Orbital Foramen Research Articles

Morphometric Analysis of Infraorbital Foramen in Human Dry Skulls

Background and aim: The infraorbital foramen morphometric and anatomical variations is the critical factor for avoiding iatrogenic nerve injuries during surgery on the middle third of the face with safe regional anesthesia. The present study aimed to carry out the morphometric analysis of infra orbital foramen in human dry skull. Material and Methods: This morphometric study was carried out on 72 dry human skulls in the Department of Anatomy, Surayya Azeem Teaching Hospital, Lahore from January 2022 to June 2022. Research and ethical committee approved the study protocol. Skulls of identified age and gender with no apparent pathology, traumatic lesions, and deformity were enrolled. Skulls (>18 years) with bone resorption in the alveolar region and had orbital and nasal cavities damaged were excluded. Vernier caliper was used for the measurement of infra orbital foramen exact location on both sides. Transverse and sagittal diameter were measured. Infraorbital foramen and inferior margins of infraorbital margin were measured in order to determine the sagittal diameter. Infraorbital foramen medial margin to lateral margin of pyriform aperture was measured transversely. This study examined the relationship between the infraorbital foramen and the 1st premolar as well as its shape. There was also an indication of accessory foramen. SPSS version 26 was used for descriptive statistics. Results: Of the total 72 dry human skulls, there were 58 (80.6%) male and 14 (19.4%) females. The incidence of oval, triangular, semilunar, and round shape infra orbital foramen (left versus right) was (38.4% vs. 40.3%), (17.8% vs. 16.9%), (26.7% vs. 28.6%), and (17.1% vs. 14.2%) respectively. The occurrence of single and accessory intra orbital foramen was 91.8% and 8.2% respectively. The intra orbital foramen opening was directed medially downward, medially in, and downward was 34 (47.2%), 32 (44.4%), and 6 (8.3%) respectively. In association with upper teeth, the intra orbital foramen on the right and left side was 38.4% and 54.9% respectively; the buccal cusps of the maxillary second premolar teeth were located on the same vertical axis. Conclusion: The present study concluded that accurate localization of the IOF is essential to prevent infraorbital nerve injury. Additionally, foramen oval shape was the most prevalent shape followed by round shape. Knowledge regarding IOF location is critical in maxillofacial region during numerous surgery procedures which might lead to infraorbital vessels and nerve. Thus careful approach should be followed to avoid damage to foramen. Keywords: Infra orbital foramen, human skulls, morphometric analysis

Valid 3D surface superimposition references to assess facial changes during growth

Currently, the primary techniques applied for the assessment of facial changes over time utilize 2D images. However, this approach has important limitations related to the dimensional reduction and the accuracy of the used data. 3D facial photography has been recently introduced as a risk-free alternative that overcomes these limitations. However, the proper reference areas that should be used to superimpose serial 3D facial images of growing individuals are not yet known. Here, we tested various 3D facial photo superimposition reference areas and compared their outcomes to those of a standard anterior cranial base superimposition technique. We found that a small rectangular area on the forehead plus an area including the middle part of the nose and the lower wall of the orbital foramen provided comparable results to the standard technique and showed adequate reproducibility. Other reference areas that have been used so far in the literature were less reliable. Within the limitations of the study, a valid superimposition reference area for serial 3D facial images of growing individuals is suggested. The method has potential to greatly expand the possibilities of this highly informative, risk free, and easily obtained 3D tool for the assessment of facial changes in growing individuals.

