The Abducens Nerve: Microanatomic and Endoscopic Study

2007 ◽  
Vol 61 (suppl_3) ◽  
pp. ONS-7-ONS-14 ◽  
Author(s):  
Giorgio Iaconetta ◽  
Mario Fusco ◽  
Luigi M. Cavallo ◽  
Paolo Cappabianca ◽  
Madjid Samii ◽  
...  
Keyword(s):  
Cranial Nerve ◽  
Rectus Muscle ◽  
Abducens Nerve ◽  
Nerve Injuries ◽  
Endoscopic Endonasal ◽  
Lateral Rectus Muscle ◽  
Endoscopic Study ◽  
Anatomic Dissection ◽  
Neurovascular Structures

Abstract Objective: Only a few anatomic studies concerning the intra- or extracranial course of the abducens nerve (Cranial Nerve VI) have been reported. This is likely because the nerve passes through anatomically intricate areas, making its neurovascular relationships complex. Here we provide an anatomically and surgically oriented classification of the abducens nerve, analyze the microanatomy of the nerve and the surrounding connective and/or neurovascular structures, and provide measurements and anatomic topography. Patients and Methods: A microsurgical anatomic dissection of 55 cadaveric human heads was performed using different skull base approaches to explore the entire course of the VIth cranial nerve, from its origin at the pontomedullary sulcus to the lateral rectus muscle. We then approached the same areas via an endoscopic endonasal transsphenoidal route, analyzed the neurovascular relationships from an anteromedial perspective, and made comparisons with the microsurgical views. Results: The abducens nerve is divided into five segments, of which three are intracranial (cisternal, gulfar, and cavernous) and two are orbital (fissural and intraconal). Using two opposing surgical routes (microsurgical transcranial and endoscopic endonasal approaches) allows us to clearly reveal the spatial relationships of the abducens nerve with other neurovascular structures on the different nerve segments. Conclusion: The classification of five segments for the abducens nerve seems anatomically valid and is surgically oriented with respect to both the microscopic and endonasal endoscopic approaches. It would be useful to explain, segment by segment, the pathogenic mechanism(s) for nerve injuries that are evidenced by lesions that exist along the entire intra- and extracranial course.

The abducens nerve

1974 ◽  
Vol 41 (5) ◽  
pp. 561-566 ◽  
Author(s):  
Hilel Nathan ◽  
Georges Ouaknine ◽  
Isaac Z. Kosary
Keyword(s):  
Cavernous Sinus ◽  
Subarachnoid Space ◽  
Cranial Nerve ◽  
Rectus Muscle ◽  
Abducens Nerve ◽  
The Other ◽  
Sixth Cranial Nerve ◽  
Content Type ◽  
Lateral Rectus Muscle ◽  
Fine Print

✓ The authors describe the origins and course of the sixth cranial nerve in 62 cadaver or autopsy cases and describe three patterns. In Pattern 1 the nerve originates and runs all its way as a single trunk. In Pattern 2 it originates as a single trunk, but splits into two branches in the subarachnoid space, while in Pattern 3 it originates as two separate trunks. In both Patterns 2 and 3 the trunks perforate the dura mater independently and enter the cavernous sinus by passing one above and the other below the petrosphenoidal ligament. In the sinus the two trunks fuse into a single trunk which then continues to the lateral rectus muscle. The practical neurological importance of these variations is discussed.

scholarly journals Benign abducens nerve palsy: diagnosis by exclusion

2019 ◽  
Vol 6 (3) ◽  
pp. 1380
Author(s):  
Praveen U. ◽  
Sushma Save ◽  
Sanjay Singh
Keyword(s):  
Cranial Nerve ◽  
Nerve Palsy ◽  
Cranial Nerves ◽  
Rectus Muscle ◽  
Abducens Nerve ◽  
Immunological Reaction ◽  
Post Vaccination ◽  
Lateral Rectus Muscle ◽  
Diagnosis By Exclusion ◽  
History Of

Of all the cranial nerves, the abducens nerve has the longest intracranial course hence is most common cranial nerve to be affected secondary to any potentially devastating intracranial cause. It can indicate significant underlying pathology. Abducens or sixth cranial nerve innervates lateral rectus muscle and pathology of this nerve results in abduction deficiency of ipsilateral eye. Most of the time it will be unilateral but bilateral involvement is also well known. It can recurrent without any underlying identifiable pathology. The 6th nerve palsy is considered as benign after ruling out all possible causes. Benign causes account for just 9 to 14% of all 6th nerve palsies in children. Most of the time benign 6th nerve palsy occurs after viral infection or vaccination as an immunological reaction. In our case patient had history of pentavalent vaccination 1 month back. After thorough investigation and ruling out all possible causes it was attributed to post vaccination immunological reaction. which resolved spontaneously over 4months.

Intramuscular Distribution of the Abducens Nerve in the Lateral Rectus Muscle for the Management of Strabismus

2018 ◽  
Vol 43 (6) ◽  
pp. 689-695 ◽  
Author(s):  
Hyun Jin Shin ◽  
Shin-Hyo Lee ◽  
Kang-Jae Shin ◽  
Ki-Seok Koh ◽  
Wu-Chul Song
Keyword(s):  
Rectus Muscle ◽  
Abducens Nerve ◽  
Lateral Rectus ◽  
Lateral Rectus Muscle

Orbital Nerves

2012 ◽  
Author(s):  
David Jordan ◽  
Louise Mawn ◽  
Richard L. Anderson
Keyword(s):  
Lacrimal Gland ◽  
Cranial Nerve ◽  
Motor Nerve ◽  
Rectus Muscle ◽  
Abducens Nerve ◽  
Sympathetic Nerves ◽  
Lower Eyelid ◽  
Infraorbital Nerve ◽  
Ciliary Ganglion ◽  
Orbital Surgery

