100例颅骨视神经管及其周围关系的观察与测量

采用100个颅底(水平锯开颅顶),对视神经管进行测量,全长均值男11.0mm,女10.46mm;眶口的直径均值男4.48mm,女4.92mm;眶口横径均值男4.13mm,女3.38mm.视神经管口前缘点至眼眶前缘上、下、内、外四壁各点的距离均值分别为:男8.87、6.50、8.89、8.82mm;女8.72、6.00、8.22、7.35mm.视神经管眶口内侧缘中点至筛前孔、筛后孔、内眦部眶缘的距离均值分别为男34.4、20.7、43.96mm;女31.42、19.94、42.97mm.颅正中矢状轴与视神经管中轴的夹角均值男37.42度,女36.44度.两侧视神经管眶口均值男29.45mm,女27.51mm.并对眶口和颅口的形态进行了观察和测量.     

三叉神经节经皮射频热凝术进针安全深度的解剖与CT对照研究

目的：探讨三叉神经节经皮射频热凝术（PRT）进针安全深度,为颅内进针避免损伤血管神经提供解剖学依据。方法：选择21例成人颅底解剖标本,用游标卡尺从颅内测量卵圆孔内侧缘中点至破裂孔外侧缘中点的距离（A）和卵圆孔内侧缘中点至三叉神经压迹上缘最高点的距离（B）;同时从颅外同一方向测量卵圆孔内侧缘至破裂孔外侧缘的距离（c）和破裂孔外侧壁垂直深度（D）;用螺旋CT扫描颅底,测量颅底水平位颅中窝最大密度投影（MIP）图像上同一方向卵圆孔内侧缘至破裂孔外侧缘的距离（E）。然后对距离c和安全距离及距离E进行统计分析,确定距离E是否可以作为指导不同患者进行PRT治疗时个体化的颅内安全进针深度。结果：①颅内卵圆孔内侧缘中点至破裂孔外侧缘中点的距离为右侧（1．19±0．15）cm,左侧（I．20±0．14）cm;②颅内卵圆孔内侧缘中点至三叉神经压迹顶点的距离为右侧（1．51±0．17）cm,左侧（1．49±0．16）cm;③颅外卵圆孔内侧缘中点至破裂孔外侧缘中点的距离为右侧（0．92±0．09cm）,左侧（O．92±0．10）cm;④破裂孔外侧壁中点垂直深度为右侧（0．55±0．07）cm,左侧（0．55±0．07）cm;⑤中颅底水平位螺旋CT最大密度投影（MIP）图像上同一方向卵圆孔内侧缘中点至破裂孔外侧缘中点的距离为右侧（1．00±0．17）cm,左侧（1．00±0．17）cm,与距离C差异无统计学意义（P〉0．05）。结论：三叉神经节PRT治疗时颅内进针深度不应超过1．00Gm,临床上可用中颅底水平位螺旋CT最大密度投影（MIP）技术显示与相同方向卵圆孔内侧缘中点至破裂孔外侧缘中点的距离的一致性,来指导不同患者进行PRT治疗时个体化的颅内安全进针深度。     

眼眶的临床应用解剖学

眼眶是容纳视器及视器血管、神经的锥形腔隙,其周围毗邻关系非常复杂:4对鼻旁窦位于眶周,眶尖的眶上裂及视神经管向后通颅中窝,下壁的眶下裂向后与颞下窝、翼腭窝相通。因此,眶内与眶周毗邻结构的疾病可相互影响。在眶区手术中,医生掌握详尽的解剖学知识将可避免手术对病人视力及眼球运动功能可能造成的副损伤。本文综述了眶的骨学特征、眼动脉的分支及临床意义、视神经眶内段的应用解剖、眶内手术入路及选择依据。 1 眶的骨学特征 成人眶容积25～28ml,眶口宽40mm,高35mm,眶的最宽部并不在眶缘而在眶缘后约10mm处。眶深(眶轴长)40～50mm,当做球后麻醉时,针刺深度不可超过40mm,以免刺入颅腔。内眶距(两眶内侧缘间距离)男性平均20.8mm,女性20.3mm;外眶距两眶外侧缘间距离)男性平均96.0mm,女性93.1mm。 1.1 眶的构成 眶呈四面锥体形深腔,分一底、一尖、四壁。(1)底:即眶口。略呈四边形,向前下外倾斜。眶缘较厚,而且各缘并非处于同一平面上:眶外侧缘较内侧缘后退约1.5cm,眶下缘也较眶上缘稍居后方。在眶上缘中、内1/3交界处,距正中线约2.5cm处有眶上切迹或眶上孔,其中两侧均呈切迹者     

