Dimension, Location and Clinical Importance of Supraorbital Foramen and Notch: A Combined Cadaveric and Dry Skull Study.

PURPOSE: The exit points of the supraorbital nerve and its branches hold significant importance in various medical procedures, including supraorbital endoscopic surgeries, forehead-facial aesthetic plastic surgeries, medical aesthetic applications and maxillofacial surgeries. Therefore, the primary objective of the present study was to precisely define the dimension, location and clinical significance of the supraorbital foramen/notch. By doing so, we aimed to enhance our understanding of this anatomical structure and its implications for surgical and aesthetic interventions in the supraorbital region. METHODS: For our study, we conducted anatomical dissections and bone measurements to assess the significance of anatomical variations of the supraorbital foramen/notch. We utilized a sample consisting of 28 cadavers and 38 skulls. The supraorbital foramen/notch was bilaterally analyzed in all 28 cadavers and 38 dry bones. We morphometrically analyzed the distance between the supraorbital foramen/notch and various anatomical landmarks, including the nasion, supraorbital margin, infraorbital margin, temporal crest, glabella, frontal cavity and midline of the face. Additionally, we measured the distance between the supraorbital foramen/notches and the frontal foramen/notches, and the width of the supraorbital foramen/notch and the distance between both supraorbital foramina/notches. RESULTS: There are 32 (57.14%) supraorbital  foramina, and the remaining are 24 (42.86%) supraorbital notches in cadavers and there are 36 (47.37%) supraorbital foramina, and the remaining are 40 (52.63%) supraorbital notches in skulls. We observed consistency in the dimension and location values of anatomical measurement parameters between cadavers and dry skulls on both right and left sides, with the exception of the parameter "distance from temporal crest" (p=0.042). Furthermore, our correlation analysis revealed a significant positive relationship between the right and left sides across all parameters, except for the following instances: in dry skulls, "distance from supraorbital margin" and in cadaver parameters, "distance from temporal crest, " "distance from frontal cavity" and "width." CONCLUSION: In our study, we observed that the distributions of supraorbital foramina and notches were nearly similar. Furthermore, our findings indicated comparable measurements between the right and left sides in both cadavers and skulls. These results suggest a degree of consistency in supraorbital anatomy within our study sample, regardless of the specimen type (cadavers or skulls) or laterality (right or left side). NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Morphometric Analysis of the Supraorbital Foramen and Notch in the Population of Bosnia and Herzegovina.

OBJECTIVE: The aim of this study was to learn about the morphological characteristics of the supraorbital foramen and to determine its precise position in relation to the surrounding anatomical landmarks in the adult population of Bosnia and Herzegovina. MATERIAL AND METHODS: For this purpose, 60 skulls from the Bosnia and Herzegovina population of known sex (32 males and 28 females), taken from the osteological collection of the Department of Human Anatomy of the Medical Faculty in Sarajevo, were subjected to morphological and morphometric analysis. Morphometric measurements were performed using a digital vernier caliper (Mitutoyo Corporation, Japan). RESULTS: The study showed that most supraorbital nerves exit the orbit through the supraorbital notch (73.8%) and the rest through the foramen (26.2%). Of this number, bilateral supraorbital notches were recorded in 58.33% of cases, a bilateral supraorbital foramen in 18.34% of cases, while in 23.33% of cases a notch was recorded on one side and a foramen on the contralateral side. Morphometric measurements performed to determine the exact position of the supraorbital foramen relative to the surrounding landmarks showed different values in males and females. An accessory foramen was also observed on the examined skulls in 16.67% of cases. CONCLUSION: Detailed knowledge of anatomical variations of the supraorbital foramen is required for safe and successful administration of regional anesthesia, in order to avoid iatrogenic nerve injuries during orbitofacial region surgery.

Studies of Supraorbital Notch and Foramen Using 3-Dimensional Facial Bone CT Scans.