The orbit contains a vast array of motor, sensory, sympathetic, and parasympathetic nerve fibers. Some of these fibers can be seen during eyelid or orbital surgery and are often landmarks of one’s location within the orbit. It is important to know the various nerve pathways, appreciate that there might be some individual variation, and preserve these pathways during orbital surgery. The discussion of nerves begins with their superficial brainstem origin, proceeds to their intracranial course, and ends with their intraorbital course and eventual termination. The following nerves enter the orbit: 1. Optic nerve (cranial nerve II). 2. Oculomotor nerve (cranial nerve III). This motor nerve gives fibers to the levator, inferior oblique, and three of the four rectus muscles. It carries parasympathetic fibers destined for the ciliary ganglion. These fibers will eventually synapse in the ciliary ganglion and then travel to the iris sphincter muscles (sphincter pupillae). Sympathetic fibers have also been recently identified in this nerve. 3. Trochlear nerve (cranial nerve IV). This motor nerve distributes fibers to the superior oblique muscle. Sympathetic fibers have recently been identified within this nerve. 4. Trigeminal nerve (cranial nerve V). a. Ophthalmic division (V 1 ) . This sensory division gives fibers to the eyeball (iris, ciliary body, cornea), lacrimal gland, conjunctiva, and eyelids, as well as to the forehead. It also carries sympathetic nerves. b. Maxillary division (V 2 ) . As it enters the orbit, the maxillary division is known as the infraorbital nerve and lies beneath the periorbita. It gives off the zygomatic nerve, which is an important branch carrying parasympathetic and sympathetic fibers to the lacrimal gland. Within the infraorbital canal, alveolar nerves arise and provide sensation to the incisor and canine teeth. The infraorbital nerve provides sensation to the lower eyelid, nose, cheek area, and upper lip. 5. Abducens nerve (cranial nerve VI). This motor nerve goes to the lateral rectus muscle. Sympathetic fibers have recently been identified within this nerve.

The Lateral Rectus Muscle and Sixth Cranial Nerve in the Pig

Nature ◽  
1956 ◽  
Vol 178 (4537) ◽  
pp. 798-799 ◽  
Author(s):  
M. E. LAW ◽  
M. J. T. FITZGERALD
Keyword(s):  
Cranial Nerve ◽  
Rectus Muscle ◽  
Lateral Rectus ◽  
Sixth Cranial Nerve ◽  
Lateral Rectus Muscle

scholarly journals Bilateral traumatic paralysis of abducent nerves and clivus fracture: Case Report

2014 ◽  
Vol 21 (4) ◽  
pp. 507-509
Author(s):  
Willen Guillermo Calderon-Miranda ◽  
Hernando Raphael Alvis-Miranda ◽  
Gabriel Alcala-Cerra ◽  
Luis Rafael Moscote-Salazar
Keyword(s):  
Nerve Palsy ◽  
Cranial Nerves ◽  
Rectus Muscle ◽  
Abducens Nerve ◽  
Abducens Nerve Palsy ◽  
Traumatic Injuries ◽  
Cranial Trauma ◽  
Lateral Rectus Muscle ◽  
Clivus Fracture ◽  
Bilateral Abducens

Abstract Clivus fractures are a rare pathology, frecuently associated tohigh power trauma. Such injuries may be associated with vascular and cranial nerves lesions. The abducens nerve is particularly vulnerable to traumatic injuries due to its long intracranial course, since their real origin until the lateral rectus muscle. The unilateral abducens nerve palsy of 1- 2-7% occurs in patients with cranial trauma, bilateral paralysis is rare. We report a patient who presented bilateral abducens nerve palsy associated with a clivus fracture

Detailed anatomy of the abducens nerve in the lateral rectus muscle

2017 ◽  
Vol 30 (7) ◽  
pp. 873-877 ◽  
Author(s):  
Yong Seok Nam ◽  
In-Beom Kim ◽  
Sun Young Shin
Keyword(s):  
Rectus Muscle ◽  
Abducens Nerve ◽  
Lateral Rectus ◽  
Lateral Rectus Muscle

scholarly journals Endoscopic endonasal approach to the lateral orbital apex: case report

2015 ◽  
Vol 16 (3) ◽  
pp. 305-308 ◽  
Author(s):  
Tomasz A. Dziedzic ◽  
Vijay K. Anand ◽  
Theodore H. Schwartz
Keyword(s):  
Optic Nerve ◽  
Rectus Muscle ◽  
Lateral Compartment ◽  
Endoscopic Approach ◽  
Minimal Access ◽  
Endoscopic Endonasal Approach ◽  
Orbital Apex ◽  
Total Resection ◽  
Endoscopic Endonasal ◽  
Lateral Rectus Muscle

Although the medial and inferior orbital apex are considered safely accessible using the endonasal endoscopic approach, the lateral apex has been considered unsafe to access since the optic nerve lies between the surgeon and the pathology. The authors present the case of a 4-year-old girl with recurrent rhabdomyosarcoma attached to the lateral rectus muscle located lateral and inferior to the optic nerve in the orbital apex. The tumor was totally resected through an endoscopic endonasal transmaxillary transpterygoidal approach using a 45° endoscope. A gross-total resection was achieved, and the patient’s vision was unchanged. This procedure is a safe, minimal-access alternative to open procedures in selected cases and provides evidence that increases the applicability of the endonasal endoscopic approach to reach the lateral compartment of the orbital apex.

Sign in / Sign up

Export Citation Format

Share Document