眶内侧壁的显微外科解剖

目的:为鼻眼相关外科手术提供解剖学参考资料.方法:在手术显微镜下观察20例(40侧)成人颅骨标本和15例30侧经10%福尔马林固定的成人尸头标本眶内侧壁的Dacryon点、筛孔、额筛缝及视神经管眶口.结果:Dacryon点至筛前、中、后孔中点、视神经管眶口的距离分别为(19.28±1.42)mm、(27.06±2.05)mm、(31.11±2.08)mm和(37.47±2.11)mm,Dacryon点至眶上缘、眶下缘的距离分别为(16.50±1.38)mm和(19.65±1.41)mm.颅骨标本的筛孔1、2、3孔和4孔出现率为0%、62.5%、32.5%和5%;尸头标本的筛动脉1、2、3、4支和5支出现率分别为10%、53.3%、33.3%、0%和3.3%.筛前、中、后孔位于额筛缝上方分别占37.5%、33.3%和35.7%,位于额筛缝分别占60%、66.7%和64.3%,所有筛孔中只有一孔(筛前孔)位于额筛缝下方.结论:Dacryon点、额筛缝是眶内侧壁的2个恒定的解剖标志,眶内侧壁手术时在额筛缝以下切除内侧壁是安全的.     

视神经管的显微外科应用解剖学

在40具成人尸体及40个颅骨上对视神经管及其邻近结构进行了观察和测量1.视神经管颅口的宽度平均为6.85±0.10mm,高度为4.05±0.09mm,眶口的宽度为5.63±0.07mm,高度为6.55±0.08mm,上壁长8.53±0.22mm,内侧壁长9.74±0.20mm,二侧颅口内侧缘间距为12.88±0.41mm,两侧眶口内侧缘间距为26.12±0.42mm。视神经管颅口上缘的硬膜襞最大前后径2.67±0.18mm。Dacryon至筛前孔距为19.25±0.36mm,筛前、后孔间距为13.61±0.27mm,筛后孔至视神经管眶口距为6.31±0.19mm。2.正常位置的视交叉占97.30±2.66%,后置视交叉占2.70±2.66%,未发现前置视交叉。鞍结节后端与视交叉前缘间距5.87±0.21mm。视神经在视神经管颅口处宽度为5.16±0.07mm,高度为2.69±0.06mm。视神经颅内段长11.47±0.28mm。于视神经管颅口处,两侧视神经内侧缘间距为13.70±0.46mm,两侧视神经间角度为60.39±2.11°。3.眼动脉单独来源于颈内动脉者占91.25±3.31%,双重来源于脑膜中动脉及颈内动脉者占7.50±3.08%,单独来源于脑膜中动脉者占1.25±1.30%。来源于颈内动脉的眼动脉84.81±4.38%为硬膜下起始,15.19±4.38%为硬膜外起始。讨论了眼动脉行经视神经硬膜鞘壁内的部分在临床上的意义。4.蝶甲型蝶窦占8.75±3.16%,鞍前型占41.25±5.50%,鞍型占50.0±7.91%。蝶甲型不与视神经管内侧壁毗邻。47.22±5.88%的筛后窦侵入蝶骨体内,与视神经管内侧壁毗邻。5.调查了视神经管内侧壁的毗邻变化以及窦与窦间骨性中隔附着线的形态变化,讨论了与临床有关的问题。     

