Bony Orbit Research Articles

Morphological examination of the visual system and orbital region in the red panda (Ailurus fulgens fulgens)

ObjectivesThe red panda is currently the only surviving member of the Ailuridae family in the Caniformia suborder. In this study, we provide data on anatomical, morphometric, histological and histochemical examination of the orbital region, eyelids, orbital gland, and eye tunics in two adult males Ailurus fulgens fulgens from the Wroclaw Zoological Garden, Poland.MethodsThe study involved morphometric analysis of the eyeball and selected accessory organs of the eye, along with analysis of the bony orbit, including its morphometry, macroscopic, and microscopic evaluation. Microscopic evaluation encompassed histological and histochemical staining, with the former involving hematoxylin & eosin (H&E), Movat pentachrome, picro-Mallory trichrome, Fontana-Masson, and the latter including PAS, AB pH 1.0, AB pH 2.5; AB pH 2.5/PAS, and HDI.ResultsThe upper (UE) and lower (LE) eyelids presented well-developed tarsal glands, sebaceous glands, and a characteristic simple alveolar gland (producing a mucous secretion). The palpebral part of the lacrimal gland was present. A single lymphoid follicle was observed only in the upper eyelids. The superficial gland of the third eyelid (SGTE) was a multilobar acinar complex that produces mucous secretion and is contained within the interlobular ducts of numerous aggregates of lymph nodes. The third eyelid (TE) was T-shaped and composed of hyaline tissue, containing CALT. The lacrimal gland (LG) also revealed a multilobar acinar complex that produced mucous secretion, with a single lymphoid follicle. The cornea consisted of 4 layers, as Bowman’s membrane was absent. The Vogt palisades composed of 7–10 layers of epithelial cells were demonstrated. The pupil was horizontally ovoid at rest (post-mortem). The sphincter pupil and the dilator pupil were well developed. Macroscopically, the tapetum lucidum appeared as a milky, non-opalescent crescent. Histologically, the choroidal tapetum lucidum cellulosum consisted of 5 to 9 layers of loosely packed oval cells. The retina showed a composition similar to that of terrestrial nocturnal carnivores.ConclusionsThe results of our research indicate that the anatomical features of the eye and orbital region in the red panda share similarities with those described in the Musteloidea clade, as well as the Canidae and Ursidae families.

Are Age and Trauma Mechanism Associated with Volume Change in the Fractures of the Bony Orbit?

Blowout fractures are common midfacial fractures in which one or several of the bones of orbital vault break. This is usually caused by a direct trauma to the eye with a blunt object such as a fist. Fracturing of the fragile orbital bones can lead to changes in the orbital volume, which may cause enophthalmos, diplopia, and impaired facial aesthetics. Objectives: The aim of this study is to investigate whether there is an association between volume change of the bony orbit and age, gender, or trauma mechanism. Methods: A retrospective study of patients with unilateral blowout or blow-in fractures treated and examined in Päijät-Häme Central Hospital, Lahti, Finland was conducted. Altogether, 127 patients met the inclusion criteria. Their computed tomographs (CT) were measured with an orbit-specific automated segmentation-based volume measurement tool, and the relative orbital volume change between fractured and intact orbital vault was calculated. Thereafter, a statistical analysis was performed. A p-value less than 0.05 was considered significant. Results: We found that relative increase in orbital volume and age have a statistically significant association (p = 0.022). Trauma mechanism and gender showed no significant role. Conclusions: Patient's age is associated with increased volume change in fractures of the bony orbit.

Unilateral optic nerve aplasia associated with microphthalmia: a rare cadaveric report

This case report describes the anatomical presentation of the anomalous optic nerve (cranial nerve II). Cranial nerve II developmental anomalies encompass both optic nerve hypoplasia and aplasia. While most studies on optic nerve anomalies rely on radiological imaging, anatomical presentation and nerve course are rarely described. The current case reveals a complete absence of the right optic nerve and its connection to the optic chiasma, resembling radiological presentation of optic nerve aplasia. In addition, the right-sided bony orbit and eyeball were smaller than the left, accompanied by a poorly developed cornea and iris with a calcified mass, resembling clinical presentation of microphthalmia. Having a thorough understanding of the gross anatomical presentation and course of optic nerve anomalies can facilitate precise diagnosis and management of visual impairments associated with these anomalies. Furthermore, such knowledge can provide valuable insights into the actual prevalence of optic nerve aplasia and further substantiate the literature.

