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Raeisi M, Jafari SH, Karimi F, Namazi MR. Location of infraorbital and accessory infraorbital foramina in Iranian population: a retrospective radiological study with crucial clinical implications. Surg Radiol Anat 2024:10.1007/s00276-024-03373-2. [PMID: 38761208 DOI: 10.1007/s00276-024-03373-2] [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: 02/12/2024] [Accepted: 04/22/2024] [Indexed: 05/20/2024]
Abstract
PURPOS The location of infraorbital foramen (IOF) and the prevalence of accessory IOF vary among different populations. It may lead to infraorbital nerve (ION) blockage during surgery. This study aimed to assess the IOF location and AIOF frequency in Iranian people. METHOD In this retrospective cross-sectional study, 500 paranasal sinus computed tomography scans of adults were examined using the INFINITT PACS system. RESULT The distance from IOF to infraorbital margin (IOM), mid-pupillary line (MPL), midsagittal line (MSL), canine eminence (CE), and skin thickness (ST) was 8.97 ± 1.79, 5.73 ± 1.84, 24.86 ± 2.23, 20.39 ± 3.47, and 10.90 ± 2.59 mm, respectively. The vertical and transverse diameters of the foramen were 3.03 ± 0.65 and 3.71 ± 0.76 mm, respectively. In addition, the shape of 63.5% of the foramina was oval. The prevalence of AIOF was 9%, and its most common location was superomedial to IOF. CONCLUSION We believe that in this study, landmarks like IOM, MPL, MSL, CE and ST could help the clinicians localize IOF and improve the ION anesthesia success rate. Furthermore, the occurrence of AIOF should be considered by physicians to reduce the chance of injuries to the infraorbital neurovascular complex.
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Affiliation(s)
- Morteza Raeisi
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Hamed Jafari
- Department of Radiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Karimi
- Department of Anatomy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
- Department of Dermatology, Molecular Dermatology Research Center, School of Medicine, Shiraz University of Medical Sciences, Zand Ave, Shiraz, 7134844119, Iran.
| | - Mohammad Reza Namazi
- Department of Dermatology, Molecular Dermatology Research Center, School of Medicine, Shiraz University of Medical Sciences, Zand Ave, Shiraz, 7134844119, Iran.
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An D, K C K, Vorakulpipat C, Ngamsom S, Kumchai T, Ruangsitt S, Chaiyasamut T, Wongsirichat N. Accessory infraorbital foramen location using cone-beam computed tomography. J Dent Anesth Pain Med 2023; 23:257-264. [PMID: 37841517 PMCID: PMC10567540 DOI: 10.17245/jdapm.2023.23.5.257] [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: 06/03/2023] [Revised: 07/24/2023] [Accepted: 08/28/2023] [Indexed: 10/17/2023] Open
Abstract
Background Accessory infraorbital foramen (AIOF) can change the normal course of emerging branches of the infraorbital nerve and blood vessels exiting the infraorbital foramen (IOF). This study aimed to examine the AIOF, number of foramina, and their position in relation to IOF using cone-beam computed tomography (CBCT). Methods We performed a retrospective CBCT assessment of hospital records between January 2018 and August 2022. The CBCT of 507 patients were examined to extract information on the prevalence, number, position, linear distance from the IOF, and diameter of AIOF in relation to demographic factors. Descriptive statistics were used to evaluate the prevalence of AIOF. Mean and standard deviation were used to calculate the linear distance and diameter of the AIOF, respectively. The AIOFs, its distribution, and number were compared between sexes and sides using the chi-square test. The independent t-test and Mann-Mann-Whitney test were used to compare the mean difference between the sexes and sides. Statistical significance was set at P < 0.05. Results In this current study, the prevalence of AIOF was 7.1% (36 of the 507 patients). Additionally, the current study examined the number of foramina using a single foramen on each side and double foramina located bilaterally at a distance from the AIOF to the IOF. The mean AIOF diameter was also studied, and the AIOF position with respect to the IOF on CBCT was superomedial or inferomedial. There were no statistically significant associations between any of the parameters assessed in this study when comparing sex and sides. Conclusions A greater number of patients with AIOF presented with a single foramen and unilateral occurrence, without a statistically significant difference. The AIOF was most commonly located superomedial to the IOF.