视神经管显微解剖学研究

目的　为视神经管减压术提供解剖学依据。方法　利用解剖学方法对 10 0个颅骨和 6 7个尸头视神经管口及四壁的结构与毗邻进行了观察和测量。结果　视神经管由蝶骨小翼两根与喋骨体构成 ,管自后内向前外斜行 ,分内、外、上、下四壁和颅、眶两口。其上壁、下壁、内侧壁、外侧壁的长度分别为 10 70±0 2 3mm ,6 2 5± 0 18mm ,9 6 7± 0 18mm ,7 91± 0 17mm。内侧壁向筛窦、蝶窦内突入形成视神经管隆凸。视神经在颅口处有硬脑膜压迹 ,视神经腹侧有眼动脉形成的压迹。结论　视神经管隆凸可作为确定视神经管位置的解剖标志。视神经管下壁和内侧壁与视神经、眼动脉、颈内动脉等结构毗邻 ,切除管壁时应注意保护邻近结构。     

骨性眶腔的应用解剖

目的 :进一步探讨骨性眶腔的构成特点 ,为相关开眶手术入路提供解剖学依据。方法 :取 30例国人成人头颅骨性标本 ,观察眶腔的构成、分部 ,并测量各部的有关参数。结果 :(1)由前向后 ,可将骨性眶腔按形态及结构的不同分为球周部、球后部和眶尖部三部分。 (2 )Dacryon点距筛前孔、筛前孔距筛后孔、筛后孔距视神经管眶口及筛后孔距眶尖的距离分别为 (2 0 .13± 2 .79)mm、(13.38± 2 .6 6 )mm、(7.4 0± 2 .0 3)mm、(13.4 1± 2 .35 )mm。 (3)Mac Carty关键孔位于翼点正前方 (2 5 .74± 4 .12 )mm及颧额蝶缝交汇点正上方 (15 .2 0± 2 .4 5 )mm处。结论 :(1)骨性眶腔各部的构成及内容不同 ,手术入路各异。 (2 )DaCryon点、筛前孔、筛后孔是眶内侧手术入路的重要标志性结构 ,(3)Mac -Carty关键孔是临床经眶颅部手术常用的钻孔部位     

小儿与成人视神经管显微外科解剖学比较

目的 :研究小儿视神经管解剖特点 ,为小儿颅底外科提供解剖学资料。方法 :35例无颅眶疾病、经福尔马林固定的尸头 ,成人组 2 0例 ,小儿组 1 5例。在手术显微镜下测量视神经管的颅口、眶口、顶、底、内、外侧壁等参数。结果 :小儿颅口宽 4 35± 0 .5 8mm ,管顶长 6 95± 1 .2 4mm ,管底长 4 6 3± 0 .2 6mm ,内侧壁长 6 5 2± 1 .0 8mm ,外侧壁长 6 4 5± 0 .97mm。眶口宽 4 6 1± 0 .6 7mm ,高 4 93± 0 .2 9mm。小儿视神经管为实质型 ;成人视神经管依蝶窦、筛窦气化程度分为三型 :倒U型 ;C型 ;D型。结论 :小儿视神经颅内段较管腔内段相对较长 ;管壁厚 ,呈实质型 ,无狭部存在 ;至成人管顶伸长是管底的 3倍 ;颅口硬膜返折部短且边缘圆钝。     

