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Najm A, Bihorac A, de Carvalho Machado V, Chrcanovic BR. Immediate implant placement in the premolar maxillary area: a cone-beam computed tomography study. J Periodontal Implant Sci 2025; 55:72-84. [PMID: 39439105 PMCID: PMC11885869 DOI: 10.5051/jpis.2303580179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 05/17/2024] [Accepted: 07/10/2024] [Indexed: 10/25/2024] Open
Abstract
PURPOSE This research aimed to investigate potential factors associated with the risk of perforation of the labial bone plate, nasal floor, or maxillary sinus floor during immediate implant placement (IIP) in the maxillary premolar area, utilizing a cone-beam computed tomography (CBCT) virtual study. METHODS CBCT exams from 179 eligible participants, encompassing 716 teeth, were included. Implants were virtually positioned in 2 orientations: along the long axis of the tooth (the prosthetically-driven position) and in an optimal position relative to adjacent anatomical structures (the bone-driven position). Binary logistic regression analysis was employed to assess potential associations between perforation or invasion and various covariates, including sex, age, tooth region, the distance from the tooth apex to the nasal floor or maxillary sinus floor, the angle between the prosthetically- and bone-driven positions (implant-line A angle [ILAA]), and the labial concavity angle (LCA). RESULTS The mean ILAA was 18.3°±8.0°, and the angle was significantly larger for the second premolar compared to the first premolar. The mean minimum implant length was 13.0±2.1 mm, with a bone anchorage of 4 mm. The incidence of perforation was 84.1% for the prosthetically-driven position and 40.5% for the bone-driven position. Factors associated with a higher risk of cortical bone wall perforation or invasion of the 2-mm safety margin from surrounding anatomical structures (in the bone-driven position) included female sex, older age, shorter distance from the tooth apex to the nasal cavity/maxillary sinus, and smaller LCA. CONCLUSIONS A high prevalence of cortical bone wall perforation or invasion of the 2-mm safety margin is anticipated when performing IIP in the maxillary premolar region.
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Affiliation(s)
- Ali Najm
- Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Amer Bihorac
- Faculty of Odontology, Malmö University, Malmö, Sweden
| | | | - Bruno Ramos Chrcanovic
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, Malmö, Sweden.
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Jabali S, Pishva S, Bardal R, Bahrami F, Mostafavi M. Quantitative evaluation of the canalis sinuosus relative to adjacent structures in cone-beam computed tomography images. JOURNAL OF ADVANCED PERIODONTOLOGY & IMPLANT DENTISTRY 2024; 16:139-143. [PMID: 39758264 PMCID: PMC11699263 DOI: 10.34172/japid.2024.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 06/12/2024] [Indexed: 01/07/2025]
Abstract
Background Careful anatomical investigation of canalis sinuosus (CS) is essential to prevent damage to blood vessels and nerves in this area during surgical procedures, such as placing dental implants in the anterior maxillary region. This study investigated the relationship and distance between the CS and its adjacent structures. Methods A total of 400 cone-beam computed tomography (CBCT) images of Iranian adults aged 20-86 years were included in this retrospective study. Two observers assessed all the images twice with a time interval of one month. The closest tooth to the CS, its position relative to the CS, and distance measurements of the CS from adjacent structures were determined. Results CS was found in 10.5% of all images. The mean diameter of the canal was 1.06±0.29 mm, which was not significantly different between the age groups, right and left sides, or genders. The most common location of CS was mid-position relative to the upper lateral incisors. In linear measurements, only the distance from the CS to the buccal cortical plate and perpendicular to the nasopalatine canal exhibited a significant difference between the two sexes, with no significant difference between the right and left sides. Conclusion CS location was significantly more palato-lateral in males. There was no significant difference in the prevalence between the two sexes.
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Affiliation(s)
- Sahar Jabali
- Department of Periodontology, School of Dentistry, Urmia University of Medical Sciences, Urmia, Iran
| | - Sajjad Pishva
- Department of Periodontology, School of Dentistry, Urmia University of Medical Sciences, Urmia, Iran
| | - Roghieh Bardal
- Department of Oral and Maxillofacial Radiology, Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Farough Bahrami
- Department of Endodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Mostafavi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Urmia University of Medical Sciences, Urmia, Iran
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Mrożek K, Marchewka J, Leszczyński B. A morphological study and the variability in the number of infraorbital foramina in the African green monkey (Grivet) (Chlorocebus aethiops) using microcomputed tomography. J Morphol 2023; 284:e21607. [PMID: 37458084 DOI: 10.1002/jmor.21607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/18/2023] [Accepted: 05/28/2023] [Indexed: 07/18/2023]
Abstract
Knowledge of the nonhuman primate morphology and anatomy related to craniofacial mechanoreception is essential for a fundamental understanding of the incidents that have occurred during the evolution of craniofacial features. The present study focuses on the variability in the number of infraorbital foramina and associated anatomical structures such as the infraorbital canal (IOC) and the infraorbital groove (IOG), as they are considered to play an important role in the behavioral ecology of these animals. A total of 19 skulls of Chlorocebus aethiops were analyzed. The number of infraorbital foramina was assessed macroscopically using a magnifying glass and a small diameter probe. Three dimensional (3D) projections and morphometric analysis of the infraorbital foramina, IOCs, and IOGs were performed using microcomputed tomography (micro-CT) for two skulls that represent one of the most common morphological types. Regardless of sex and body side, the most common morphological type observed in the studied species is the presence of three infraorbital foramina. The IOC takes a funnel or pinched shape. 3D projections were made to assess the course of the infraorbital vascular and nerve bundles in selected individuals. The results indicate a high morphological diversity within the species, although there appears to be a consistent distribution pattern of infraorbital neurovascular bundles in species of the Cercopithecidae family. The use of X-ray micro-CT allowed 3D visualization of the maxillary region to determine the variability of the infraorbital foramina and to track the division of the infraorbital neurovascular bundle in the case of the most common macroscopic expression of the number of the infraorbital foramen in C. aethiops, as well as the morphometric of the IOCs and IOGs which are related to mechanoreception of the primate's snout.
