectus muscle (IRM) were quantified relative to the fixed landmark of the posterior maxillary wall. The point where the OMN branch to the inferior oblique muscle (IOM) crossed the lateral IRM margin was quantified. Results A total of 18 OA branches were identified with a mean ± standard deviation of 2.6 ± 0.53 branches. The mean distance of the OA branch insertion from the posterior maxillary wall was 7.11 ± 5.65 mm. The average number of OMN branches to the IRM was 1.63 ± 0.74 with a mean insertion distance of 1.88 ± 1.89 mm. The OMN branch to the IOM crossed the lateral IRM margin 5.38 ± 5.42 mm from the posterior maxillary wall. Conclusions This cadaveric study quantifies the variability of two critical neurovascular structures salient to endoscopic approaches to the inferior intraconal space, the OMN, and OA contributions to the IRM. Knowledge of the interrelationship between these structures is essential in safe technique for dissection.

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Incidence and Risk Factors of Inferior Rectus Muscle Palsy in Pediatric Orbital Blowout Fractures

Craniomaxillofacial Trauma & Reconstruction ◽

10.1055/s-0037-1601884 ◽

2018 ◽

Vol 11 (1) ◽

pp. 028-034 ◽

Cited By ~ 1

Author(s):

Stephanie M. Young ◽

Yan Tong Koh ◽

Errol W. Chan ◽

Shantha Amrith

Keyword(s):

Risk Factors ◽

Clinical Features ◽

Pediatric Patients ◽

Rectus Muscle ◽

Orbital Floor ◽

Case Review ◽

Inferior Rectus ◽

Retrospective Case ◽

Orbital Blowout Fractures ◽

Inferior Rectus Muscle

The aim of this study was to evaluate the incidence, clinical features, and risk factors of sustaining inferior rectus (IR) palsy in a group of pediatric patients with orbital floor blowout fractures. We performed a retrospective case review of sequential cases of pediatric orbital floor blowout fractures (<18 years old) from 2000 to 2013 in a tertiary ophthalmic center in Singapore. A total of 48 patients were included in our study, of whom 5 had IR palsy (10.4%). Patients with IR palsy had a higher mean age (16.4 ± 1.5 years) compared with patients without IR palsy (12.4 ± 3.3 years), had significantly ( p < 0.05) worse preoperative motility, and had significantly greater proportion developing postoperative hypertropia (100%) compared with patients without IR palsy (4.7%). Our series of pediatric blowout fractures demonstrated IR palsy prevalence and clinical features for IR palsy which may be distinct to the pediatric group.

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