眶上裂及其内容物

Ｔｈｅｓｕｐｅｒｉｏｒｏｒｂｉｔａｌｆｉｓｓｕｒｅａｎｄｉｔｓｃｏｎ ｔｅｎｔｓＦ .Ｇｏｖｓａ ,Ｇ .Ｋａｙａｌｉｏｇｌｕ ,Ｍ .Ｅｒｔｕｒｋ ,ｅｔａｌ.眶上裂及其内容物眶上裂的局部解剖学标志对颅中窝、海绵窦和眼眶的一般定位及手术入路是有用的。本研究在 5 7块关节离断的蝶骨、10 2块颅底及 5 8例成人尸头标本上对眶上裂及其相关结构进行了显微外科解剖学和形态测量。根据Ｓｈａｒｍａ等 ( 1988)的分类法以 9种不同形状对眶上裂进行观察 ,最常见的是Ⅵ型。测得眶上裂内上缘至外上缘的距离右侧为 17.3± 3 .4ｍｍ ,左侧为 16.9…     

视神经管及眶上裂区巨微解剖学研究

视神经管及眶上裂为颅眶沟通的２个重要骨性孔隙。视神经及眼动脉经视神经孔出入眶，而所有通过海绵窦的脑神经及眼静脉均经眶上裂出入眶。虽然关于海绵窦及眼眶的显微解剖学研究已报道许多［１～８］，但作为两者交通的视神经管及眶上裂区的系统显微解剖学研究却很少［９...     

Morphometric measurements from various reference points in the orbit of male Caucasians

The aim of this study was to determine the morphometric variations from various reference points to decrease risks in orbital surgery. Sixty-two orbits obtained from 31 skulls of male adult Caucasians were measured with a millimetric compass. On the medial orbital wall, the midpoint of the anterior lacrimal crest was the reference point; from this point we measured distances of 23.9+/-3.3 mm, 35.6+/-2.3 mm, 41.7+/-3.1 mm and 6.9+/-1.5 mm respectively to the anterior ethmoidal foramen, posterior ethmoidal foramen, midpoint of the medial aspect of the optic canal and posterior lacrimal crest. On the same wall, distances from the plane of the anterior and posterior ethmoidal foramina to the ethmoido-maxillary suture and distance from the posterior ethmoidal foramen to the anterior ethmoidal foramen and midpoint of the medial margin of the optic canal were 14.9+/-2.3 mm, 9.8+/-2.9 mm and 6.8+/-2.2 mm respectively. On the inferior orbital wall, the main reference point was the infraorbital foramen, and from this point to the midpoints of the lateral margin of the fossa for the lacrimal gland, inferior orbital fissure, inferior orbital rim and inferior aspect of the optic canal was 23.8+/-7.2 mm, 31.9+/-3.9 mm, 6.7+/-1.9 mm and 50.3+/-3.2 mm respectively. On the superior orbital wall, the distances from the supraorbital foramen to the midpoints of the superior orbital fissure, fossa for the lacrimal gland and superior aspect of the optic canal were 45.7+/-3.6 mm, 26.0+/-2.5 mm and 45.3+/-3.2 mm respectively. Furthermore, on the same wall, the distance from the posterior ethmoidal foramen to the midpoint of the superior orbital fissure was 14.6+/-2.8 mm. Finally, on the lateral orbital wall the frontozygomatic suture was the reference point. From this point distances to the midpoints of the fossa for the lacrimal gland, superior orbital fissure, lateral aspect of the optic canal and inferior orbital fissure were 17.5+/-2.1 mm, 37.7+/-3.6 mm, 44.9+/-2.5 mm and 33.4+/-3.1 mm respectively.     

Morphometric measurements from various reference points in the orbit of male Caucasians

