Background/Aim. The detailed knowledge of the architecture of the upper
eyelid is very important in numerous upper eyelid corrective surgeries. The
article deals with the detailed anatomy of the major components of the upper
lid, which are commonly seen in surgical practice. Methods. This study was
conducted on 19 human cadavers (12 adults and 7 infants) without pathologic
changes in the orbital region and eyelids. Anatomic microdissection of the
contents of the orbita was performed bilaterally on 12 orbits from 6 unfixed
cadavers (3 male and 3 female). Micromorphologic investigations of the
orbital tissue were performed on 8 en bloc excised and formalin-fixed orbits
of infant cadavers. Specimens were fixed according to the Duvernoy method. An
intra-arterial injection of 5% mixture of melt formalin and black ink was
administered into the carotid arterial system. Using routine fixation,
decalcination, dehydration, illumination, impregnation and molding procedures
in paraplast, specimens were prepared for cross-sections. Results. The
measurement of the muscle length and diameter in situ in 6 nonfixed cadavers
(12 orbits) showed an average length of the levator palpbrae superioris (LPS)
muscle body of the 42.0 ? 1.41 mm on the right, and 40.3 ? 1.63 mm on the
left side. In all the cases, the LPS had blood supply from 4 different
arterial systems: the lacrimal, supratrochlear, and supraorbital artery and
muscle branches of the ophthalmic artery. The LPS muscle in all the specimens
was supplied by the superior medial branch of the oculomotor nerve. The
connective tissue associated with the LPS muscle contains two transverse
ligaments: the superior (Whitnall?s) and intermuscular transverse ligaments
(ITL). The orbital septum in all the specimens originated from the arcus
marginalis of the frontal bone, and consisted of two layers - the superficial
and the inner layer. In addition, a detailed histological analysis revealed
that the upper eyelid?s crease was formed by the conjoined fascia including
the fascia of the orbicularis muscle, the superficial layer of the orbital
septum, and the aponeurosis of the LPS muscle, as well as the pretarsal
fascia. Conclusion. The conducted study provided a valuable morphological
basis for biomechanical and clinical considerations regarding blepharoptosis
surgery.
Surgical anatomy and histology of the levator palpebrae superioris muscle for blepharoptosis correction