Automated 3-D Computer-Aided Measurement of the Bony Orbit: Evaluation of Correlations among Volume, Depth, and Surface Area.

(1)The study aimed to measure the depth, volume, and surface area of the intact human orbit by applying an automated method of CT segmentation and to evaluate correlations among depth, volume, and surface area. Additionally, the relative increases in volume and surface area in proportion to the diagonal of the orbit were assessed. (2) CT data from 174 patients were analyzed. A ball-shaped mesh consisting of tetrahedral elements was inserted inside orbits until it encountered the bony boundaries. Orbital volume, area depth, and their correlations were measured. For the validation, an ICC was used. (3) The differences between genders were significant (p < 10-7) but there were no differences between sides. When comparing orbit from larger to smaller, a paired sample t-test indicated a significant difference in groups (p < 10-10). A simple linear model (Volume~1 + Gender + Depth + Gender:Depth) revealed that only depth had a significant effect on volume (p < 10-19). The ICCs were 1.0. (4) Orbital volume, depth, and surface area measurements based on an automated CT segmentation algorithm demonstrated high repeatability and reliability. Male orbits were always larger on average by 14%. There were no differences between the sides. The volume and surface area ratio did not differ between genders and was approximately 0.75.

Surgical treatment of orbital tumors in a single center: Analysis and results.

Orbital tumors, arising within the bony orbit and its contents, present diverse challenges due to their varied origins and complex anatomical context. These tumors, classified as primary, secondary, or metastatic, are further subdivided into intraconal and extraconal based on their relationship with the muscle cone. This classification significantly influences surgical approach and management. This study highlights surgical experiences with orbital tumors, underscoring the importance of tailored surgical approaches based on the lesion's site and its proximity to the optic nerve. This retrospective study at the National Institute of Cancer's Head and Neck Department (2005-2014) analyzed 29 patients with orbital tumors treated with surgery, radiotherapy, chemotherapy, or combinations of them. Patient demographics, tumor characteristics, and treatment responses were evaluated using computed tomography (CT), magnetic resonance imaging, and positron emission tomography-CT imaging. Malignant tumors often required orbital exenteration and reconstruction, highlighting the study's commitment to advancing orbital tumor treatment. 29 patients (18 females and 11 males, age 18-88 years, mean 53.5 years) with orbital tumors exhibited symptoms such as decreased vision and exophthalmos. Tumors included primary lesions like choroidal melanoma and secondary types like epidermoid carcinoma. Treatments varied, involving a multidisciplinary team for surgical approaches like exenteration, with follow-up from 1 to 9 years. Radiotherapy and chemotherapy were used for specific cases. Our study underscores the need for a multidisciplinary approach in treating orbital tumors, involving various surgical specialists and advanced technologies like neuronavigation for tailored treatment. The integration of surgery with radiotherapy and chemotherapy highlights the effectiveness of multidimensional treatment strategies.

Complete Preservation of Orbital Fat by Restoration of Attenuated Orbital Septa Using an Acellular Dermal Matrix in Lower Blepharoplasty.

We hypothesized that application of acellular dermal matrix (ADM) over the orbital septum overlying the herniated orbital fat to tighten and strengthen the attenuated orbital septum in lower blepharoplasty would allow successful repositioning of the herniated orbital fat within the bony orbit. The author prospectively compared the cosmetic outcomes of lower blepharoplasty using ADM with standard blepharoplasty. We evaluated recurrence of eyelid bulging and tear trough deformity, volume of the lower periorbital region, and enophthalmos and eyelid droop 1 year after surgery. Twenty-two of the 24 enrolled patients completed the study. There was no significant difference in recurrence of eyelid bulging and tear trough deformity between standard blepharoplasty and blepharoplasty with ADM graft groups. In the standard blepharoplasty group, the volume of the lower periorbital region decreased significantly after surgery. In the blepharoplasty with ADM graft group, there was no significant change in the volume of the lower periorbital region after surgery. In the standard blepharoplasty group, there was no significant change in eyelid droop on either side after surgery. In the blepharoplasty with ADM graft group, the eyelid droop decreased significantly after surgery on the right side but showed no significant change on the left side. There was no significant change in enophthalmos after surgery for either group. This study demonstrated that ADM graft provided effective support for maintaining the replaced orbital fat in lower blepharoplasty. In the long-term, blepharoplasty with ADM graft might be effective in slowing development of age-related enophthalmos. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Morphometric analysis of orbital CT scan in a Jordanian sample