The aim of this study was to determine the morphometric variations from various reference points to decrease risks in orbital surgery. Sixty-two orbits obtained from 31 skulls of male adult Caucasians were measured with a millimetric compass. On the medial orbital wall, the midpoint of the anterior lacrimal crest was the reference point; from this point we measured distances of 23.9Dž.3 mm, 35.6DŽ.3 mm, 41.7Dž.1 mm and 6.9ǃ.5 mm respectively to the anterior ethmoidal foramen, posterior ethmoidal foramen, midpoint of the medial aspect of the optic canal and posterior lacrimal crest. On the same wall, distances from the plane of the anterior and posterior ethmoidal foramina to the ethmoido-maxillary suture and distance from the posterior ethmoidal foramen to the anterior ethmoidal foramen and midpoint of the medial margin of the optic canal were 14.9DŽ.3 mm, 9.8DŽ.9 mm and 6.8DŽ.2 mm respectively. On the inferior orbital wall, the main reference point was the infraorbital foramen, and from this point to the midpoints of the lateral margin of the fossa for the lacrimal gland, inferior orbital fissure, inferior orbital rim and inferior aspect of the optic canal was 23.8lj.2 mm, 31.9Dž.9 mm, 6.7ǃ.9 mm and 50.3Dž.2 mm respectively. On the superior orbital wall, the distances from the supraorbital foramen to the midpoints of the superior orbital fissure, fossa for the lacrimal gland and superior aspect of the optic canal were 45.7Dž.6 mm, 26.0DŽ.5 mm and 45.3Dž.2 mm respectively. Furthermore, on the same wall, the distance from the posterior ethmoidal foramen to the midpoint of the superior orbital fissure was 14.6DŽ.8 mm. Finally, on the lateral orbital wall the frontozygomatic suture was the reference point. From this point distances to the midpoints of the fossa for the lacrimal gland, superior orbital fissure, lateral aspect of the optic canal and inferior orbital fissure were 17.5DŽ.1 mm, 37.7Dž.6 mm, 44.9DŽ.5 mm and 33.4Dž.1 mm respectively. The French version of this article is available in the form of electronic supplementary material to this paper can be obtained by using the Springer Link server located at http://dx.doi.org/10.1007/s00276-002-0071-0. Résumé. Le but de cette étude était de déterminer les variations morphométriques à partir de différents points de référence afin de diminuer le risque en chirurgie orbitaire. Soixante-deux orbites, obtenues à partir de 31 crânes de sujets mâles adultes caucasiens, ont été mesurées avec un compas millimétrique. Sur la paroi médiale de l'orbite le milieu de la crête lacrymale antérieure était le point de référence ; à partir de ce point ont été obtenues des mesures de 23,9Dž,3 mm, 35,6DŽ,3 mm, 41,7Dž,1 mm, 6,9ǃ,5 mm respectivement pour le foramen ethmoïdal antérieur, le foramen ethmoïdal postérieur, le milieu du bord médial du canal optique et la crête lacrymale postérieure. Sur cette même paroi, la distance entre le niveau des foramen ethmoïdaux antérieur et postérieur et la suture ethmoïdo-maxillaire, et la distance entre le foramen ethmoïdal postérieur et le milieu du bord médial du canal optique ont été trouvées à respectivement 14,9DŽ,3 mm, 9,8DŽ,9 mm, 6,8DŽ,2 mm. Sur la paroi inférieure de l'orbite, le principal point de référence était le foramen infra-orbitaire; à partir de ce point ont été mesurées respectivement les distances jusqu'aux milieux du bord latéral de la fosse de la glande lacrymale, de la fissure orbitaire inférieure, du bord orbitaire inférieur et du bord inférieur du canal optique respectivement à 23,8lj,2 mm, 31,9Dž,9 mm, 6,7ǃ,9 mm, 50,3Dž,2 mm. Sur la paroi supérieure de l'orbite, les distances à partir du foramen supra-orbitaire jusqu'aux milieux de la fissure orbitaire supérieure, de la fosse de la glande lacrymale et du bord supérieur du canal optique ont été trouvées respectivement à 45,7Dž,6 mm, 26,0DŽ,5 mm, 45,3Dž,2 mm. De plus, sur cette même paroi, la distance séparant le foramen ethmoïdal postérieur et le milieu de la fissure orbitaire supérieure a été mesurée à 14,6DŽ,8 mm. Pour terminer, sur la paroi latérale de l'orbite, la suture fronto-zygomatique était le point de référence. A partir de ce point, des mesures ont été réalisées jusqu'aux milieux de la fosse de la glande lacrymale, de la fissure orbitaire supérieure, du bord latéral du canal optique et de la fissure orbitaire inférieure, trouvées respectivement à 17,5DŽ,1 mm, 37,7Dž,6 mm, 44,9DŽ,5 mm et 33,4Dž,1 mm.     

