Establishing the Precise Location of Apanga Marma and defining its Structural Component through Cadaveric Study

Abstract

Background: Apanga marma is a Jatrurdhwagata marma that is positioned within half angula dimension below the tail end of the eyebrow and outer to the lateral canthus of the eye. Its injury causes andhya and dristiupaghata. Sushruta classifies it as Sira structurally, however Vagbhata classifies it as Snayu marma. The precise position, radiance, and conflicts in opinion in identifying the structural entity and applied importance of this marma must be clarified. The objective of this study was to locate and ascertain the position and structural entity of Apanga marma. Materials and Methods: Study was conducted in two steps: Conceptual study by reviewing the literatures and cadaveric observational study by dissection over 4 cadavers. Results and Discussion: The Apanga marma was discovered to be positioned on the anterior section of the superior temporal fossa, near the lateral canthus of the eye. Extracranial, intracranial, and intraorbital neurovascular structures were observed within the designated area. Structures in the area include the Middle cerebral artery, the Middle meningeal artery, and the Abducent nerve, which can cause visual problems or total blindness if injured. Conclusion: Apanga marma was found to be located in the anterior section of the superficial temporal fossa, lateral to the lateral orbital edge, beneath the tail end of the eyebrow, and above the zygomatic arch. The middle meningeal and middle cerebral arteries were discovered as a specific anatomical entity in the marma area, resulting in blindness or vision impairment upon injury.