Anthropometric measurements of infra orbital foramen in a selected Senegalese population; surgical implications

The infraorbital foramen (IOF) is an essential anatomical structure for maxillary block anesthesia in dental practice and maxillofacial surgery. The literature also reports the importance of knowing the morphometric characteristics of the infraorbital foramen because it can be damaged during maxillofacial surgery. PurposeThe aim of our study is to determine anthropometric characteristics of the infra orbital foramen in a selected Senegalese population. Material and methodsA total of 87 CT-Scan of patients were included in our research. The data were collected from cerebral CT-Scan in three-dimensionnal reconstruction of patients. The transverse and vertical diameters of the IOF and its distance to the nearest point of the infraorbital margin, lateral nasal border and lower border of the maxillary were measured and the shape determined. Result87 CT-scan of patients were be analyzed. The mean transverse diameter of IOF on the left side was 5.00 mm ± 0.130 while on right it was 4.99 mm ± 0.130. The mean distance between the right foramen and the infraorbital margin was 11.0 mm ± 0.284 and 10.6 mm ± 0.272 for the left side. Foramen was located at 46% on the line above the 2nd premolar. The right IOF was round in 52% of subjects while the left was oval for 44% and semi lunar for 4%. An accessory IOF was found in 11% of the subjects. ConclusionKnowledge of the precise anatomical location of IOF is important in surgical procedures and reduce the relative risks during clinical procedures.This study showed many differences in the location of the infra orbital foramen with caucasians measurments done.

Sexual dimorphism and infra orbital foramen: a computerized tomography-Scan study in a coorte of Senegalese population

Background The infraorbital foramen (IOF) is an essential anatomical structure for maxillary block anesthesia in dental practice and maxillofacial surgery. The literature also reports the importance of knowing the morphometric characteristics of the IOF because it can be damaged. The aim of our study is to determine anthropometric characteristics of infra orbital foramen in Senegalese population in relationship with the sex. Material and methods A total of 87 CT-Scan of patients were included in our sample and data collected from patient's cerebral CT-Scan. The transverse and vertical diameters of the IOF and its distance to the nearest point of the infraorbital margin, lateral nasal border and lower border of the maxillary were measured and the shape determined. Results 87 CT-scan of patients were be analyzed. This research showed that the transverse diameter of the left IOF in female was 5.05 mm ± 0.205 and 4.97 mm ± 0.22 in male. The mean vertical diameter of the right foramen found in our study was 5.30 mm ± 0.191 for the female subject and 5.28 mm ± 0.137 for the men foramen was located at 46% on the line above the 2nd premolar. The right IOF was round in 52% of subjects. An accessory IOF was found in 20% of female subjects. Conclusions Knowledge of the precise anatomical location of IOF is important in surgical procedures and reduce the relative risks during clinical procedures.This study showed many differences in the location of the IOF with caucasians measurments done.

Cidence of Meningo Orbital Foramen in Dry South Indian Skulls and its clinical significance

cidence of Meningo Orbital Foramen in Dry South Indian Skulls and its clinical significance

Effects of infraorbital nerve's anatomical course on the fracture pattern of the orbital floor

In this study, details of the infraorbital nerve's (ION's) anatomical course variants were compared using computed tomography (CT), and relationships between the variants and fracture patterns in the orbital floor were investigated. Fifty-two normal individuals and 50 patients with unilateral isolated orbital floor fractures were enrolled in this study. Four measurements in normal individuals and five measurements in fracture patients were obtained in parasagittal sections. The anatomical variations of the ION were categorized into three types according to the classification by Ferences etal. Among the normal individuals, 42 orbits were classified as type 1 ION, 48 orbits as type 2, and 14 orbits as type 3. The distance from the inferior orbital rim to the upper border of the inferior orbital foramen and the length of descension portion of the ION in type 1 ION were significantly shorter than in type 2 and type 3 IONs. In patients with orbital floor fractures, the distance from the inferior orbital rim to the upper border of the inferior orbital foramen was positively correlated with herniation level of bone and soft tissue. The ION had three anatomical variants according to the degree of descension in the anterior portion of the orbit. When fracture of the orbital floor occurs in patients with type 1 ION, inferior displacement of the fractured orbital bone and orbital soft tissue may be less severe than in patients with other ION types.