Navigational area of the cranio-orbital foramen and its significance in orbital surgery

The cranio-orbital foramen (COF) is located on the lateral wall of the orbit. It is a potential source of hemorrhage during deep lateral orbital dissection, since it functions as an anastomosis between the lacrimal artery and the middle meningeal artery. The aim of this study was to guide and facilitate the surgical procedures in the orbit, so as to determine a navigational area and the precise location of the COF and to standardize certain anatomical marks. The navigational area of the COF and topographical features were studied in 75 craniums with presented COF. 33 bilateral main COFs, 41 (18 on the right, 23 on the left) unilateral main COFs at the main cranium and 19 accessory COFs were studied for their navigational features on the orbit. The distances between the COF and the fronto-zygomatic suture, supraorbital notch, lateral angle of the superior orbital fissure (SOF) and Whitnall’s tubercle were measured. The mean distance of the COF from the fronto-zygomatic suture, supraorbital notch, lateral angle of the SOF and Whitnall’s tubercle was 26.3, 37.3, 92 and 27.1 mm, respectively. For the navigational area signs of the COF, areas of the orbit that form the transversal and vertical lines are generated on the reference points. Whilst the upper outer area of the orbit contains a potential bleeding risk, the bottom section of the outer column is identified as safe for the surgical operations of the lateral orbital wall. The fronto-zygomatic suture and Whitnall’s tubercle are recommended as the most reliable navigational landmarks for identifying the COF. Hence, the transversal and vertical orientation of the COF should be mastered by the surgeons reconstructing the anterior base of the skull and the orbit.     

改良经眶入路翼腭窝穿刺解剖学观测

目的　为眶入路法行翼腭窝穿刺提供新的进针路径。 方法　对77个（154侧）成人颅的眶和翼腭窝进行相关的观察和测量。 结果　眶外缘点至眶外下缘点、圆孔外口下缘、眶上裂后端、眶下裂前端的距离分别为：左（4.93±1.80）mm,右(4.02±2.05）mm;左（43.74±2.75）mm,右(43.80±2.89）mm;左（47.83±2.47）mm,右(47.74±2.53）mm;左（17.74±2.18）mm,右(17.43±1.97）mm。穿刺针（直针）由眶外缘点进入翼腭窝的成功率为：左侧96.10%;右侧93.51%。对穿刺针（直针）进入翼腭窝失败者改用弯针穿刺,直针和弯针由眶外缘点进入翼腭窝的总成功率为：左、右均达98.70%。 结论　经眶外缘点行眶入路翼腭窝穿刺可明显提高穿刺成功率。     

Localization of the supraorbital,infraorbital, and mental foramina using palpable,bony landmarks

The purpose of this study was to locate the infraorbital, supraorbital, and mental foramina by using palpable anatomical landmarks that are conducive to surgical use. Fourteen embalmed cadavers (27 sides) were dissected to expose the supraorbital, infraorbital, and mental foramina. Measurements were made from the lateral orbital rim at the zygomaticofrontal (ZF) suture to both the supraorbital and infraorbital foramina. The distance from the inferior orbital rim at the zygomaticomaxillary (ZM) suture to both foramina was also measured. The distance to the mental foramen was measured from the angle and the inferior border of the mandible. The supraorbital foramen was located 26.2 ± 2.8 mm medial and 13.5 ± 3.7 mm superior to the ZF suture. The infraorbital foramen was located 23.8 ± 3.1 mm medial and 30.9 ± 3.8 mm inferior to the ZF suture, on average. Vertical measurements made from the ZM suture to the supraorbital foramen averaged 34.4 ± 3.6 mm and from the ZM suture to the infraorbital foramina averaged 7.6 ± 2.2 mm. The mental foramen was 64.2 ± 6.4 mm medial to the angle of the mandible and 12.9 ± 1.6 mm superior to the inferior border of the mandible. This study provides data that may be useful in predicting the location of the supraorbital, infraorbital, and mental foramina using palpable landmarks. These data may be particularly helpful for surgery in patients with missing teeth or fractures of the maxillary bone. Clin. Anat., 2010. © 2009 Wiley‐Liss, Inc.     