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Affiliation(s)
- Daesung An
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Kumar K C
- Department of Oral and Maxillofacial surgery, OM Samaj Dental Hospital, Naikap, Kathmandu, Nepal
| | - Chakorn Vorakulpipat
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Supak Ngamsom
- Oral and Maxillofacial Radiology Department, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Thongnard Kumchai
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Bangkokthonburi University, Bangkok, Thailand
| | - Sunya Ruangsitt
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Bangkokthonburi University, Bangkok, Thailand
| | - Teeranut Chaiyasamut
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Natthamet Wongsirichat
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Bangkokthonburi University, Bangkok, Thailand
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Osbon SA, Butaric LN. Investigating the relationship between infraorbital canal morphology and maxillary sinus size. Anat Rec (Hoboken) 2023; 306:110-123. [PMID: 35633032 DOI: 10.1002/ar.25007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/18/2022] [Accepted: 05/20/2022] [Indexed: 01/29/2023]
Abstract
The purpose of the current study was to investigate relationships between maxillary sinus (MS) dimensions and the bony structures associated with the infraorbital nerve (ION). Computed tomographic scans of 87 adult crania (174 sides) from four morphologically diverse groups (West Africans, East Africans, North Asians, Europeans) were utilized. Seven primary variables were collected: infraorbital canal (IOC) type; infraorbital foramen (IOF) shape; distance from the foramen rotundum to IOF (FR-IOF); distance from the posterior wall of the infraorbital groove to IOF (IOG-IOF); and MS length, breadth, and height. Chi-square analyses indicated a significant association between IOC-type and IOF-shape (Pearson chi-square = 12.710; p-value = .013), with the most common pattern being oval IOFs and Type-I IOCs (45.68% of the sample; 74/162 sides). Analysis of covariance indicated a significant effect of ancestry (F = 8.333; p < .001) and MS length (F = 15.406; p < .001) on IOG-IOF distance. Ordinal regression analyses indicated that MS length (Wald chi-square = 7.103; p = .008) also maintained a significant effect on IOC-type, while multinominal regression analyses indicated that none of the measured parameters had a significant effect on IOF-shape. These results have clinical implications: recognizing IOC-type and IOF-shape relative to the MS is important to avoid ION damage during medical procedures. Overall, this study found most individuals possess Type-I IOCs (housed in the maxillary sinus roof) and oval-shaped IOFs. Most aspects of the ION pathway, including IOC-type and IOF-shape, were not influenced by ancestry or sex. However, antero-posteriorly longer MSs tend to possess Type-III IOCs protruding into the sinus, which could lead to surgical complications.
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Affiliation(s)
- SaCora A Osbon
- Department of Anatomy, College of Osteopathic Medicine, Des Moines University, Des Moines, Iowa, USA
| | - Lauren N Butaric
- Department of Anatomy, College of Osteopathic Medicine, Des Moines University, Des Moines, Iowa, USA
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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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Smit S, Hutchinson EF, Kramer B. A morphometric analysis of the immature human infraorbital canal. Surg Radiol Anat 2020; 43:201-210. [PMID: 32918571 DOI: 10.1007/s00276-020-02563-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 08/29/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE The importance of the infraorbital canal in the growth of the maxilla and associated mid-facial region has significance for innervation of this region as well as the associated dentition, yet little is known about the development of the canal. An analysis of its dimensions and morphology during the late prenatal and early postnatal periods was thus undertaken. The aim of this study was to describe changes in the morphology, size and branching pattern of the infraorbital canal during the late prenatal and early postnatal stages of human growth. METHODS Fifty human fetal and neonatal maxillae were analyzed. The sample included 27 late prenatal individuals (30 gestational weeks and birth) and 23 early postnatal individuals (birth and 1 year). Maxillae were scanned using a Nikon XTH 225 L micro-CT unit and analyzed using VG studiomax v3.2. Measurements included the maximum width, height and surface area of each foramen associated with the infraorbital canal and the total length of the canal, bilaterally. RESULTS All the measurements of the canal were greater in the early postnatal group than in the late prenatal group, while the walls and branching pattern of the canal were better developed in the postnatal group. Bone development occurred within the walls as development proceeded. Variations in the branching pattern of the canal were found. CONCLUSION The morphology of the infraorbital canal reflected the developmental stage of associated structures such as the dentition, maxillary sinus and orbit.
