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Bhupendra Patel, MD
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 may be enlarged in the presence of optic nerve glioma; 1 mm of asymmetry between right and left is abnormal
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