A study of supra orbital foramen and supra orbital notches in unknown human skulls

A study of supra orbital foramen and supra orbital notches in unknown human skulls

Anatomical Study of the Intraosseous Pathway of the Infraorbital Nerve.

The infraorbital nerve (ION) is at risk for iatrogenic injury during orbital floor repair. The authors aim to anatomically characterize the intraosseous course of the ION between the inferior orbital fissure and infraorbital foramen. Ten cadaver heads (20 orbits) were dissected, with exposure of the orbital floor. The ION was identified from the infraorbital fissure to inferior orbital foramen. The presence and caliber of an osseous roof was noted. Distances measured were infraorbital foramen to infraorbital margin; length of the inferior orbital groove; length of the inferior orbital canal; length from the inferior orbital fissure to the infraorbital margin. Three variations of the osseous anatomy around the ION were identified. Four cadavers had no identifiable groove (Type 1, 40%) and the ION was completely roofed throughout its course. Five specimens exhibited a thin, transparent osseous roof over the nerve before forming the true canal, which we describe as a "pseudocanal" (Type 2, 50%). A true groove was seen in both orbits from a single cadaver (Type 3, 10%). Each cadaver had an ION course of the same type on both sides. Mean ± SD intraorbital foramen to infraorbital margin distance was 7.1 ± 1.4 mm. Distance from the infraorbital fissure to the infraorbital margin was 28.5 ± 2.3 mm. The course of the infraorbital nerve can be described as Type 1 (true canal), Type 2 (pseudocanal), and Type 3 (groove and canal). The authors propose that this novel classification system will raise awareness of variations in orbital floor anatomy.

Anthropometric Analysis of Infraorbital Foramen in Adult Indian Dry Skull

Abstract Introduction: Normally infra orbital foramen (IOF) is situated on the anterior surface of maxilla about 1cm below the infra orbital margin (IOM) bilaterally. Infra orbital vessels and nerves emerge out through this foramen. Infra orbital nerve (ION) terminates by supplying skin over the lower eyelid, conjunctiva, lateral aspect of external surface of nose, upper lip, ala of the nose and the premolar teeth. Infra orbital vessels supply the area surrounding the IOF. Objective: To measure distance between superior part of the rim of the IOF to IOM (DIM) and the distance between the medial part of the rim of the IOF to lateral margin of the pyriform aperture (DIP). Compare the measurements of both sides. Compare our studies with other authors. Materials and methods: Sixty adult dry skulls of unknown sex were studied. Those skulls with damaged foramen were excluded. Measurements were done in millimetres. Result: The mean DIM on right side is 5.96 mm and on left side it is 6.07. Mean DIP on right side is 16.70 mm and on left side it is 16.63mm. We have observed that there is no much significant variations in respect to sides. Our values were within the range of many others value. Conclusion: Knowing exact location of IOF using different land mark is important for providing local anaesthesia in maxillofacial, plastic surgical operations and radio ablative neurotomy procedures. Thus information obtained is very useful IOF to avoid iatrogenic injury in the infra orbital area.

A study of anatomical relations of supraorbital notch and foramen

Aim and Objective: The supraorbital foramen is a bony elongated path located above the orbit (eye socket) and under the forehead. The supraorbital foramen lies directly below the eyebrow. The aim of the study is to analyse the anatomical relations of supra orbital notch and foramen in south indian skulls at saveetha dental college Chennai. Materials and methods: The study will be done in 21 dry skulls. The occurrence of supraorbital foramen is examined in those skulls. The distance between the supraorbital foramen from nasal midline, and its horizontal and vertical diameter is measured using a Vernier calliper. Results: The mean distance of SOF/SON from nasal midline on the right are 30.18±3.78 and on the left are 29.51±3.01. and The mean vertical and horizontal diameters of SOF on the right side are 2.45±2.96 and 4.69±1.72, while those on the left side are 1.01±2.90 and 4.55±1.53, respectively Conclusion: This study helps to determine the precise location of supraorbital foramen or notch in relation to various anatomical structures which is essential for performing invasive surgical procedures involving anesthetic and therapeutic procedures.