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Affiliation(s)
- Kamil Mrożek
- Nature Education Center, Jagiellonian University, Krakow, Poland
- Laboratory of Anthropology, Institute of Zoology and Biomedical Research, Jagiellonian University, Krakow, Poland
| | - Justyna Marchewka
- Department of Human Biology, Institute of Biological Sciences, Cardinal Stefan Wyszynski University, Warsaw, Poland
| | - Bartosz Leszczyński
- Department of Medical Physics, Marian Smoluchowski Institute of Physics, Jagiellonian University, Krakow, Poland
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Accuracy of linear-probe ultrasonography in diagnosis of infraorbital rim fractures. Ultrasound J 2023; 15:9. [PMID: 36763227 PMCID: PMC9918656 DOI: 10.1186/s13089-022-00298-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 11/27/2022] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Maxillofacial fractures are a common cause of visits to emergency department, accounting for more than 400,000 annual visits in the United States. Gold standard diagnostic tool is conventional computerized tomography (CT) or 3DCT reconstruction. However, the disadvantages of CT are radiation exposure, unavailable in some hospital and expensiveness. Whereas the bony structures overlap is a problem in diagnostic when using plain film X-ray. The objective of this study is to show the accuracy of a linear-probe ultrasound compared to computed tomography and plain film X-ray in diagnosis of infraorbital rim fracture. METHODS Patients clinically suspected of an inferior orbital rim fracture underwent linear-probe ultrasonographic investigation, plain film X-ray and CT. CT was used as gold standard in this diagnostic study. A radiologist and senior resident of plastic surgery were the examiner and interobserver for comparison. RESULT A total of 34 patients with suspected infraorbital rim fractures were investigated. Sensitivity of the linear-probe ultrasonography versus CT in the detection of infraorbital rim fracture was 92.9% (95% CI 66.1-99.8), specificity was 90.0% (95% CI 68.3-98.8), positive predictive value was 86.7% (95% CI 59.5-98.3), negative predictive value was 94.7% ( 95% CI 74.0-99.9), accuracy 91%. CONCLUSION Linear probe ultrasonography is a good diagnostic tool and has better reliability than the plain film X-ray and can be used as alternative to CT in inferior orbital rim fracture.
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Mahajan A, Verma R, Razdan SK, Passey J. Morphological and Morphometric Relations of Infraorbital Foramen in North Indian Population. Cureus 2023; 15:e34525. [PMID: 36874344 PMCID: PMC9981513 DOI: 10.7759/cureus.34525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction The evidence regarding the anatomy of the infraorbital foramen in the Indian population is limited. It mainly focuses on its shape, size, and incidence in the Indian population. The current study aimed to evaluate morphometric parameters of infraorbital foramen that can help clinicians during surgery and procedures around it. Methods We evaluated 90 dry adult human hemi-skulls. The morphological parameters studied included the assessment of the shape of the infraorbital foramen, its horizontal and vertical diameters, and its relation to the teeth of the upper jaw. In addition, we measured the distance of the infraorbital foramen from the anterior nasal spine, nasion, infraorbital margin, and the lower extent of the alveolar margin. The length of the infraorbital canal till the inferior orbital fissure and the infraorbital groove and the infraorbital canal orientation angles in different planes were also measured. The measurement values were compared between the right and left side hemi-skulls. Results The oval-shaped infraorbital foramen was most commonly noticed. The mean vertical and transverse diameters were 3.8 mm and 2.6 mm, respectively, on the right side. The left side's mean vertical and transverse diameters were 3.9 mm and 2.5 mm, respectively. The most common location of infraorbital foramen was in line with the maxillary second premolar tooth. The distances of infraorbital foramen from the alveolar margin were 29.6 mm and 29 mm on the right and left sides, respectively. The distances of the infraorbital foramen from the anterior nasal spine were 34.3 mm and 34.2 mm on the right and left sides, respectively. The distances of infraorbital foramen from the nasion were 42.3 mm and 42.2 mm on the right and left sides, respectively. The distances of infraorbital foramen from the inferior orbital margin were 5.8 mm and 6.2 mm on the right and left sides, respectively. The distances between the inferior orbital margin and infraorbital groove were 12.7 mm and 12.7 mm on the right and left sides, respectively. The distances between the inferior orbital margin and inferior orbital fissure were 27.5 mm and 27.1 mm on the right and left sides, respectively. The orientation angles of infraorbital foramen were 48.31° in the horizontal plane, 34.07° in the Frankfurt plane, and 14.4° in the parasagittal plane. Conclusion Our findings suggest that the location of the infraorbital foramen is difficult to standardize, considering the wide interindividual variations in the foramen relations. Further research should be performed to investigate the parameters related to the distance and orientation of the infraorbital foramen in relation to nearby bony landmarks that are least affected by individual variations in skull morphology.
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Affiliation(s)
- Arpita Mahajan
- Anatomy, Hamdard Institute of Medical Sciences and Research, New Delhi, IND
| | - Ranjana Verma
- Anatomy, Government Institute of Medical Sciences, Greater Noida, IND
| | - Shayama K Razdan
- Anatomy, Hamdard Institute of Medical Sciences and Research, New Delhi, IND
| | - Jigyasa Passey
- Anatomy, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
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Suntiruamjairucksa J, Chentanez V. Localization of infraorbital foramen and accessory infraorbital foramen with reference to facial bony landmarks: predictive method and its accuracy. Anat Cell Biol 2022; 55:55-62. [PMID: 35131950 PMCID: PMC8968235 DOI: 10.5115/acb.21.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/30/2021] [Accepted: 12/03/2021] [Indexed: 11/27/2022] Open
Affiliation(s)
| | - Vilai Chentanez
- Department of Anatomy, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Botermans A, Lidén A, de Carvalho Machado V, Chrcanovic BR. Immediate Implant Placement in the Maxillary Aesthetic Zone: A Cone Beam Computed Tomography Study. J Clin Med 2021; 10:5853. [PMID: 34945150 PMCID: PMC8708737 DOI: 10.3390/jcm10245853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/07/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022] Open
Abstract
This study aimed to investigate the factors that could be associated with the risk of labial cortical bone wall perforation with immediate implant placement (IIP) in the maxillary aesthetic zone, in a cone-beam computed tomography (CBCT) virtual study. CBCT exams from 126 qualified subjects (756 teeth) were included. Implants were virtually positioned in two different positions: in the long axis of the tooth (prosthetically-driven position) and in an ideal position in relation to adjacent anatomical structures (bone-driven position). Two different implant diameters were planned for each tooth position, namely, 3.75 and 4.3 mm for central incisors and canines, and 3.0 and 3.3 mm for lateral incisors. The incidence of perforation was nearly 80% and 5% for prosthetically- and bone-driven position, respectively. Factors associated with a higher risk of cortical bone wall perforation (bone-driven position), according to logistic regression analysis, were women, wider implants, Sagittal Root Position class IV, and decrease of the labial concavity angle. Perforation of the labial cortical bone wall can be greatly minimized when the implant is placed in a bone-driven position compared to a prosthetically-driven position. It is important to preoperatively evaluate the morphological features of the implant site for risk assessment and to individualize the treatment plan.
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Affiliation(s)
- Anna Botermans
- Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden; (A.B.); (A.L.)
| | - Anna Lidén
- Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden; (A.B.); (A.L.)
| | | | - Bruno Ramos Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden
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Hester KM, Rahimi OB, Fry CL, Nation HL. The relative locations of the supraorbital, infraorbital, and mental foramina: A cadaveric study. J Anat 2021; 239:782-787. [PMID: 34120334 PMCID: PMC8450472 DOI: 10.1111/joa.13482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 12/22/2020] [Accepted: 05/22/2021] [Indexed: 11/28/2022] Open
Abstract
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.