ABSTRACT Background Anatomical variation exists among different ethnicities in almost all body parts, including the bony skull. Researchers have found some variations between both sexes in the inner measurements of the bony orbit as well as variations related to racial differences. In this study, we assessed different parameters related to the bony orbit that are important clinically, using data collected from a random sample of the diverse population of Jordan, seeking to find out how our population correlates with the variations mentioned in the literature, and applying the results for their clinical importance for many disciplines of medicine related to ophthalmology and maxillofacial surgery, among others. Research Design and Methods This was a cross-sectional study conducted on healthy patients from the Jordan University Hospital. We randomly selected participants aged between 17 and 89, who attended the ophthalmology clinic in the Jordan University Hospital. For each patient, we obtained clinical data and computed tomography (CT) images, using four two-dimensional measurements of the orbit: D1 = distance from the orbital canal to the frontozygomatic fissure, D2 = distance from the orbital canal to the nasion, D3 = distance between the supraorbital and infraorbital canals, and D4 = distance between the nasion and the frontozygomatic fissure. Results We included a total of 161 participants, with a mean age of 54.4 (±19.3) years. They were 83 men (51.6%) and 78 women (48.4%). We found a significant difference in D3 between Jordanian males and females from various races, which might indicate a possible strong effect of sexual hormones on the orbital development. Conclusions We analyzed different measurements that are clinically relevant on a sample of Jordanian patients. These measurements can be useful for surgical decision-making and for research purposes. Our key limitations were related to concerns about the safety of CT imaging for the soft tissue of the eye and the use of two-dimensional measurements instead of three-dimensional ones.

Three-dimensional soft tissue reconstruction and volume measurement used for the diagnosis of dysthyroid optic neuropathy.

Dysthyroid optic neuropathy (DON) leads to vision loss. This study aimed to investigate a new method that can directly evaluate the change in muscle cone inner volume (MCIV) and distinguish DON orbits from non-DONs. This study included 54 patients (108 orbits) who were diagnosed with thyroid eye disease and treated at the Beijing Tongren Hospital between December 2019 and September 2021. The extraocular muscle volume (EOMV), orbital fat volume (OFV), and bony orbit volume (BOV) of the patients were measured using three-dimensional reconstruction. MCIV was measured using artificially defined boundaries. The associations between these volumes and clinical indicators were studied, and the diagnostic efficacy of these volumes for DON was described using receiver operating characteristic (ROC) curves. The ROC curve showed that the area under the curve of MCIV/BOV (%) combined with EOMV/BOV (%) reached 0.862 (p < 0.001), with a sensitivity of 85.7% and a specificity of 76.1%. The combination of MCIV/BOV (%) and EOMV/BOV (%) is a good indicator for the diagnosis of DON, which aids in the early detection and intervention of DON.

Unilateral Cleft Lip and Palate Has Asymmetry of Bony Orbits: A Retrospective Study.