Localization of important facial foramina encountered in maxillo-facial surgery

Knowledge of the location of foramina in the maxillo-facial region is necessary in clinical situations requiring regional nerve blocks and in open as well as endoscopic surgical procedures to avoid injury to corresponding nerves. In this study, measurements were taken on 79 adult dried human skulls to determine the position of the supraorbital, infraorbital, and mental foramina. Supraorbital foramina were found to be approximately 25 mm lateral to the midline, 30 mm medial to the temporal crest of the frontal bone, and 2-3 mm superior to the supraorbital rim. Additional exits for branches of the supraorbital nerve were present in 14% of skulls. The intersection of the zygomatico-maxillary suture with the inferior orbital rim was a readily palpable landmark for locating the infraorbital foramen. This foramen was approximately 7 mm inferior to the inferior orbital rim and 28.5-mm lateral to the midline. Mental foramina were on average, 25.8-mm lateral to the midline and about 13-mm superior to the inferior mandibular margin. Both the infraorbital and mental foramina were most often on a vertical line with the second premolar (Position 3). The distances of the foramina from the midline were similar on both sides demonstrating facial symmetry. In about 80% of skulls, the supraorbital, infraorbital, and mental foramina/notches were along the same vertical line. These measurements may be of value to clinicians in localizing and safeguarding these nerves and providing effective nerve blocks.     

Anatomical Consideration of the Anterior and Lateral Cutaneous Nerves in the Scalp

To better understand the anatomic location of scalp nerves involved in various neurosurgical procedures, including awake surgery and neuropathic pain control, a total of 30 anterolateral scalp cutaneous nerves were examined in Korean adult cadavers. The dissection was performed from the distal to the proximal aspects of the nerve. Considering the external bony landmarks, each reference point was defined for all measurements. The supraorbital nerve arose from the supraorbital notch or supraorbital foramen 29 mm lateral to the midline (range, 25-33 mm) and 5 mm below the supraorbital upper margin (range, 4-6 mm). The supratrochlear nerve exited from the orbital rim 16 mm lateral to the midline (range, 12-21 mm) and 7 mm below the supraorbital upper margin (range, 6-9 mm). The zygomaticotemporal nerve pierced the deep temporalis fascia 10 mm posterior to the frontozygomatic suture (range, 7-13 mm) and 22 mm above the upper margin of the zygomatic arch (range, 15-27 mm). In addition, three types of zygomaticotemporal nerve branches were found. Considering the superficial temporal artery, the auriculotemporal nerve was mostly located superficial or posterior to the artery (80%). There were no significant differences between the right and left sides or based on gender (P>0.05). These data can be applied to many neurosurgical diagnostic or therapeutic procedures related to anterolateral scalp cutaneous nerve.     

The relative locations of the supraorbital,infraorbital, and mental foramina: A cadaveric study