BACKGROUND: The supraorbital foramen or notch is located at the superior orbital rim. Previous studies have reported anatomical variations in these structures. However, the results varied depending on races and the measurement method used. OBJECTIVE: The purpose of this study is to identify the morphological features of supraorbital foramen or notch based on locational relationship using images of 3-dimensional (3D) facial bone CT scans. STUDY DESIGN: Retrospective study. SETTING: University hospital emergency department.  METHODS: Identification and analysis of patients who have undergone facial bone 3D CT were performed using Clinical Data Warehouse v 2.5 (CDW, Planit Healthcare, Seoul, Korea). The search word that we used with the CDW for analysis was "facial bone 3D CT".First, the region of the supraorbital rim was examined to clarify whether or not the supraorbital foramen or notch was present. Second, the diameter of the supraorbital foramen or notch was measured. Lastly, the distance from midpoint (nasion) to the supraorbital notch or foramen was measured. RESULTS: The supraorbital notch was found more frequently than the supraorbital foramen. Among supraorbital double types, the coexistence of notch and foramen was found more frequently than the coexistence of notch and notch or foramen and foramen. The diameter of supraorbital notch was wider than the supraorbital foramen, which was located more laterally from the nasion than the supraorbital notch. LIMITATION: The actual size of the facial image or the skull size of the patient was not considered, which might affect the distance of supraorbital notch or foramen from the midline. CONCLUSION: Supraorbital notch was more frequently found than the supraorbital foramen. The supraorbital notch had a wider diameter and was more centrally located than the supraorbital foramen.

Morphometric evaluation, locational relationship, and surgical significance of the maxillofacial region landmarks / Evaluación morfométrica, relación de ubicación e importancia quirúrgica de los puntos de referencia de la región maxilofacial

SUMMARY: The aim of this study was to examine the localization of the landmarks in the maxillofacial region and their relations with each other and to evaluate them morphologically and clinically. Our study included 41 dry adult human skulls of unknown age and sex of Anatolian population. Statistical analysis of the data obtained in our study was performed with SPSS v.20.0 software (IBM Corp., Armonk, NY, USA). Statistical significance was accepted as P ? 0.05. Whereas the mean right supraorbital depth (SOD) value was significantly greater than the mean left SOD value (p 0.05). Correlation values in our study varied between -0.156 and 0.612. The highest correlation value was obtained in the positive direction between the orbital height (OH) and supraorbital foramen-infraorbital foramen (SOF-IOF) measurements (r = 0.612, p < 0.001). We believe that measurements of the orbit, SOF, and IOF and our data on their localizations, along with the relationships that we observed in our study will allow surgeons to avoid damaging the neurovascular bundles during surgical interventions and local anesthesia procedures in the frontal, periorbital, and maxillofacial regions.

RESUMEN: El objetivo de este estudio fue examinar la localización de los hitos en la región maxilofacial y sus relaciones entre sí y evaluarlos morfológica y clínicamente. Nuestro estudio incluyó 41 cráneos humanos adultos secos de edad y sexo desconocidos de la población de Anatolia. El análisis estadístico de los datos obtenidos en nuestro estudio se realizó con el software SPSS v.20.0 (IBM Corp., Armonk, NY, EE. UU.). La significación estadística se aceptó como P ? 0,05. Mientras que el valor medio de la profundidad supraorbitaria derecha (SOD) fue significativamente mayor que el valor medio de la SOD izquierda (p 0,05). Los valores de correlación en nuestro estudio variaron entre -0,156 y 0,612. El mayor valor de correlación se obtuvo en la dirección positiva entre las medidas de altura orbitaria (OH) y foramen supraorbitario-foramen infraorbitario (SOF-IOF) (r = 0,612, p <0,001). Creemos que las mediciones de la órbita, SOF e IOF y nuestros datos sobre sus localizaciones, junto con las relaciones que observamos en nuestro estudio, permitirán a los cirujanos evitar dañar los haces neurovasculares durante las intervenciones quirúrgicas y los procedimientos de anestesia local en la zona frontal, periorbitaria. y regiones maxilofaciales.

Frontal Sinus Morphometry in Relation to Surgically Relevant Landmarks in the Middle East Population: Can We Globalize?

BACKGROUND: The frontal bone is frequently approached during neurosurgical procedures. Feared complications of such surgeries include cerebrospinal fluid leak, among others, and frequently result from a breach of the frontal sinus. For this reason, the sinus should be avoided when possible. The supraorbital notch (SON) is a reliable and easily identifiable surgical landmark and its relation to the frontal sinus has been previously studied. However, the frontal sinus shows significant variability in size and shape between populations. METHODS: In the present study, we investigate the frontal sinus dimension and its relation to the SON in the Middle Eastern population. RESULTS: The analysis of a set of computed tomography scans reveals a significant variation in size between genders, and we subsequently provide neurosurgeons in the region with population-targeted, gender-specific risk maps. CONCLUSIONS: We finally conclude that a 2-cm margin rostral and lateral to the SON is safest.

Facial Nerve Preservation for Supraorbital Approaches: Anatomical Mapping Based on Consistent Landmarks.

