Graded Eyelid Crease Approach to the Superior Orbital Apex: An Anatomical Study.

IF 1.2 4区 医学 Q3 OPHTHALMOLOGY Ophthalmic Plastic and Reconstructive Surgery Pub Date : 2024-11-19 DOI:10.1097/IOP.0000000000002812
Jessica Y Tong, Jeffrey Sung, WengOnn Chan, Alkis J Psaltis, Dinesh Selva
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Abstract

Purpose: To describe a graded eyelid crease approach to access the superior orbital apex, and to quantify the working space enabled with the sequential release of structures along the superior orbital rim.

Methods: Cadaveric dissection study of 7 cadaver heads (14 orbits). This technique involved a subperiosteal approach to the superior orbital apex. This was performed by sequential dissection from 1) the supraorbital neurovascular bundle (SNB) to the zygomaticofrontal suture, 2) extension of this plane to the Whitnall's tubercle, 3a) dissection around the SNB up to the trochlea while preserving the SNB, or 3b) release and division of the SNB, and finally 4) subperiosteal release of the trochlea. Measurements were taken between each landmark (mean ± 1 SD). With each step, a silicone mold was created of the subperiosteal cavity with maximal orbital retraction, which was maintained within 10 mm from the superior orbital rim. The length (mm), width (mm), height (mm), and weight (g) of the mold were quantified.

Results: The mean distance from SNB to the zygomaticofrontal suture is 27.0 ± 2.9 mm; zygomaticofrontal suture to Whitnall's tubercle 8.9 ± 3.1 mm, and SNB to trochlea 4.6 ± 2.7 mm. There was a linear increase in the length, width, and height of the silicone mold with each progressive step. The largest gains in height and weight of the silicone mold were noted progressing from step 2 to 3a.

Conclusion: Quantitative analysis of the transorbital approach to the superior orbital apex demonstrates that dissection around the SNB provides a wider surgical corridor of access.

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眶上穹窿的分级眼睑皱襞入路:解剖学研究。
目的:描述一种分级眼睑皱襞方法,以进入上眼眶顶,并量化沿上眼眶边缘依次松解结构所带来的工作空间:方法:对 7 个尸体头部(14 个眼眶)进行解剖研究。方法:对 7 个尸体头部(14 个眼眶)进行解剖研究。具体方法是:1)从眶上神经血管束(SNB)到颧额缝,2)将该平面延伸至惠特纳尔结节,3a)在保留SNB的同时围绕SNB解剖至套骨,或3b)松解并分割SNB,最后4)骨膜下松解套骨。在每个地标之间进行测量(平均值 ± 1 SD)。每一步都要制作骨膜下腔的硅胶模型,最大限度地收缩眼眶,并将其保持在距眶上缘 10 毫米的范围内。对模具的长度(毫米)、宽度(毫米)、高度(毫米)和重量(克)进行量化:SNB到颧额缝的平均距离为(27.0 ± 2.9)毫米;颧额缝到Whitnall's结节的平均距离为(8.9 ± 3.1)毫米;SNB到蝶骨的平均距离为(4.6 ± 2.7)毫米。硅胶模具的长度、宽度和高度随着每个渐进步骤呈线性增长。从第 2 步到第 3a 步,硅胶模具的高度和重量增幅最大:眶上顶经眶入路的定量分析表明,围绕SNB的剥离可提供更宽的手术通道。
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来源期刊
CiteScore
2.50
自引率
10.00%
发文量
322
审稿时长
3-8 weeks
期刊介绍: Ophthalmic Plastic and Reconstructive Surgery features original articles and reviews on topics such as ptosis, eyelid reconstruction, orbital diagnosis and surgery, lacrimal problems, and eyelid malposition. Update reports on diagnostic techniques, surgical equipment and instrumentation, and medical therapies are included, as well as detailed analyses of recent research findings and their clinical applications.
期刊最新文献
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