Facial asymmetry is common in unilateral clefts. Since virtual surgical planning (VSP) is becoming more common and automated segmentation is utilized more often, the position and asymmetry of the orbits can affect the design outcome. The aim of this study is to evaluate whether non-syndromic unilateral cleft lip and palate (UCLP) patients requiring orthognathic surgery have asymmetry of the bony orbits. Retrospectively, we analyzed the preoperative cone-beam computed tomography (CBCT) or computed tomography (CT) data of UCLP (n = 15) patients scheduled for a Le Fort 1 (n = 10) or bimaxillary osteotomy (n = 5) with VSP at the Cleft Palate and Craniofacial Center, Helsinki University Hospital. The width, height, and depth of the bony orbit and the distance between the sella turcica and infraorbital canal were measured. A volumetric analysis of the orbits was also performed. The measurements were tested for distribution, and the cleft side and the contralateral side were compared statistically with a two-sided paired t-test. To assess asymmetry in the non-cleft population, we performed the same measurements of skeletal class III patients undergoing orthognathic surgery at Päijät-Häme Central Hospital (n = 16). The volume of bony orbit was statistically significantly smaller (p = 0.014), the distance from the infraorbital canal to sella turcica was shorter (p = 0.019), and the anatomical location of the orbit was more medio-posterior on the cleft side than on the contralateral side. The non-cleft group showed no statistically significant asymmetry in any measurements. According to these preliminary results, UCLP patients undergoing orthognathic surgery show asymmetry of the bony orbit not seen in skeletal class III patients without a cleft. This should be considered in VSP for the correction of maxillary hypoplasia and facial asymmetry in patients with UCLP.

Are Magnetic Resonance Imaging-Generated 3Dimensional Models Comparable to Computed Tomography-Generated 3Dimensional Models for Orbital Fracture Reconstruction? An In-Vitro Volumetric Analysis

Magnetic resonance imaging (MRI) is being increasingly considered as an alternative for the evaluation and reconstruction of orbital fractures. No previous research has compared the orbital volume of an MRI-imaged, three-dimensional (3D), reconstructed, and virtually restored bony orbit to the gold standard of computed tomography (CT). To measure the orbital volumes generated from MRI-based 3D models of fractured bony orbits with virtually positioned prebent fan plates in situ and compare them to the volumes of CT-based virtually reconstructed orbital models. This retrospective in-vitro study used CT and MRI data from adult patients with orbital trauma assessed at the Royal Brisbane and Women's Hospital Outpatient Maxillofacial Clinic from 2011 to 2012. Only those with orbital blowout fractures were included in the study. The primary predictor variable was imaging modality, with CT- and MRI-based 3D models used for plate bending and placement. The primary outcome variable was the orbital volume of the enclosed 3D models. Additional data collected was age, sex, and side of fractured orbit. The effect of operator variability on plate contouring and orbital volume was quantified. The Wilcoxon signed rank test was used to assess differences between orbital volumes with a significance level P<.05. Of 11 eligible participants, six patients (four male and two female; mean age 31±8.6years) were enrolled. Two sets of six CT-based virtually restored orbits were smaller than the intact contralateral CT models by an average of 1.02cm3 (95% CI -0.07 to 2.11cm3; P=.028) and 0.99cm3 (95% CI 0.07 to 1.91cm3; P=.028), respectively. The average volume difference between the MRI-based virtually restored orbit and the intact contralateral MRI model was 0.97cm3 (95% CI -1.08 to 1.94cm3; P=.75). Imaging modality did affect orbital volume difference for 1 set of CT and MRI models (0.63cm3; 95% CI -0.11 to 1.29cm3; P=.046) but not the other (0.69cm3; 95% CI -0.11 to 1.23cm3; P=.075). Single operator variability in plate bending did not result in significant (P=.75) volume differences. MRI can be used to reconstruct orbital volume with a clinically acceptable level of accuracy.

Cavernous hemangioma of zygomatic bone - A rare case report

A 45-year-old woman presented with a history of unilateral fixed, painless, gradually progressive swelling in the right frontal part of the zygomatic bone for 6 years. On examination, the best-corrected visual acuity (BCVA) of the right and left eye was 20/20. On palpation, the swelling was a solitary mass of hard consistency, painless, adhering to deep planes under normal-looking skin. Orbital computed tomography (CT) scanning showed monostotic fibrous dysplasia of the lateral wall of the right bony orbit of the zygoma. The right orbital mass was managed by excisional biopsy with bone grafting. The histopathological report revealed a cavernous hemangioma of the zygomatic bone.