The purpose of this study is to investigate the applicability of the current surgical guideline stating that the main facial foramina that transmit cutaneous nerves to the face (supraorbital notch/foramen, infraorbital foramen, and mental foramen) are equidistant from the midline in European and Hispanic populations. Previous studies suggest this surgical guideline is not applicable for all ethnicities; however, to our knowledge, no data have been published regarding the accuracy of this guideline pertaining to the Hispanic population. An experimental study was performed on 67 cadavers donated to the Human Anatomy Program at UT Health San Antonio. The supraorbital, infraorbital, and mental foramina were dissected and midline structures including the crista galli, internasal suture, anterior nasal spine, and mandibular symphysis were identified. The distance from each foramen to midline was recorded using a digital caliper. For all cadavers/ethnicities studied, the supraorbital, infraorbital, and mental foramina were 25.32 mm, 29.57 mm, and 25.55 mm to the midline, respectively. Thus, the infraorbital foramen is located significantly more lateral compared to the supraorbital (p < 0.0001) and mental foramina (p < 0.0001). After dividing the sample based on ethnicity, this relationship was also true for the European sample and tended to be true for the Hispanic sample. Significant anatomical variations exist in the current surgical guideline stating that the supraorbital foramen, infraorbital foramen, and mental foramen are equidistant from the midline. Clinicians may need to adjust their methodology during surgical procedures of the face in order to optimize patient care.     

The cranio-orbital foramen, the groove on the lateral wall of the human orbit, and the orbital branch of the middle meningeal artery

The cranio-orbital foramen, a foramen in the lateral wall of the orbit, contains an anastomosis between the anterior branch of the middle meningeal artery and the lacrimal artery. Previous workers have speculated that the groove starting either from the cranio-orbital foramen or the lateral extremity of the superior orbital fissure contains the anastomotic artery. We investigated the cranio-orbital foramen and the groove on the lateral wall of the orbit in a series of 170 dried adult human skulls, and the course of the orbital branch of the middle meningeal artery in 74 specimens from 37 cadavers. We observed the cranio-orbital foramen in 141 skulls (82.9%). It was unilateral in 55 (32.4%) and bilateral in 86 (50.6%) skulls. The groove on the lateral wall of the human orbit was observed in 122 skulls (71.8%). It was unilateral in 40 (23.5%) and bilateral in 82 (48.2%). The groove on the lateral wall of the orbit started from the cranio-orbital foramen in 20 skulls (11.8%). The orbital branch of the middle meningeal artery was found in 48 cadaveric specimens (64.9%): 32 (43.2%) passed through the cranio-orbital foramen and 12 (16.2%) passed through the superior orbital fissure. In four specimens (5.4%), orbital branches of the middle meningeal artery passed through both the superior orbital fissure and the cranio-orbital foramen. The anatomy of the cranio-orbital foramen and the course of the orbital branch should be well known by surgeons reconstructing the anterior base of the skull, the orbit after orbital base surgery, and during excision of meningiomas.     

The Localization of the Supraorbital Notch or Foramen is Crucial for Headache and Supraorbital Neuralgia Avoiding and Treatment

The aim of this study was to provide the morphological and morphometric data of the supraorbital foramina or notches related to sex, side, and the climatic conditions where the population lived. It was hypothesized that the distribution of the occurrence and location of these openings depends on climatic conditions in which the population lived. Orbits from 866 dried skulls obtained from three climatic regions: warm, temperate, and cold were examined. The examination concentrated on the configuration (notch/foramen) and on the distances to the reference points: nasion, frontomalare orbitale, infraorbital foramen and the superior orbital rim. In 14.3% of cases a smooth supraorbital rim was observed while different variants of the structures were observed in 85.7% of the cases. In cold climatic conditions, supraorbital foramina were found in the highest frequency (35.4%). In warm and temperate climates, the observed frequencies of supraorbital foramen were the lowest (18.8% and 19.9%, respectively). Frequency of supraorbital notches was the lowest of those skulls from a cold climate (44.0%) and the highest in those from a warm climate (59.0%). These results support the hypothesis that the occurrence of the supraorbital notches is greater in populations from warm compared with cold regions. This would provide a greater exit route for the neurovascular bundle and this may be related to the thermoregulatory processes in the supraorbital region. Furthermore, knowledge of precise locations of supraorbital structures is important when a supraorbital nerve block is given, for example, in the treatment of migraine headaches. Anat Rec, 2012. © 2012 Wiley Periodicals, Inc.