A Study of Occurrence and Morphometric Analysis on Meningo Orbital Foramen

Aim and Objective: To study the occurrence and morphometric analysis on meningo-orbital foramen. Background: Foramen meningo-orbital is present in the greater wing of sphenoid bone close to superior orbital fissure.It is a site of anastomoses between the orbital branch of middle meningeal artery and recurrent meningeal branch of ophthalmic artery. It was stated that it is a rare occurrence. But nowadays there is frequent incidence of this foramen. Reason: This study is conducted to improve our knowledge about the occurrence of the meningo-orbital foramen in the skull which may be of surgical significance to ophthalmologist, neurosurgeons and radiologists.

Morphometric characteristics of the optic canal and the optic nerve.

The optic nerve (ON), a major component of the visual system, is divided into four segments: the intrabulbar (IB), the intraorbital (IO), the intraca- nalicular (ICn) and the intracranial (ICr). The ICr ends with the two nerves partially decussating in the optic chiasm (OCh). The purpose of this study is to provide a detailed description of the dimensions of the OC (the diameter and the surface area of its foramina and the central segment, as well as the length of the OC and the thickness of its walls) as well as the ON (the length of the ON segments, the diameter of the ICn segment of the ON, the angle of decussation in the OCh, as well as the distance between the two ON at the cranial foramen of the OC). The acquired data was then used to estimate the volu- me of the OC and the ICn segment of the ON. The morphometric research was performed on 25 cadavers (17 male and 8 female) and 30 skulls. The surface area of the central segment of the OC was significantly smaller than the cranial foramen (p = 0.02) and the orbital foramen (p = 0.009). The inferior wall of the OC was significantly shorter than the other OC walls (p < 0.0001). The IO segment of the ON was the longest, where the difference to the ICn and ICr was statistically significant (p < 0.0001). The surface area of the ON at the cranial foramen was significantly larger than the surface area at the central segment of the OC (p = 0.02) and orbital foramen (p < 0.0001). The difference between the surface areas of the ON at the orbital foramen and the central segment of the OC was also statistically significant (p = 0.01). The estimated volume of the OC was calculated to be 190.72 mm3, and the volume of the ICn segment of the ON was estimated to be 50.25 mm3. It is absolutely crucial to open the central segment of the OC when decompressing the ON, due to the narrowing of the OC in this segment.

Genetically induced abnormal cranial development in human trisomy 18 with holoprosencephaly: comparisons with the normal tempo of osteogenic-neural development.

Craniofacial malformations are common congenital defects caused by failed midline inductive signals. These midline defects are associated with exposure of the fetus to exogenous teratogens and with inborn genetic errors such as those found in Down, Patau, Edwards' and Smith-Lemli-Opitz syndromes. Yet, there are no studies that analyze contributions of synchronous neurocranial and neural development in these disorders.Here we present the first in-depth analysis of malformations of the basicranium of a holoprosencephalic (HPE) trisomy 18 (T18; Edwards' syndrome) fetus with synophthalmic cyclopia and alobar HPE. With a combination of traditional gross dissection and state-of-the-art computed tomography, we demonstrate the deleterious effects of T18 caused by a translocation at 18p11.31.Bony features included a single developmentally unseparated frontal bone, and complete dual absence of the anterior cranial fossa and ethmoid bone. From a superior view with the calvarium plates removed, there was direct visual access to the orbital foramen and hard palate. Both the eyes and the pituitary gland, normally protected by bony structures, were exposed in the cranial cavity and in direct contact with the brain. The middle cranial fossa was shifted anteriorly, and foramina were either missing or displaced to an abnormal location due to the absence or misplacement of its respective cranial nerve (CN). When CN development was conserved in its induction and placement, the respective foramen developed in its normal location albeit with abnormal gross anatomical features, as seen in the facial nerve (CNVII) and the internal acoustic meatus. More anteriorly localized CNs and their foramina were absent or heavily disrupted compared with posterior ones. The severe malformations exhibited in the cranial fossae, orbital region, pituitary gland and sella turcica highlight the crucial involvement of transcription factors such as TGIF, which is located on chromosome 18 and contributes to neural patterning, in the proper development of neural and cranial structures. Our study of a T18 specimen emphasizes the intricate interplay between bone and brain development in midline craniofacial abnormalities in general.