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Affiliation(s)
- Kathylin M. Hester
- Department of Cell Systems and AnatomyUT Health San AntonioSan AntonioTexasUSA
| | - Omid B. Rahimi
- Department of Cell Systems and AnatomyUT Health San AntonioSan AntonioTexasUSA
| | - Constance L. Fry
- Department of OphthalmologyUT Health San AntonioSan AntonioTexasUSA
| | - Haley L. Nation
- Department of Cell Systems and AnatomyUT Health San AntonioSan AntonioTexasUSA
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Pruksapong C, Kawichai W, Attainsee A, Sawani A. The anatomical variations of the emergence routes of supraorbital nerve cadaveric study and systematic review. Asian J Surg 2021; 45:220-225. [PMID: 34167870 DOI: 10.1016/j.asjsur.2021.04.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/17/2021] [Accepted: 04/29/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Knowledge of the location of supraorbital nerve is essential to perform supraorbital endoscopic surgery, regional nerve block, and nerve decompression in the treatment of migraine. This study discusses the emergence routes of supraorbital nerve as well as a systematic literature review on previous anatomical studies. This comparative analysis will be beneficial for surgeons worldwide. METHODS The study sample consisted of 19 cadavers with bilateral supraorbital nerve dissections. The emergence route of the nerve through either a notch or foramen was recorded. Additionally, the distance from midline, nerve branching patterns, and diameter of emergence routes were measured. RESULTS Our findings showed an equal number of supraorbital emergence route between notch and foramen (42%) and demonstrated average distance from emergence route and facial midline 22.34 (3.05) mm in male and 23.58 ± 2.42 mm in female. Diameter of notch type is 3.97 (0.99) mm and 3.39 (1.09) mm in foramen type. Data from systematic review showed range of distance from emergence route to facial midline from 22.2 to 33.7 mm. East Asia population had significant shorter distance of supraorbital emergence route to facial midline than Middle Asia and Caucasian population. CONCLUSION This study provides greater insight into the anatomic variations and supraorbital never course in an understudied minority population. Surgeons should be aware of this critical area and strive to minimize dissection to prevent iatrogenic nerve injury.
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Affiliation(s)
- Chatchai Pruksapong
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Phramongkutklao Hospital and College of Medicine.
| | - Wanida Kawichai
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Phramongkutklao Hospital and College of Medicine
| | - Akaradech Attainsee
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Phramongkutklao Hospital and College of Medicine
| | - Ali Sawani
- Doris Duke Research Fellow, University of Minnesota
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Positional Variation of the Infraorbital Foramen in Caucasians and Black Africans from Britain: Surgical Relevance and Comparison to the Existing Literature. J Craniofac Surg 2021; 32:1162-1165. [PMID: 32956313 DOI: 10.1097/scs.0000000000007014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Midface augmentation and orbital surgery carry an inherent risk of injury to the infraorbital vascular bundle, especially the infraorbital nerve where it exits the infraorbital foramen (IOF). This can result in significant morbidity for the patient, including paresthesia and neuralgia. Studies report significant heterogeneity in IOF position according to gender, ethnicity, and laterality. A knowledge of the relationship of the IOF to regional soft tissue, bony landmarks, and its variation among ethnicities is likely to reduce iatrogenic injuries. METHODS A single-center retrospective computed tomography (CT)-based study was conducted. Twenty Caucasians and 20 Black Africans patients were selected from an existing radiologic database at Moorfields Eye Hospital, London, UK. DICOM image viewing software (Syngo, Siemens Healthineers) was used to record the position of the IOF using standardized sagittal and axial views. RESULTS There was a statistically significant difference in the horizontal position of the IOF in the 2 races (P = 0.00). The combined measurements were used to derive a rectangular zone of variability measuring 14.30 mm by 10.60 mm. This zone was found to lie 3.50 mm below the infraorbital rim, 7.10 mm medial to the piriform aperture, and 11.60 mm from the lateral orbital rim. CONCLUSION A sound knowledge of key facial landmarks is necessitated when performing midface augmentation and orbital surgery. An anatomical safe zone depicting the variation of the IOF will help reduce iatrogenic injury to the infraorbital nerve and prevent patient morbidity.
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Marchewka J, Mrożek K, Leszczyński B, Wróbel A, Głąb H. Variability in the number of infraorbital foramina in rhesus macaques (Macaca mulatta) and cynomolgus macaques (Macaca fascicularis). Anat Rec (Hoboken) 2020; 304:818-831. [PMID: 32558307 DOI: 10.1002/ar.24478] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 04/14/2020] [Accepted: 04/28/2020] [Indexed: 11/11/2022]
Abstract
This study aimed to determine the number of infraorbital foramina in monkeys of the Papionini tribe. The authors performed a μCT analysis of the morphology of the infraorbital foramina. A total number of 52 simian skulls belonged to two macaque species: Macaca mulatta and Macaca fascicularis were used in the study. The number of infraorbital foramina was counted macroscopically and with the use of a magnifying glass. Next, the skull representing the most common morphological type was selected and scanned by micro-computed tomography (μCT). The Shapiro-Wilk normality test was used in the study. To compare the differences in the number of infraorbital foramen between species, sex and sides, the Mann-Whitney U test was applied. Three infraorbital foramina were present in most individuals from the test group. The Mann-Whitney test revealed no statistically significant difference between the number of foramina on the right- and left-hand side. Likewise, no statistically significant differences between the numbers of infraorbital foramina across sexes were observed. Volumetric reconstructions revealed the presence of separate infraorbital canals for each infraorbital foramen. Craniofacial innervation in macaques is formed by complex branching patterns of cranial nerves. Variability in the number of infraorbital foramina suggests a variable maxillary innervation pattern in these animals. Based on the analysis of volumetric projections, the presence of two labial branches and a single nasal branch of the infraorbital nerve is suggested. Detailed descriptions are supported by quantitative data and μCT evidence.
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Affiliation(s)
- Justyna Marchewka
- Department of Human Biology, Institute of Biological Sciences, Cardinal Stefan Wyszynski University, Warszawa, Poland
| | - Kamil Mrożek
- Nature Education Centre, Jagiellonian University, Krakow, Poland.,Department of Anthropology, Institute of Zoology and Biomedical Research, Jagiellonian University, Krakow, Poland
| | - Bartosz Leszczyński
- Department of Medical Physics, Marian Smoluchowski Institute of Physics, Jagiellonian University, Krakow, Poland
| | - Andrzej Wróbel
- Department of Medical Physics, Marian Smoluchowski Institute of Physics, Jagiellonian University, Krakow, Poland
| | - Henryk Głąb
- Department of Anthropology, Institute of Zoology and Biomedical Research, Jagiellonian University, Krakow, Poland
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Precision Analysis of Supraorbital Transcranial Exits Using Three Dimensional Multidetector Computed Tomography. J Craniofac Surg 2020; 30:1894-1897. [PMID: 31022132 DOI: 10.1097/scs.0000000000005557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Anatomical variation in supraorbital transcranial exits, which can be divided into the lateral supraorbital exit and the medial frontal exit, has been investigated in several studies during the past few decades. However, in previous studies, inconsistent criteria were used for classifying those exits. The authors analyzed variations in supraorbital transcranial exits using 3 dimensional multidetector computed tomography (3D MDCT), and present a consistent classification of the types of those exits with precise location measurements. METHODS In 1181 patients (2362 orbits) who underwent facial 3D MDCT, the authors measured a set of qualitative and quantitative parameters. The qualitative parameters included an assessment of the location and type of the exit, and the number of accessory foramina. The quantitative parameters included various distance measurements. RESULTS A frontal exit was present in 2071 orbits and a supraorbital exit in 953. Neither a frontal exit nor a supraorbital exit was found in 11 orbits. The most common type of frontal exit was the notch type, followed by the foramen type and none. The mean distance from the nasion to the frontal exit was 24.70 ± 3.50 mm on the right side and 23.69 ± 3.42 mm on the left side. CONCLUSION In conclusion, various types of supraorbital transcranial exits were observed, of which the frontal notch was the most common. This is the first study to conduct a consistent analysis of a large sample of skulls to characterize the distribution of supraorbital transcranial exit types using a comprehensive and clear set of criteria.
