Drs. Dale Meyer & Edward Wladis
Procedures

Thyroid-Related Disease - Orbital Bones

Orbital Anatomy

  • Orbital volume and dimensions: = 30 cc, 35(Height) x 45(Width) x 45 mm(medial wall depth), globe 25 x 25 mm
  • Bones: (F)rontal, (M)axillary,(Z)ygomatic, (L)acrimal, (E)thmoid, (P)alatine, (S)phenoid

 

Orbital Walls and Openings

Superior orbital fissure (SOF):

  • 22 mm long
  • separates greater wing of sphenoid from lesser wing of sphenoid
  • transmits third, fourth, sixth and V1 AND SYMPATHETIC FIBERS
  • lateral rectus origin separates into superior and inferior divisions
  • Superior division transmits lacrimal, frontal and trochlear nerves
  • Inferior division transmits superior and inferior divisions of CN III, nasociliary branch of CN V, CN IV, superior ophthalmic vein, and sympathetic nerve plexus
  • Venous system: superior ophthalmic vein

Inferior orbital fissure (IOF)

  • Located between lateral orbital wall and the orbital floor
  • Transmits V2 ( maxillary) , pterygoid nerves  nerve arising from pterygopalatine ganglion
  • infraorbital nerve (a branch of V2) enters the infraobital groove and infraorbital canal for sensation to lower eyelid, cheek, upper lid, upper teeth
  • Venous system inferior ophthalmic vein

Holes/Notches/Canals

 

Nasolacrimal canal Nasolacrimal canal

  • lacrimal sac fossa to the inferior meatus
  • separates greater wing of sphenoid from lesser wing of sphenoid
  • transmits third, fourth, sixth and V1 AND SYMPATHETIC FIBERS
  • lateral rectus origin separates into superior and inferior divisions
  • Superior division transmits lacrimal, frontal and trochlear nerves
  • Inferior division transmits superior and inferior divisions of CN III, nasociliary branch of CN V, CN IV, superior ophthalmic vein, and sympathetic nerve plexus
  • Venous system: superior ophthalmic vein

Supraorbital foramen/notch

  • transmits blood vessels
  • supraorbital nerve
  • Anterior/posterior ethmoidal foramen: transmits ethmoidal blood vessels and nerve
  • Zygomatic foramen: transmits zygomaticofrontal and zygomaticotemporal nerves, zygomatic artery
  • Nasolacrimal duct (NLD): exits into inferior meatus
  • Infraorbital canal: transmits infraorbital nerve (V2)

Ethmoidal foramina

  • anterior ethmoidal artery
  • posterior ethmoidal artery
  • allows infections and neoplasms to enter to orbit from the sinuses

Optic Canal

  • 8-10 mm long
  • located within the less wing of sphenoid
  • separated from SOF by OPTIC STRUT
  • Transmits. Ophthalmic nerve, ophthalmic artery, sympathetic nerves
  • Optic foramen is 6.5 mm wide: it might be enlarged in the presence of optic nerve glioma; 1 mm of asymmetry between right and left is abnormal

 



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