BACKGROUND: The supraorbital keyhole approach (SOKA) provides a safe and advantageous access to the anterior cranial fossa. The implemented skin incision varies depending on surgeon's preferences and requirements. Facial nerve (FN) injury might appear in up to 5.6% of patients. There is a lack of validated tenets for avoiding FN injury. OBJECTIVE: To define a safety area for FN preservation during a SOKA. METHODS: Ten dried skulls and 5 injected cadaveric heads (10 sides) were used. A Cartesian frame was created with its horizontal axis at the level of the supraorbital notch and the vertical axis just lateral to the frontozygomatic junction (FZj). FNs were dissected and points along their course were registered and transferred to the Cartesian frame. RESULTS: Ten microscopic dissections of the FN were performed preserving all branches. A safety area could be defined 8 mm superior and 10 mm inferior to the FZj extending medially to the supraorbital notch and beyond. A 20 mm2 area superior and lateral to the FZj provided low probability (≤10%) of injuring the FN. Similarly, starting 4 mm inferior to the FZj, a lateral safety area was also found. A probabilistic colored heat map was built to represent the results. CONCLUSION: We provide a "safety zone" for a SOKA incision in which the probability to encounter the FN is low. Clinical studies following our method may validate our findings and add evidence to the tenets for minimizing morbidity related to the SOKA incision.

Visualization of the supraorbital notch/foramen using magnetic resonance imaging.

The supraorbital notch/foramen involving the segment of the supraorbital nerve (SON) and the supraorbital artery (SOA) has little been explored with magnetic resonance imaging (MRI). Therefore, we explored these structures using MRI. A total of 90 patients underwent thin-sliced contrast MRI. In addition, eight sides of the orbits were dissected in four cadaveric heads. Cadaver dissections showed that the SOA coursed consistently beneath and in close proximity to the SON and reached the supraorbital notch/foramen. On axial MRI images, the supraorbital notch/foramen was identified in 98% on the right side and in 99% on the left. The distance from the midline to the midpoint of the supraorbital notch/foramen and depth from the skin surface to the supraorbital foramen/exit were measured. The median distance was 22.6 ±â€¯3.08 mm on the right side and 22.8 ±â€¯3.07 mm on the left, whereas the depth was 7.7 ±â€¯1.39 mm on the right and 7.7 ±â€¯1.43 mm on the left. Eighty percent of the sagittal images showed well-developed diploic veins in the supraorbital rim. Of these, 8.3% had anastomotic channels with the subcutaneous veins through the anterior wall of the supraorbital rim, 11.8% through the inferior wall, and 9% through the SOF. The SON and SOA segments passing through the supraorbital exit can be reliably located using contrast MRI. The supraorbital rim may function as the intracranial to extracranial anastomotic channel.

Computerized tomographic evaluation of supraorbital notches and foramen in patients with frontal migraine headaches and correlation with clinical symptoms.

PURPOSE: To correlate the location and size of supraorbital notches (SON) and foramen (SOF) with migraine headache symptoms in a migraine patient population. METHODS: A retrospective review was performed on consecutive patients who were candidates for frontal migraine surgery with available preoperative computed tomography (CT) images of the face/perinasal sinuses. The supraorbital anatomy from CT images was analyzed and correlated with presenting migraine headache symptoms. To assess for anatomic variations associated with migraine headaches, normative anatomic data were obtained by performing a meta-analysis. RESULTS: Fifty-six patients were included, 95% were female, aged 17-80 (mean = 47) years. Bilateral SON were present in 58.9% patients, combination of SON/SOF in 25%, and bilateral SOF in 16.1%. SOF mean diameter (1.22 mm) was 45% smaller than SON (2.20 mm, p < 0.0001). The mean lateral distance from midline for SOF (2.74 cm) was ~0.5 cm farther than SON (2.25 cm, p < 0.0001). Migraine patients with SOF had 178.6% longer mean migraine headache duration (p = 0.0020), 9.8% higher intensity (p = 0.0052), and 91.4% greater migraine headache index (p = 0.0498) compared to those without SOF. Compared to normative patient data, migraine patients are more likely to have SON/SOF (100% vs. 83%, p = 0.0047) and have mean SON and SOF diameters that are 34.3-41.5% smaller (p < 0.0001). DISCUSSION: Nerve compression at SON and especially SOF contributes significantly to migraine headache symptoms, and these structures (if present) should be released during frontal migraine surgery. Given the variable presence and location of SON/SOF, analysis of available face/perinasal sinus CT images helps preoperative planning for foraminotomy and band release.