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Iwanaga J, Kikuta S, Kusukawa J, Tomaszewski KA, Walocha JA, Tubbs RS. Anatomic Study of Accessory Infraorbital Nerves and Foramina: Application for a Better Understanding of Complications of Le Fort Fractures and Osteotomy. J Oral Maxillofac Surg 2020; 78:717-723. [PMID: 32035836 DOI: 10.1016/j.joms.2020.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/06/2020] [Accepted: 01/06/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE Neurosensory disturbance of the infraorbital nerve is one of the many complications of the Le Fort osteotomy. An accessory infraorbital foramen (AIOF) can be one reason for such complications. Therefore, the purpose of the present study was to elucidate the distribution of the accessory infraorbital nerve (AION) arising from the AIOF. MATERIALS AND METHODS We dissected 60 sides from 30 fresh-frozen cadaveric heads. RESULTS An AIOF was found in 36.7% of the heads examined. When an AIOF was detected, the nerve was traced distally and proximally. The mean horizontal and vertical diameters of the AIOF were 1.64 ± 0.88 and 1.75 ± 0.87 mm, respectively. The largest AIOF was 3.42 × 3.79 mm. All AIOFs were located medial to the infraorbital foramen. Most of the AIONs (87.5%) had branches to the external nose. CONCLUSIONS The AION should always be remembered by surgeons to allow for improved outcomes and better understanding of the complications such as those occurring after Le Fort osteotomy.
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Affiliation(s)
- Joe Iwanaga
- Associate Professor, Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA; Associate Professor, Dental and Oral Medical Center and Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Japan.
| | - Shogo Kikuta
- Assistant Professor, Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Japan
| | - Jingo Kusukawa
- Professor, Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Japan
| | - Krzysztof A Tomaszewski
- Associate Professor, Department of Anatomy, Jagiellonian University Medical College; Associate Professor, International Evidence-Based Anatomy Working Group; and Associate Professor, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
| | - Jerzy A Walocha
- Professor, Department of Anatomy, Jagiellonian University Medical College; and Professor, International Evidence-Based Anatomy Working Group, Krakow, Poland
| | - R Shane Tubbs
- Professor, Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA; Professor, Department of Anatomical Sciences, St. George's University, St. George's, Grenada; and Professor, Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, LA
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Shin KJ, Shin HJ, Lee SH. Location of the infraorbital foramen with reference to soft tissue landmarks for regional nerve blocks during midface surgery. Clin Anat 2020; 33:1159-1163. [PMID: 31894604 DOI: 10.1002/ca.23556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 12/23/2019] [Accepted: 12/28/2019] [Indexed: 11/11/2022]
Abstract
PURPOSE An infraorbital nerve (ION) block is widely used to accomplish regional anesthesia during surgical procedures involving the midface region. This study aimed to elucidate the exact location of the infraorbital foramen (IOF) in relation to clinically useful soft-tissue landmarks for achieving an effective ION block. METHODS Forty-three hemifaces from 23 embalmed Korean cadavers were dissected. The lateral canthus, peak of Cupid's bow, medial limbus, and midline were used as reference points. The distances from the IOF to the midline and the lateral canthus were measured. RESULTS The IOF was located approximately 25 mm below the lateral canthus and 27 mm lateral to the midline. In all cases, the IOF was situated within 9.0 mm of the crossing point of the oblique line connecting the lateral canthus to the peak of Cupid's bow and the vertical line through the medial limbus. CONCLUSION Considering the spread of an anesthetic agent, injecting it into the crossing point of the oblique line through the lateral canthus to the peak of Cupid's bow and the vertical line through the medial limbus would successfully block the ION in most patients.
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Affiliation(s)
- Kang-Jae Shin
- Department of Anatomy and Cell Biology, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Hyun Jin Shin
- Department of Ophthalmology, Research Institute of Medical Science, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Shin-Hyo Lee
- Department of Anatomy, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
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Sokhn S, Challita R, Challita A, Challita R. The Infraorbital Foramen in a Sample of the Lebanese Population: A Radiographic Study. Cureus 2019; 11:e6381. [PMID: 31938659 PMCID: PMC6957048 DOI: 10.7759/cureus.6381] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose The infraorbital foramen (IOF) is an important structure in the maxillofacial region through which important structures pass. Wide variability in the shape and location of the infraorbital foramen among different populations and ethnic groups is present. So we conducted this study to specify the IOF shape, the presence of accessory foramina, and the IOF location with respect to anatomic landmarks in the Lebanese population. Patients and method A cross-sectional retrospective study was conducted on cone-beam computed tomography (CBCT) scans of 105 Lebanese adult patients. Images were reviewed and the shape, diameter, and location of the IOF were recorded. The presence of an accessory foramen was also noted. Then, SPSS version 21 (IBM Corp., Armonk, NY, US) was used for the statistical analysis. Results Concerning the distances from the IOF to the anatomic landmarks, the distance from the IOF to the infraorbital margin measured 7.98 ± 1.41 mm, to the lateral nasal wall 10.61 ± 2.39 mm, and to the midline 24.71 ± 2.09 mm. When distances were compared, a statistical difference was only identified in the distance between the IOF and the lateral nasal wall (p=0.00), and the distance between the IOF and the middle of the face (p=0.016) between genders. For the shape of the IOF, 54.8% of the IOF were circular in shape, and this shape was the most common shape in females. An accessory foramen was present in 8.6% of the cases. Finally, the mean diameter of the foramina measured 3.71 ± 0.63 mm. Conclusion The IOF shows a lot of variability between different populations. Thus, the exact location should always be remembered during an infraorbital nerve (ION) block, during maxillofacial surgeries, and during esthetic procedures involving the facial region in order to prevent unnecessary complications.