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Affiliation(s)
- Surraine Smit
- School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, York Road, Johannesburg, 2193, South Africa
| | - Erin F Hutchinson
- School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, York Road, Johannesburg, 2193, South Africa.
| | - Beverley Kramer
- School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, York Road, Johannesburg, 2193, South Africa
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False and true accessory infraorbital foramina, and the infraorbital lamina cribriformis. Morphologie 2020; 104:51-58. [PMID: 31924470 DOI: 10.1016/j.morpho.2019.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 12/13/2019] [Accepted: 12/16/2019] [Indexed: 11/23/2022]
Abstract
The infraorbital nerve (ION) and artery (IOA) course in the infraorbital canal (IOC) to exit through the infraorbital foramen (IOF). Few previous studies brought evidence of accessory IOF. Evaluation of the IOF in Cone Beam Computed Tomography (CBCT) is more accurate to determine whether or not foramina of maxilla are supplied by canaliculi deriving from the IOC. We performed a retrospective anatomical study of the CBCT files of 200 patients. An accessory infraorbital foramen located inferior to the infraorbital margin (AIOF) was found in 18/200 right maxillae and in 13/200 left ones. Canaliculi deriving from the IOC supplied accessory foramina in the sutura notha- AIOF(SN) - in 15 maxillae. Noteworthy, the AIOF(SN)-negative maxillae displayed the SN and the vascular foramina of Macalister. In 94% of cases the AIOF were unique. A single maxilla (3%) had a double AIOF. In a different case (3%) were found three accessory infraorbital foraminules transforming the anterior wall of the antrum into a veritable lamina cribriformis infraorbitalis. A single prior study distinguished AIOF from AIOF(SN), while most of different other ones were performed on dry bones. Therefore, the reports of prevalence for the number and location of AIOF should be regarded with caution. Foramina of the SN could equally get intraosseous and extraosseous supply, this distinction being accurately made in CBCT.
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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: 0] [Impact Index Per Article: 0] [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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Jamil FA, Asmael HM, Hasan AM, Rzoqi MG. Pain Reduction in Extensive Apical Surgery of the Anterior Maxilla: A Comparative Clinical Study. J Oral Maxillofac Surg 2019; 77:715-720. [PMID: 30940355 DOI: 10.1016/j.joms.2018.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 09/23/2018] [Accepted: 09/23/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE The purpose of this study was to compare the outcomes of 2 different anesthetic techniques (local infiltration vs infraorbital nerve block) for eliminating pain during apical surgeries that are associated with extensive periapical pathology in the anterior maxilla. MATERIALS AND METHODS Patients were randomly divided into 2 groups: patients in group I were anesthetized labially by local infiltration injections, whereas those in group II received a single infraorbital nerve block. Palatal injections were given for the 2 groups. Once the pain was initiated during surgery, the procedure was discontinued until profound anesthesia was secured. The studied variables were age, gender, onset of anesthesia, operative time, and intraoperative pain. Any complication associated with the injection techniques, intraoperatively and postoperatively, also was assessed and recorded. Then, the collected data were analyzed using proper statistical methods. The significance level was set at a P value less than or equal to .05. RESULTS One hundred patients (50 per group; age range, 16 to 43 yr), predominantly men, were enrolled in this study. The results showed rapid onset of anesthesia in group II with a highly significant difference from group I (P ≤ .05). Duration of the operation ranged from 44 to 57 minutes. Pain during the surgical procedure was reported by most patients in group I (92%). Collateral anesthesia (82%) and increased numbness of the upper lip (72%) were reported in group I. Ecchymosis at the infraorbital foramen or rim (8%) and paresthesia in the skin over the infraorbital region (6%) and cheek (4%) were observed in group II. CONCLUSIONS In apical surgeries, the anesthetic efficiency of the infraorbital nerve block was superior to that of local infiltration. It had rapid onset, longer duration, and greater potency and avoided multiple transmucosal injections. Furthermore, it was associated with minor and transient side effects.
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Affiliation(s)
- Firas A Jamil
- Assistant Lecturer, Department of Oral and Maxillofacial Surgery, Dental Teaching Hospital, College of Dentistry, University of Baghdad, Baghdad, Iraq.
| | - Huda Moutaz Asmael
- Assistant Lecturer, Department of Oral and Maxillofacial Surgery, Dental Teaching Hospital, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Ali Mohammed Hasan
- Assistant Lecturer, Department of Oral and Maxillofacial Surgery, Dental Teaching Hospital, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Mohammed G Rzoqi
- Assistant Lecturer, Department of Pedodontics and Preventive Dentistry, Dental Teaching Hospital, College of Dentistry, University of Baghdad, Baghdad, Iraq
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