Comparison between Palpation and Superficial Marking Techniques in Determining Infraorbital Foramen in Chinese Women

Background : Difficulties in determining infraorbital foramen were often found in anesthesia procedures, reconstruction surgery, acupuncture, and botox insertion. The most common technique used is palpation technique. However, there are some disadvantages in this technique.The aim of this study was to establish a new superficial marking technique to determine the position of infraorbital foramen by making a horizontal imaginary line from the top part of nose wings. Methods : This study was an analytical cross-sectional study conducted at the Faculty of Medicine, Universitas Padjadjaran in Jatinangor-Sumedang during the period of April to November 2012. A total of thirty Chinese female students were assessed to measure the mean distance between the inferior orbital margin to the infra orbital foramen and inferior orbital margin to horizontal imaginary line from the top part of nose wings. The differences were then checked using paired t-test. Results : There was a significance difference between the mean distance of the inferior orbital margin to the infra orbital foramen and the inferior orbital margin to the horizontal imaginary line from the top part of the nose wings on the right and left face of Chinese women with p<0.05 (p=0.000). Conclusion : Infra orbital foramen cannot be determined by using superficial marking technique in Chinese women. Keywords : Infra orbital foramen, palpation technique, superfacial marking technique DOI: 10.15850/amj.v2n1.427

Intradural Tophaceous Gout of the Cavernous Sinus and Spine: Case Report and Review of Literature

Background: Purine-rich diets and improper metabolism of uric acid result in deposition of monosodium urate crystals in multiple organs throughout the body. Gout is typically characterized by recurrent attacks of inflammatory arthritis; however, deposition of uric acid crystals in the spinal canal may result in debilitating back pain, neural compression, and progressive myelopathy. While extradural gout is a widely reported source of spinal cord compression, we present a novel case of an individual with intradural tophaceous gout in the cranial and spinal cavities. Case history: A 61-year-old African-American male presented with diplopia, masticatory difficulty, and facial pain. Serial imaging revealed an enlarging, heterogeneously enhancing mass in the left cavernous sinus with extension into the superior orbital fissure and foramen ovale, raising suspicion for a meningioma. Successful surgical resection of the cavernous lesion was undertaken to eliminate the risk of permanent ophthalmoplegia and blindness. The pathological findings were felt to be compatible with chondroma. Nine years later, after stable yearly imaging follow-up of the cranial lesion, the patient presented with progressive myelopathy. Imaging of the spine revealed enhancing, intradural lesions suggestive of calcified meningiomas. Surgical resection was undertaken to preserve motor function. Histopathologic diagnosis after spinal decompression was tophaceous gout. Retrospective review of the cranial pathology indicated that this lesion, too, was consistent with tophaceous gout. Conclusion: The pathophysiology of spinal tophaceous gout is well known and extradural lesions are not uncommon. However, multifocal intradural tophi involving intracranial and intraspinal compartments have not been previously reported. This case represents the first reported case of both intracranial and intraspinal intradural tophaceous gout causing neurological deficits.