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Affiliation(s)
- Sayde Sokhn
- Oral and Maxillofacial Imaging, Lebanese University, Beirut, LBN
| | - Ronald Challita
- Obstetrics and Gynecology, Faculty of Medicine, Lebanese University, Beirut, LBN
| | - Anthony Challita
- Periodontology and Implantology, Lebanese University, Beirut, LBN
| | - Raymond Challita
- Plastic and Reconstructive Surgery, Faculty of Medicine, Lebanese University, Beirut, LBN
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Bucioğlu H, Elvan Ö, Esen K, Temel G, Öksüz N, Yilmaz GG, Özcan C, Tezer MS. Radiologic Evaluation of Exiting Points of Supraorbital Region Neurovascular Bundles in Patients With Migraine. J Craniofac Surg 2019; 30:2198-2201. [PMID: 31306381 DOI: 10.1097/scs.0000000000005751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To reveal the presence and nature of exiting points of supraorbital region neurovascular structures and determine the distances of those structures to midline with computed tomography images by taking into account gender and sides in patients with migraine. METHODS The study was conducted retrospectively on computed tomography images of 70 migraine and 70 control patients with a mean age of 39.5 ± 13.8 years (range: 18-80). Presence and nature (foramen or notch) of exiting points of neurovascular structures in terms of side and gender in both groups, and the distances of these structures to the midline of the face were evaluated. RESULTS In migraine and control groups, the most commonly seen structure was single notch. Coexistence of foramen and notch was statistically significant in migraine and female migraine groups than control and female control groups (P < 0.05). Bilateral presence of supraorbital structure was 51.4% in migraine group and 64.3% in control group patients. In all cases, foramen-midline distance was statistically significant longer than the notch-midline distance (P < 0.05). In migraine patients, no statistically significant difference was detected regarding distances of foramen and notch to midline in terms of side and gender. CONCLUSION Consideration of variable presence and location of the supraorbital notch and foramen, analysis of computed tomography scan might be beneficial in preoperative planning of foraminotomy and fascial band release in adult migraine patients to prevent intraoperative complications. Also, coexistence is more frequent on left side in migraine patients that might cause overlooking those structures during surgery.
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Affiliation(s)
| | | | - Kaan Esen
- Department of Radiology, School of Medicine
| | | | - Nevra Öksüz
- Department of Neurology, School of Medicine, Mersin University, Mersin
| | | | - Cengiz Özcan
- Department of Otorhinolaryngology, School of Medicine
| | - Mesut Sabri Tezer
- Oral and Maxillofacial Surgery Department, Faculty of Medicine, Istanbul University, Istanbul, Turkey
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17
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Abstract
Several researchers have analyzed the collocation of infraorbital foramen, but no study has so far considered the possible influence of cranial size.Three measurements (distances from anterior nasal spine, inferior orbital rim, angle at the intersection between the line from anterior nasal spine and the transversal plane parallel to the Frankfurt plane) were taken on 100 skulls belonging to a contemporary skeletal collection. In addition, maximum cranial length, maximum cranial breadth, cranial height, and bizygomatic breadth were measured, together with 2 indices (horizontal cephalic index and Giardina Y-index). Differences according to sex and side were assessed through 2-way analysis of variance test (P <0.05). Measurements showing statistically significant differences according to sex were further assessed through 1-way analysis of covariance test including cranial measurements and indices as covariates (P <0.05).Statistically significant differences according to sex and side were found respectively for the distance from anterior nasal spine and the angle at infraorbital foramen (P <0.05). One-way analysis of covariance test verified that the sexual dimorphism of infraorbital foramen- anterior nasal spine distance was independent from the general measurements of cranium.The present study first proved that sexually dimorphic parameters useful for the localization of infraorbital foramen do not depend upon the cranium size.
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The Morphology of the Infraorbital Nerve and Foramen in the Presence of an Accessory Infraorbital Foramen. J Craniofac Surg 2019; 30:244-253. [DOI: 10.1097/scs.0000000000004889] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Nanayakkara D, Manawaratne R, Sampath H, Vadysinghe A, Peiris R. Supraorbital nerve exits: positional variations and localization relative to surgical landmarks. Anat Cell Biol 2018; 51:19-24. [PMID: 29644106 PMCID: PMC5890013 DOI: 10.5115/acb.2018.51.1.19] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 11/26/2017] [Accepted: 11/27/2017] [Indexed: 11/27/2022] Open
Abstract
Significant variations exist in the occurrence, form, and position of supraorbital nerve exits through the frontal bone. Detailed knowledge of the positional variations of supraorbital exits is important to ensure safe and successful regional anesthesia, and to avoid iatrogenic nerve injuries during surgery of the orbitofacial region. Supraorbital nerve exits from 116 sides of 58 dry intact adult skulls (37 male and 21 female) in a Sri Lankan population were examined to determine the morphological features and the precise position in relation to the facial midline, temporal crest of frontal bone, and frontozygomatic suture. A majority of supraorbital nerve exits existed as notches (73.8%) and the rest as foramina (26.2%). Accessory exits were seen in 18.9% skulls. Of the skulls examined, 55.1% displayed bilateral supraorbital notches, 8.6% had bilateral supraorbital foramina, and 36.3% had a notch on one side and a foramen on the contralateral side. In males, the supraorbital nerve exit was located 23.64±3.49 mm laterally from the facial midline, 27.86±2.76 mm medially from the temporal crest of the frontal bone, 28.66±2.56 mm from the frontozygomatic suture, and 2.12±1.07 mm above the supraorbital margin in the case of a foramen, and in females 22.69±3.28 mm laterally from the facial midline, 26.32±3.02 medially from temporal crest of frontal bone, 27.29±3.05 from the frontozygomatic suture, and 2.99±1.49 mm above the supraorbital margin when it existed as a foramen. The observations made in this study will be useful when planning a supraorbital nerve block and surgery in the supraorbital region.
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Affiliation(s)
- Deepthi Nanayakkara
- Department of Basic Sciences, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Ruwanthi Manawaratne
- Department of Basic Sciences, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Harshana Sampath
- Department of Basic Sciences, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Amal Vadysinghe
- Department of Forensic Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Roshan Peiris
- Department of Basic Sciences, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
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Zdilla MJ, Koons AW, Russell ML, Mangus KR, Bliss KN. The Infraorbital Foramen Is Located Midway Between the Nasospinale and Jugale: Considerations for Infraorbital Nerve Block and Maxillofacial Surgery. J Craniofac Surg 2018; 29:523-527. [PMID: 29381630 PMCID: PMC5839919 DOI: 10.1097/scs.0000000000004186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Identification of the infraorbital foramen is important in infraorbital nerve block and the prevention of iatrogenic injury of the infraorbital nerve in maxillofacial surgeries. This study assessed the location of 887 infraorbital foramina from 518 adult crania of varied sex and population. The study assessed the midpoint of a line segment spanning from nasospinale to jugale (NS-J) relative to the infraorbital foramen. The mean distance of the NS-J midpoint from the infraorbital foramen was 2.1 ± 1.9 mm (mean ± SD) with a mode of 0 mm (266:887; 30%). The NS-J midpoint was located in the same plane or inferior to the infraorbital foramen in 98.4% of sides (873:887). There were no significant differences between sexes, populations, or sides with regard to the NS-J midpoint to infraorbital foramen distance. The NS-J midpoint can be used to locate the infraorbital foramen in both females and males of varied populations regardless of craniofacial diversity. The results of this study will aid in infraorbital nerve block procedures and maxillofacial surgery.