Seeing through the eyes of the sabertooth Thylacosmilus atrox (Metatheria, Sparassodonta)

The evolution of mammalian vision is difficult to study because the actual receptor organs—the eyes—are not preserved in the fossil record. Orbital orientation and size are the traditional proxies for inferring aspects of ocular function, such as stereoscopy. Adaptations for good stereopsis have evolved in living predaceous mammals, and it is reasonable to infer that fossil representatives would follow the same pattern. This applies to the sparassodonts, an extinct group of South American hypercarnivores related to marsupials, with one exception. In the sabertooth Thylacosmilus atrox, the bony orbits were notably divergent, like those of a cow or a horse, and thus radically differing from conditions in any other known mammalian predator. Orbital convergence alone, however, does not determine presence of stereopsis; frontation and verticality of the orbits also play a role. We show that the orbits of Thylacosmilus were frontated and verticalized in a way that favored some degree of stereopsis and compensated for limited convergence in orbital orientation. The forcing function behind these morphological tradeoffs was the extraordinary growth of its rootless canines, which affected skull shape in Thylacosmilus in numerous ways, including relative orbital displacement.

Retrospective comparison of one-stage and two-stage orbital reconstruction in patients suffering from combined injuries of the midface

Reconstruction of the bony orbit in patients with combined midface injuries is frequently discussed in the current literature. Two main concepts can be distinguished: single-stage reconstruction, usually with a hand-bent titanium orbital mesh, and two-stage reconstruction, in which osteosynthesis of the zygomaticomaxillary complex (ZMC) is followed by orbital reconstruction with a virtually-planned, patient-specific titanium implant in a second surgery. This study aimed to compare one-stage and two-stage surgical approaches on combined midface fractures regarding postoperative diplopia. A total of 58 patients treated with one-stage (n = 29) or two-stage (n = 29) reconstruction of the ZMC and orbit were included, and their postoperative course over five months was retrospectively analysed. A descriptive quantitative analysis of the course of occurrence of diplopia was recorded to calculate the success of orbital repair in complex midface fractures including the orbit. The two workflows differed in the prevalence of postoperative clinical diplopia and eyelid complications. Multiple factors affect the decision whether or not to reconstruct the orbit first, and in the same intervention as the associated midface fracture. Thorough evaluation of each individual patient with a patient-specific choice of surgical concept is crucial, and includes multiple factors.

Morphometry of the Bony Orbit and Periorbital Structures: Personal Perspectives From Decades of Related Research.

The author introduces his personal perspectives on the bony orbit, nerves, arteries, and ligaments relating to orbital re- construction surgery. A supraorbital fissure was 40.0 ± 2.5 mm from the supraorbital notch. Posterior ethmoidal foramen was 31.7 ± 3.0 mm from the anterior lacrimal crest. The infraorbital fissure, where the infraorbital groove started, was 26.4 ± 2.6 mm from the infraorbital foramen. The supraorbital fissure was 34.3 ± 2.7 mm from the frontozygomatic suture. The medial palpebral ligament consisted of 2 layers. The superficial layer of the palpebral ligament (SMPL) was from the anterior lacrimal crest to the upper and lower tarsal plates. The deep layer of the palpebral ligament (DMPL) lay from the anterior lacrimal crest to the posterior lacrimal crest, covering the lacrimal sac. Horner muscle was at the posterior lacrimal crest just lateral to the attachment of the DLPL and ran laterally to the tarsal plate deep to the SLPL. Three components of the lateral canthal area are: (1) lateral palpebral raphe, (2) superficial lateral palpebral ligament (SLPL), and (3) deep lateral palpebral ligament (DLPL). The lateral ends of superior and inferior orbicularis oculi muscles interlaced at the lateral commissure and formed the lateral palpebral raphe. The superficial lateral palpebral ligament extended from the lateral ends of the tarsal plate to the periosteum of the lateral orbital rim. The lateral palpebral ligament extended from the lateral ends of the tarsal plate deep to the origin of SLPL to the Whitnall tu- bercle on the zygomatic bone. The palpebral branch of the in- fraorbital artery emerged from the infraorbital foramen and ran superior and lateral to the orbital septum. After passing through the orbital septum, distributed to the orbital fat.

A Computed Tomographic Investigation of the Ophthalmic Artery Volume and Its Relevance to Soft Tissue Filler Injections.