English

INTRODUCTION: A study was done on 100 intact, unsexed human skulls in the Department of Anatomy, KIMS, Bangalore, to observe and record the presence of a groove in the lateral wall of the orbit, synonymous with infra orbital sulcus. This entity has been described by the fortieth edition of Gray's text book of Anatomy to extend from the lateral end of superior orbital fissure to the orbital floor. It sometimes contains an anastomosis between middle meningeal artery and infra orbital artery. The upper end of the groove may coincide with the cranioorbital foramen (of Hyrtl, synonymous with foramen meningoorbitale).Material& Methods: 100 intact unsexed adult human skulls from the department of Anatomy KIMS Bangalore were studied. They were presumed to be of South Indian origin. RESULTS: In the present study 52 grooves were present in 200 orbits, of which 25 were on the right and 27 on the left. The origin of the groove from the cranio orbital foramen occurred once on the left. DISCUSSION: the results of the present study have been compared with previous workers. The authors hope that the study will be of use to ophthalmologists, neurosurgeons and anthropologists.

Morphology and morphometry of infra orbital foramen in South Indian adult dry skulls

Abstract Background: The infra orbital foramen (IOF) situated below infra-orbital margin (IOM) transmits infra­orbital nerve and infra- orbital vessels. The knowledge of the dimension, shape and direction of the IOF has important implications in various surgical and anaesthetic procedures. This will avoid iatrogenic injury to neurovascular bundle emerging from the IOF. Material and methods: Sixty adult dry skulls of unknown sex from the Department of Anatomy and Department of Forensic Medicine were used. IOF on both sides of skulls were assessed for the shape and direction by inspection. The vertical and horizontal diameter of the IOF was measured using a digital Vernier caliper to the nearest millimeters and the results were statistically analyzed. Results: The shape of the IOF was vertically oval in majority of the skulls (37.5%) and was semi lunar shaped in 10.83% of the skull. The IOF was directed infero­medially in about 52.5% of the cases and was directed medially in 6.67% of the cases. The mean transverse diameter was 2.96mm and the mean vertical diameter was 3.7mm. All the above results were compared with studies of previous workers. Conclusion: The present study confirms that there is racial as well as regional variation in the shape and dimensions of IOF, thus emphasizing the need to have morphometric data for South Indian population.

Morphology and morphometry of infra orbital foramen in South Indian adult dry skulls

Morphology and morphometry of infra orbital foramen in South Indian adult dry skulls

The epidural approach to the Meckel’s cave: a how I do it

Meckel's cave (MC) is a meningeal cleft lying in the middle fossa laterally to the cavernous sinus. Tumours that develop inside the MC may require a surgical resection. The authors describe the surgical technique of the intracranial epidural approach to the MC. Based upon anatomical dissection showing the relevant surgical anatomy, and illustrated by the video of an operated case, the authors detail the surgical procedure. The key point is to shave the floor of the middle fossa and skeletonize the superior orbital fissure, rotundum and ovale foramen in order to delineate the plane of dural elevation and expose the lateral wall of the MC. The rules of exposure and resection of the tumour are then shown. Variations and limitations of the approach are discussed. Conducted in a stepwise manner and following relevant landmarks, the epidural anterolateral approach offers a safe and reliable exposure to the diseases that develop within the MC.

MORPHOMETRIC STUDY OF INFRA ORBITAL FORAMEN IN DRY ADULT SKULLS AND ITS SURGICAL RELEVANCE

Infra orbital foramen (IOF) is an opening in the maxillary bone of skull located below the infra orbital margin (IOM) of the orbit. The study was conducted to determine the distance between infra orbital foramen and infra orbital margin, accessory infra orbital foramen in dry adult skulls with the aim of improving the efficiency in clinical situations such as maxillofacial surgeries and infra orbital nerve block. A total of one hundred dry human skulls were measured using vernier caliper by using sagittal and transverse measures. The general mean distance of IOF from IOM was 6.69+2.86mm (ranged from 3 to 11mm). The accessory IOFs were observed in 10.1% of the skulls (including both the sides). The knowledge of the distances from surgically encountered anatomic landmarks may be of assistance in locating these important maxillofacial neurologic structures during many procedures. This information may play an even more important role as new techniques for minimally invasive surgery are developed. Understanding the location of these foramina will also assist the clinician in performing local anesthetic blocks.