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Affiliation(s)
- Matthew J. Zdilla
- Department of Natural Sciences and Mathematics, West Liberty University, West Liberty, West Virginia, 26074
- Department of Graduate Health Sciences, West Liberty University, West Liberty, West Virginia, 26074
| | - Aaron W. Koons
- Department of Natural Sciences and Mathematics, West Liberty University, West Liberty, West Virginia, 26074
| | - Michelle L. Russell
- Department of Natural Sciences and Mathematics, West Liberty University, West Liberty, West Virginia, 26074
| | - Kelsey R. Mangus
- Department of Natural Sciences and Mathematics, West Liberty University, West Liberty, West Virginia, 26074
| | - Kaitlyn N. Bliss
- Department of Natural Sciences and Mathematics, West Liberty University, West Liberty, West Virginia, 26074
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Pittayapat P, Jacobs R, Bornstein MM, Odri GA, Lambrichts I, Willems G, Politis C, Olszewski R. Three-dimensional Frankfort horizontal plane for 3D cephalometry: a comparative assessment of conventional versus novel landmarks and horizontal planes. Eur J Orthod 2017; 40:239-248. [DOI: 10.1093/ejo/cjx066] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Pisha Pittayapat
- OIC, OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Reinhilde Jacobs
- OIC, OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Michael M Bornstein
- OIC, OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, Sai Ying Pun, China
| | - Guillaume A Odri
- Service de Chirurgie Orthopédique et Traumatologique, Centre Hospitalier Régional d’Orléans, Orléans cedex 2, France
| | - Ivo Lambrichts
- Biomedical Research Institute, Laboratory of Morphology, Hasselt University, Campus Diepenbeek, Diepenbeek, Belgium
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, University of Leuven, Belgium
| | - Constantinus Politis
- OIC, OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Raphael Olszewski
- Department of Oral and Maxillofacial Surgery, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium
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Machado VDC, Chrcanovic BR, Felippe MB, Manhães Júnior LRC, de Carvalho PSP. Assessment of accessory canals of the canalis sinuosus: a study of 1000 cone beam computed tomography examinations. Int J Oral Maxillofac Surg 2016; 45:1586-1591. [PMID: 27720336 DOI: 10.1016/j.ijom.2016.09.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 06/21/2016] [Accepted: 09/09/2016] [Indexed: 11/18/2022]
Abstract
The aim of this study was to verify the presence, spatial location, and calibre of the accessory canals (AC) of the canalis sinuosus by cone beam computed tomography, and their relationship to the anterior maxilla. This retrospective analysis included the scans of 1000 subjects. Parameters registered were sex, age, number of AC, presence or absence of AC with a diameter <1.0mm, AC diameter (only for AC with a diameter >1.0mm), and AC location in relation to the adjacent teeth. Males showed a statistically higher frequency of AC than females. The difference in age distribution was not statistically significant. Twenty percent of all AC presented a diameter of a least 1.0mm. The end of the AC trajectory was most frequently located palatal to the anterior maxillary teeth. All relationships analyzed here were very weak (age vs. number of AC, age vs. AC diameter, number of AC vs. sex). Overall, the results of this study showed that AC of the canalis sinuosus are a common anatomical structure in the anterior maxilla, regardless of age and sex.
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Affiliation(s)
- V de C Machado
- Slice Diagnóstico Volumétrico por Imagem, Belo Horizonte, Brazil.
| | - B R Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - M B Felippe
- Clínica de Radiologia, Faculdade de Odontologia São Leopoldo Mandic, Campinas, Brazil
| | - L R C Manhães Júnior
- Faculdade de Odontologia, Universidade Estadual Paulista Júlio de Mesquita Filho, São José dos Campos, Brazil
| | - P S P de Carvalho
- Departamento de Cirurgia e Clínica Integrada, Faculdade de Odontologia de Araçatuba, Universidade Estadual Paulista Júlio de Mesquita Filho, Araçatuba, Brazil
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Chrcanovic BR, de Carvalho Machado V, Gjelvold B. A morphometric analysis of the mandibular canal by cone beam computed tomography and its relevance to the sagittal split ramus osteotomy. Oral Maxillofac Surg 2016; 20:183-190. [PMID: 26875084 DOI: 10.1007/s10006-016-0550-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 02/08/2016] [Indexed: 06/05/2023]
Abstract
PURPOSE The aim of the present study was to morphometrically analyze the mandibular canal through the mandibular ramus by cone beam computed tomography (CBCT) and to relate the findings to performing sagittal split ramus osteotomy. METHODS CBCT of 200 patients were analyzed. Five parameters were measured at the axial scan, from the mandibular foramen to 21 mm below it (3-mm intervals). The canal was classified according to the position within the bone marrow space. Variations were evaluated according to age, sex, side, and number of mandibular teeth. RESULTS/CONCLUSIONS The following measurements increased gradually towards the most inferior level of measurement: the total thickness of the mandibular ramus through the center of the mandibular canal, the width of the bone marrow space (both buccal and lingual), and the narrowest width from the mandibular canal inner cortical to the mandibular ramus external cortical. The inner diameter of the mandibular canal slightly decreased to the same direction. Concerning the mandibular canal position within the bone marrow space, the percentage of the separate type increased towards the most inferior level of measurement, and the contact and fusion types decreased. Age, number of teeth, and sex had no significant influence on the total thickness of the mandibular ramus and on the narrowest width from the mandibular canal inner cortical to the mandibular ramus external cortical.
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Affiliation(s)
- Bruno Ramos Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Carl Gustafs väg 34, 205 06, Malmö, Sweden.
| | | | - Björn Gjelvold
- Clinics for Prosthodontics, Centre of Dental Specialist Care, Malmö, Sweden
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Location of the infraorbital foramen with reference to soft tissue landmarks. Surg Radiol Anat 2016; 39:11-15. [PMID: 27146295 DOI: 10.1007/s00276-016-1683-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 04/28/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE The location of the infraorbital foramen and its variations are important during periorbital, dental, plastic, and oromaxillofacial surgeries. The aim of this study is to document the most practical anatomical soft tissue landmarks for defining the location of infraorbital foramen and infraorbital nerve for effective nerve blockade and to decrease its risk of injury during periorbital surgeries. METHODS Forty sides from 20 adult fixed cadavers were used for this study. The position of the infraorbital nerve was determined in reference to the lateral edge of the ala of the nose, medial and lateral palpebral commissures. All these three soft tissue landmarks were then connected to each other forming a triangular shaped region. RESULTS In 75 % of the cases the infraorbital foramen was located on the line which is connecting the lateral palpebral commissure to the ala of the nose. The closest distance of infraorbital foramen to the inferior orbital margin and to facial midline was also measured. The infraorbital foramen was located outside the previously defined triangular region in 20 % and inside the triangle in 5 %. The closest mean distance between the infraorbital foramen and the infraorbital margin was measured as 8.8 ± 1.0 mm and the distance between the medial wall of the infraorbital foramen and the facial midline was measured as 30.3 ± 2.7 mm. CONCLUSION The triangular region and the soft tissue landmarks we offered in this study may facilitate prediction of the locations of the infraorbital foramen thus, the infraorbital nerve.