The measured intraarterial volume of cadaveric ophthalmic arteries was utilized for safety recommendations during facial soft tissue filler injections. However, its clinical practicability and model applicability have become questionable. To measure the volume of the ophthalmic artery in living individuals by utilizing computed tomography (CT) imaging technology. A total of 40 Chinese patients (23 males, 17 females) were included in this study with a mean age of 61.0 (14.2) years and a mean body mass index of 23.7 (3.3) kg/m2. Patients were investigated with CT imaging technology to evaluate the length, diameter, and volume of the bilateral ophthalmic arteries as well as the length of the bony orbits, resulting in a total of 80 investigated ophthalmic arteries and orbits. Independent of gender, the average length of the ophthalmic artery was 80.6 (18.7) mm, the calculated volume of the ophthalmic artery was 0.16 (0.05) mL and the minimal and maximal internal diameter of the ophthalmic artery were 0.50 (0.05) mm and 1.06 (0.1) mm, respectively. Based on the results obtained from the investigation of 80 ophthalmic arteries it must be concluded that current safety recommendations should be reevaluated. The volume of the ophthalmic artery appears to be 0.2 mL rather than 0.1 mL as previously reported. In addition, it appears impractical to limit the volume of soft tissue filler bolus injections to 0.1 mL due to the aesthetic requirements of each individual patient and treatment plan.

Morphometric and volumetric evaluations of orbit using three-dimensional computed tomography in southwestern Iranian population

BackgroundThe aim of the present research was to assess morphometric and volumetric measurements of bony orbit using computed tomography to define the effects of age and gender on orbital anthropometry. Method302 orbital cavities in 151 adult samples (18–90 years with a mean age of 43.10 ± 20.25 years) were investigated (100 males [66.2%] and 51 females [33.8%]). The samples represented no history of orbital trauma, dysplasia, or other diseases with a putative effect on orbital growth. ResultsThe mean orbital height for the right and left sides were 3.75 ± 0.20 and 3.74 ± 0.21 cm, respectively, while the orbital width was 3.44 ± 0.17 and 3.46 ± 0.17 cm, respectively. The mean interorbital-biorbital width was 2.26 ± 0.26 and 9.55 ± 0.41 cm, respectively. The mean OI in both genders was 108.52 ± 6.83. There was no significant difference in OI index between the genders or sides. The study population belonged to the Megaseme category. The mean right/left orbital volume (OV) of both genders was 25.20 and 24.68 cm3, respectively. OV was significantly larger in males than females (P < 0.005) and showed sexual dimorphism. There was a positive, statistically significant association of OV with the samples' age (P < 0.0001) ConclusionThe outcomes of this research showed that the CT and 3D volumetric methods represent useful baseline morphometric data for the southwestern Iranian population using a reliable technique in orbital volumetry. The obtained data can be used for the diagnosis of orbital pathologies and anthropological studies.

Ocular prosthetics in children-Possibilities and challenges

One of the greatest challenges for ocularists is prosthetic fitting in children, especially in children with congenital anomalies such as clinical anophthalmia or functionless (blind) microphthalmia. The most frequent reason for prosthetic fitting in children is acondition following enucleation for retinoblastoma, followed by trauma and congenital pathologies. The standard treatment after enucleation or evisceration begins intraoperatively with the selection of an suitable implant and the use of aconformer at the end of the operation to shape the prosthetic cavity. An initial prosthesis can be fitted 4weeks postoperatively, with afinal fitting taking place 3months later. If iatrogenic scarring or scarring due to an infection of the prosthetic cavity occurs, the approach of the ocularist must be appropriately adapted with the use of modified prosthesis shapes and shorter treatment intervals. Surgical options include scar excision and oral mucosa or amniotic membrane transplantation. Congenital anomalies require the shortest treatment intervals and even more so for anophthalmia than for microphthalmia. The strategy is characterized by simultaneous stimulation of the soft tissue of the ocular adnexa as well as the bony orbit. As self-inflating hydrogel expanders are no longer available, conservative prosthetic treatment is the only option. Close cooperation between child/parent, ocularist and ophthalmic plastic surgeon is the best prerequisite for agood long-term treatment outcome.