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Morphometric analysis of the infraorbital foramen, canal and groove using cone beam CT: considerations for creating artificial organs. Int J Artif Organs 2016; 39:28-36. [PMID: 26868217 DOI: 10.5301/ijao.5000469] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2016] [Indexed: 12/17/2022]
Abstract
PURPOSE The aim of this study was to examine the anatomy and variations of the infraorbital foramen and its surroundings via morphometric measurements using cone beam computed tomography (CBCT) scans derived from a 3D volumetric rendering program. METHODS 354 sides of CBCT scans from 177 patients were examined in this study. DICOM data from these images were exported to Maxilim® software in order to generate 3D surface models. The morphometric measurements were done for infraorbital foramen (IOF), infraorbital groove (IOG) and infraorbital canal (IOC). All images were evaluated by 1 radiologist. To assess intra-observer reliability, the Wilcoxon matched-pairs signed rank test was used. Differences between sex, side, age and measurements were evaluated using chi-square and paired t-test and measurements were evaluated using 1-way ANOVA tests. Differences were considered significant when p<0.05. RESULTS The most common shape was oval for IOF and parallel for IOC without any accessory foramen. The results showed that females have smaller dimensions for the measurements between the two foramen rotundum (FR), FR-IOF, sella-FR, center of the IOF (cIOF)-nasion (N), cIOF-NB (nasion-B) (p>0.05). No significant difference was found according to age groups (p>0.05). CONCLUSIONS These results provide detailed knowledge of the anatomical characteristics in this particular area. CBCT imaging with lower radiation dose and thin slices can be a powerful tool for anesthesia procedures like infra orbital nerve blocks, for surgical approaches like osteotomies and neurectomies and also for generating artificial prostheses.
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Rusu MC, Săndulescu M, Ilie OC. Infraorbital canal bilaterally replaced by a lateroantral canal. Surg Radiol Anat 2015; 37:1149-53. [PMID: 25823691 DOI: 10.1007/s00276-015-1468-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 03/23/2015] [Indexed: 11/24/2022]
Abstract
The infraorbital canal (IOC) normally courses above the maxillary sinus in the orbit floor. During a retrospective study of cone beam computed tomography (CBCT) scans, we found a previously unknown variant of the IOC. The IOCs were absent, being replaced by lateroantral canals coursing around and not above the maxillary sinus to open at infraorbital foramina which were located above the second upper premolar teeth. On coronal multiplanar reconstructions, the lateroantral canals were located anatomically at the outer limit of the zygomatic recess of each maxillary sinus, while the upper wall of the sinus was devoid of any canal. Such rare variant should be kept in mind by dental practitioners and surgeons, as it can determine modifications of common procedures. In this regard, the anatomy of maxilla, as well as mandible, should be evaluated in CBCT on a case-by-case basis.
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Affiliation(s)
- M C Rusu
- Division of Anatomy, Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, 8, Eroilor Sanitari Blvd., Sector 5, 050474, Bucharest, Romania.
| | - M Săndulescu
- Division of Oral Implantology, Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - O C Ilie
- Department of Anatomy, "Victor Babeş" University of Medicine and Pharmacy, Timişoara, Romania
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Location of facial foramina and mandibular angle from cone beam computed tomographic scans. J Craniofac Surg 2014; 26:268-73. [PMID: 25490577 DOI: 10.1097/scs.0000000000001247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The current study's purpose was to determine morphometric analysis of all facial foramina and mandibular angle relative to surgical landmarks from cone beam computed tomographic scans. MATERIALS AND METHODS Three-dimensional computed tomographic scans were reconstructed from data of 100 patients (200 sides) aged between 19 and 76 years. Morphometric measurements of all facial foramina relative to surgical landmarks were taken. Mandibular angle was measured. RESULTS There was no statistically significant difference between the left and right sides for all parameters (P > 0.05). Therefore, we found bilateral symmetry in the position of all facial foramina and mandibular angle. However, statistically significant differences were determined in sexes in some of these parameters and mandibular angle. CONCLUSIONS The knowledge about locations of facial foramina and mandibular angle is important for performing local nerve block and surgery in the face to avoid the neurovascular structures. This study provides a guideline for locations of facial foramina and mandibular angle, which may help surgeons to understand the nerve location precisely during surgery.
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The clinical landmark of infraorbital foramen in Chinese population: a prospective measurement study. EUROPEAN JOURNAL OF PLASTIC SURGERY 2014. [DOI: 10.1007/s00238-014-0977-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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El Sheikh E, Nasr WF, Al Shahat Ibrahim A. Anatomical variations of supraorbital notch and foramen: a study on human adult Egyptian skulls. EUROPEAN JOURNAL OF PLASTIC SURGERY 2014. [DOI: 10.1007/s00238-013-0903-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sheikhi M, Zamaninaser A, Jalalian F. Length and anatomic routes of the greater palatine canal as observed by cone beam computed tomography. Dent Res J (Isfahan) 2013; 10:155-61. [PMID: 23946729 PMCID: PMC3731953 DOI: 10.4103/1735-3327.113324] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Greater palatine canal is used for maxillary nerve block. This procedure has some complications such as proptosis, blindness, and intravascular injection. This study aimed to determine the mean greater palatine canal length (CL) and its typical anatomic routes, as well as provide a reliable facial index for computing the CL by using cone beam computed tomography (CBCT) data. MATERIALS AND METHODS A total of 138 CBCT scans (65 females and 73 males) were evaluated. The path of the canal and the CL were determined by sex, age, and side. The mean distance from the inferior border of the infraorbital foramen (IOF) to the crest of alveolar bone between maxillary premolar(CMP) was measured and compared with the CL. Paired t-tests, independent t-test, and one-way analysis of variance (ANOVA) were used for statistical analysis. RESULTS The mean of CL was 31.82 ± 1.37 mm (31.70 ± 2.44 mm on the right side and 31.94 ± 2.40 mm on the left side), and the values were 32.49 ± 2.37 mm in males and 30.55 ± 1.76 mm among females (P = 0.001). The mean distance from the IOF to the CMP was 32.01 ± 2.18 mm, which was not significantly different to the CL (P = 0.336). CONCLUSIONS The mean CL was significantly different according to sex and side. The mean distance from the IOF to CMP was significantly different according to sex. On comparing the mean distance from the IOF to the CMP with the CL, no significant difference was observed. Therefore, the mean distance from the IOF to CMP may be a reliable clinical index.
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Affiliation(s)
- Mahnaz Sheikhi
- Torabinejad Dental Research Center and Department of Oral and Maxillofacial Radiology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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Peris-Celda M, Pinheiro-Neto CD, Scopel TF, Fernandez-Miranda JC, Gardner PA, Snyderman CH. Endoscopic endonasal approach to the infraorbital nerve with nasolacrimal duct preservation. J Neurol Surg B Skull Base 2013; 74:393-8. [PMID: 24436942 DOI: 10.1055/s-0033-1347372] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 03/10/2013] [Indexed: 10/26/2022] Open
Abstract
Objectives Infraorbital nerve (ION) decompression, excision to remove intrinsic tumors, and resection with oncological margins in malignancies with perineural invasion or dissemination are usually accomplished with an open approach. The objective is to describe the surgical anatomy, technique, and indications of the endonasal endoscopic approach (EEA) to the ION with nasolacrimal duct preservation. Design Eleven sides of formalin-fixed specimens were dissected. An anterior maxillary antrostomy was performed. The length of the ION prominence within the sinus and anatomic features of the covering bone were studied. A 45-degree endoscope visualized the infraorbital prominence endonasally. An angled dissector and dural blade allowed for dissection and resection of the ION ipsilaterally and contralaterally. Results The bone features of the ION prominence allowed for ipsilateral dissection in 10 out of 11 sides. In one case with the ION surrounded by thick cortical bone, the dissection could only be started by drilling contralaterally. The 45-degree endoscope visualized 92.2% and 100% of the length of the nerve using the ipsilateral and contralateral nostrils, respectively. Ipsilaterally, 83% of its length was resected, and 96.3% was resected contralaterally. Conclusion The ION can be approached using an ipsilateral EEA with nasolacrimal duct preservation in most cases. The contralateral approach provides a wider angle to access the ION. This technique is primarily indicated in cases where the EEA can be used for tumor resection and oncological margins within the ION.