Orbital soft tissues, bones, and allometry: Implications for the size and position of crocodylian eyes.

Although the visual system of crocodylians has attracted interest regarding optical parameters and retinal anatomy, fundamental questions remain about the allometry of the eyeball and whether such scaling is the same across all crown groups of crocodylians. In addition, anatomy and identities of adnexal soft tissues that interact with the visual system are not well understood in many cases. We used contrast-enhancing iodine stain and high-resolution micro-computed tomography to assess the anatomy of orbital soft tissues, including extraocular muscles and glands, in crocodylians. We also used regression analysis to estimate the allometric relationship between the bony orbit and eyeball across Alligator mississippiensis and Crocodylus niloticus for the first time. Results revealed tight, negatively allometric relationships between the bony orbit and eyeball. Notably, the eyes of C. niloticus were larger for a given orbit size than the eyes of A. mississippiensis, although the slope of the relationship was no different between these two crown crocodylian groups. Among the findings from our anatomical study, new details were uncovered about the homologies of muscles of the abducens complex. In particular, M. rectus lateralis of crocodylians is revealed to have a more complex form than previously appreciated, being adhered to the tendon of the nictitating membrane, which may be apomorphic for Crocodylia. Our calculation of the orbit-eyeball allometric relationship and study of the adnexal soft tissues of the crocodylian visual system, in combination with previous work by other teams in other crown saurian clades, is a critical, formerly missing, piece in the Extant Phylogenetic Bracket for restoring the visual apparatus of extinct crocodyliforms and other archosauriform groups.

Basic Consideration for Facial Aging: Age-Related Changes of the Bony Orbit and Orbicularis Oculi Muscle in East Asians.

Age-related changes in the periocular areas are mainly caused by anatomic changes of the bony orbit and orbicularis oculi muscle (OOM). To achieve effective rejuvenation, it is necessary to understand the age-related aspects of these anatomic changes. The aim of this study was to analyze the configuration of the bony orbit and OOM with computed tomography (CT) and to evaluate the effects of aging on these structures. A total of 220 orbits and OOMs of 110 Japanese participants (55 males, 55 females) aged 20 to 87 years were enrolled. The long diameter of the orbits, orbital ellipticity, OOM thickness, and OOM attachment to the inferior orbital rim were analyzed. These variables were statistically evaluated for their relationship with age. The long diameter of the orbit was significantly longer in those over than in those under 60 years, with a moderate and significant positive correlation between orbital ellipticity and age. OOM thickness and age showed a strong negative correlation. The degree of OOM attachment to the inferior orbital rim decreased significantly with age. This study showed that age-related changes of the bony orbit in Japanese individuals tended to be the same as those in Caucasians, but there were differences in the degree of changes observed. As a new finding in the Japanese population, the OOM not only thins with aging, but also gradually loosens from the facial bone. In the elderly, only the nasal side of the OOM was attached to the bone. In clinical applications, this knowledge could contribute to the development of cosmetic surgeries.

Surgical management of bony orbit tumors

BackgroundA variety of primary tumors affect the bony orbit. They include, sphenoid ridge meningioma, fibrous dysplasia, ossifying fibroma, osteoma and aneurismal bone cyst. Controversies in the treatment strategies still exist. This study is retrospective study that included 20 patients operated upon in the last three years—at neurosurgery department in Minia University Hospital—with tumors related to the bony orbit. We studied the data, to see what was done, what should have been done. CT and MRI were used for all patients preoperatively and for postoperative follow-up.ResultsFourteen patients had sphenoid ridge meningiomas, two patients had osteomas, two patients had fibrous dysplasia, one had ossifying fibromas and one aneurysmal bone cyst. Proptosis improved in all cases. But one patient had deterioration of vision. There were no postoperative cases of enophthalmos or pulsating exophthalmos.ConclusionsEarly surgical intervention is mandatory before the tumor becomes less amenable. Both CT and MRI should be done preoperatively. Opening the bony superior orbital fissure is a mandatory step in all cases, whereas the optic canal should be drilled out open only if the optic nerve is compromised within the canal. Thorough knowledge of the skull base operative techniques is a must.