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Affiliation(s)
- Maria Peris-Celda
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Carlos D Pinheiro-Neto
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Tiago F Scopel
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Juan C Fernandez-Miranda
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Paul A Gardner
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Carl H Snyderman
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
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A rare nerve variation: duplication of infraorbital nerve. J Craniofac Surg 2013; 24:694-5. [PMID: 23524796 DOI: 10.1097/scs.0b013e3182802399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Morphometric analysis of the infraorbital groove, canal, and foramen on three-dimensional reconstruction of computed tomography scans. Surg Radiol Anat 2013; 35:565-71. [PMID: 23404562 DOI: 10.1007/s00276-013-1077-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Accepted: 01/20/2013] [Indexed: 10/27/2022]
Abstract
PURPOSE This study aimed to investigate the anatomy of the infraorbital foramen (IOF), infraorbital canal (IOC), and infraorbital groove (IOG) with regard to surgical and invasive procedures using three-dimensional reconstruction of CT scans. METHODS The CT scans of 100 patients were evaluated retrospectively. The morphology of the IOF, IOC, and IOG as well as their relationships to different anatomic landmarks was assessed in a three-dimensional model. RESULTS The mean length of the IOC and IOG and the angle of the IOC relative to IOG were 11.7 ± 1.9, 16.7 ± 2.4 mm, and 145.5° ± 8.5°, respectively. The mean angles of the IOC relative to vertical and horizontal planes were 13.2° ± 6.4° and 46.7° ± 7.6°, respectively. In the relationships between the IOF and different anatomic landmarks, the mean distances from the IOF to supraorbital notch/foramen, facial midline, and infraorbital rim were 5.6 ± 3.1 mm laterally, 26.5 ± 1.9 mm laterally, and 9.6 ± 1.7 mm inferiorly, respectively. The mean distance from the IOF to anterior nasal spine (ANS) was 35.0 ± 2.6 mm, and the mean angle of the axis that passed the IOF and ANS relative to horizontal plane was 28.8° ± 4.1°. In addition, the mean soft tissue thickness overlying the IOF was 11.4 ± 1.9 mm. CONCLUSIONS These results provide detailed knowledge of the anatomical characteristics and clinical importance of the IOF. Such knowledge is of paramount importance for surgeons when performing maxillofacial surgery and regional block anesthesia.
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Characterisation of the supraorbital foramen and notch as an exit route for the supraorbital nerve in populations from different climatic conditions. HOMO-JOURNAL OF COMPARATIVE HUMAN BIOLOGY 2013; 64:58-70. [DOI: 10.1016/j.jchb.2012.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Accepted: 09/14/2012] [Indexed: 11/18/2022]
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Location of the supraorbital and infraorbital foramen with references to the soft tissue landmarks in a Chinese population. J Craniofac Surg 2013; 23:1154-5. [PMID: 22801112 DOI: 10.1097/scs.0b013e31824e2bd0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The purpose of the current study was to determine the supraorbital foramen (SOF) and infraorbital foramen (IOF) based on soft tissue landmarks, to facilitate prediction of the location of this structure during facial surgery. Forty-two hemispheres of 21 adult cadavers (16 men and 5 women; aged 30-75 years) were dissected to expose the SOF and IOF. The locations of the SOF and IOF were evaluated with direct and photographic measurements. The data gained were analyzed by statistical method. The SOF localized 23.11 ± 2.35 mm superior and 9.48 ± 3.06 mm lateral to the angulus oculi medialis (AOM). The vertical angle from AOM to SOF was 68.3 (SD, 6.44) degrees. The SOF localized 24.81 (SD, 3.39) mm inferior and 10.89 (SD, 2.78) mm lateral to the AOM on the front view. The vertical angle from AOM to IOF was 66.5 (SD, 5.18) degrees. The SOF localized 11.22 (SD, 2.01) mm inferior and 6.09 (SD, 2.32) mm lateral to the ala of the nose (AL) on the front view. The vertical angle from AL to IOF was 61.7 (SD, 7.61) degrees. These results were a little different from the results of some other populations. We found the IOFs located on the point of one-fifth proportion distant to the ALs along the vertical direction distance from AL to SOF, whereas the AOMs located on the point of three-fifths proportion distant from the AL. Our results may provide more detailed information to predict the location of the SOFs and IOFs and help to prevent nerve or vessel damage.
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Raschke R, Hazani R, Yaremchuk MJ. Identifying a safe zone for midface augmentation using anatomic landmarks for the infraorbital foramen. Aesthet Surg J 2013; 33:13-8. [PMID: 23220876 DOI: 10.1177/1090820x12468752] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Midface augmentation is commonly used to improve the appearance of concave faces and to achieve balance in the facial contour. It can also be an adjunct to orthognathic or reconstructive surgery. However, an inherent risk of midface augmentation is injury to the infraorbital nerve where it exits the infraorbital foramen (IOF). This can result in significant morbidity, including loss of sensation to the midface, nasal sidewall, upper lip, and lower eyelid. OBJECTIVES The authors identify a safe zone of dissection in the midface for subperiosteal placement of infraorbital, paranasal, malar, and submalar implants, which avoids injury to the infraorbital nerve. METHODS Given the popularity of transconjuctival and intraoral access to the midface skeleton, the authors identified relevant bony and dental landmarks from radiographic images and measured distances between the IOF and these landmarks. Forty-four computed tomography scans of adult hemifaces were used to accurately locate the IOF in relation to the anatomic landmarks. RESULTS Most often, the IOF's location correlated with the second premolar on a vertical axis. The average distance between the IOF and the infraorbital rim, piriform aperture, tip of the second premolar cusps, and lateral orbital rim was approximately 8.61, 17.43, 41.81, and 25.93 mm (respectively) in men and 8.25, 15.69, 37.33, and 24.21 mm (respectively) in women. CONCLUSIONS A safe zone of dissection for midface augmentation has been identified, which differs from previous findings. Awareness of this zone may help clinicians locate the IOF and avoid injury to the nerve.
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Affiliation(s)
- Ralf Raschke
- Massachusetts General Hospital-Harvard Medical School, Boston, MA 02114-3117, USA
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Tomaszewska A, Kwiatkowska B, Jankauskas R. The Localization of the Supraorbital Notch or Foramen is Crucial for Headache and Supraorbital Neuralgia Avoiding and Treatment. Anat Rec (Hoboken) 2012; 295:1494-503. [DOI: 10.1002/ar.22534] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Accepted: 06/13/2012] [Indexed: 11/11/2022]
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