A comparison of the relationship between the golden ratio and anatomical characteristics of the supraorbital foramen in bare skulls belonging to the Byzantine era and modern era / Comparación de la relación entre la proporción áurea y las características anatómicas del foramen supraorbitario en cráneos de la época bizantina y la edad moderna

The aim of the present study is to determine the frequency of the occurrence of supraorbital foramen/notch (SOF/N) in the skulls of the people who lived in the modern era and the late Byzantine era, to determine the symmetry and the asymmetry between the two halves of the skulls by measuring the linear distance to various landmarks, to check the consistency between the location of the SOF/N and the golden ratio by calculating the ratio between linear distances and to evaluate the differences between the skulls from both historical periods. In the study, the frequency of the occurrence of the supraorbital notch in the skulls from the Byzantine era was found to be 26.60 % on the right and 13.30 % on the left while it was 14.30 % on the right and 9.52 % on the left in the skulls belonging to modern humans. In the skulls belonging to the Byzantine era, the average distance between SOF/N and the sagittal axis passing along the lateral orbital wall was found to be 34.81±2.51 mm and 32.99±2.81 mm respectively on the right and the left while it was 33.14±2.19 mm and 33.39±2.06 mm in the skulls belonging to modern era. The average distance between the SOF/N and the sagittal plane passing along the midline of the skull was found to be 24.55±2.79 mm and 21.57±2.44 mm on the right and the left respectively in the skulls belonging to the Byzantine era while it was 0.04±3.30 mm and 20.96±2.37 mm in the skulls belonging to the modern era. The average distance between the SOF/N and sagittal plane passing along the medial orbital wall was found to be 23.78±3.60 mm and 23.81±3.20 mm on the right and the left respectively in the skulls belonging to the Byzantine era while it was found to be 22.23±3.29 mm and 23.97±1.93 mm in the skulls belonging to the modern era. The average value of the distance between the sagittal planes passing along the lateral and medial sides of the orbit and the ratios between the distance from SOF/N to the sagittal plane passing along the lateral side of the orbit was found to be 1.47±0.21 mm and 1.60±0.08 mm respectively in the skulls belonging to the Byzantine era and the modern era. No significant difference was found between this ratio and the golden ratio; the average value of the ratios between the distance from the SOF/N to the sagittal plane passing along the midline of the skull and the distance from the SOF/N to the sagittal plane passing along the lateral side of the orbit was found to be 0.98±0.26 mm and 1.04±0.36 mm respectively in the skulls belonging to the Byzantine era and the modern era. A significant difference was found between this ratio and the golden ratio for both historical periods (modern society and late Byzantine period) (p <0.005). The comparison of the relevant anatomic characteristics of the SOF/N is very important for anthropologists while a broad knowledge on proportional calculations regarding morphometric values and the location are important for reconstructive surgeons and the experts in forensics and pain control.

El objetivo fue determinar la frecuencia del foramen y incisura supraorbitaria (FSO/E) en cráneos de individuos de la era moderna y aquellos de la era bizantina, para determinar la simetría y asimetría entre las dos mitades de cráneos, mediante la medición de la distancia lineal a varios puntos de referencia, para comprobar la coherencia entre la ubicación del FSO/ y la proporción áurea, a través del cálculo de la relación entre las distancias lineales. Además, se evaluaron las diferencias entre los cráneos de periodos históricos. En el estudio, se determinó que la frecuencia registrada de la incisura supraorbitaria en los cráneos de la época bizantina fue del 26,60% en el lado derecho y 13,30 % en el izquierdo; mientras que en cráneos humanos modernos fue de 14,30% en el lado derecho y 9,52 % en el izquierdo. En los cráneos pertenecientes a la época bizantina, la distancia media entre FSO/E y el eje sagital a lo largo de la pared lateral de la órbita fue de 34,81±2,51 mm y 32,99±2,81 mm, a la derecha e izquierda, respectivamente; mientras que en cráneos de la era moderna fue de 33,14±2,19 mm y 33,39±2,06 mm, a la derecha e izquierda, respectivamente. La distancia media entre la FSO/E y el plano sagital que pasa a lo largo de la línea mediana del cráneo, en los cráneos de la época bizantina, fue de 24,55±2,79 mm y 21,57±2,44 mm a la derecha e izquierda, respectivamente; mientras que fue de 0,04±3,30 mm y 20,96±2,37 mm en los cráneos de la era moderna. La distancia media entre la FSO/E y el plano sagital que pasa a lo largo de la pared medial de la órbita, en los cráneos pertenecientes a la época bizantina fue de 23,78±3,60 mm y 23,81±3,20 mm, a la derecha e izquierda, respectivamente; mientras que en los cráneos pertenecientes a la era moderna fue de 22,23±3,29 mm y 23,97±1,93 mm, a la derecha e izquierda, respectivamente. Se determinó que el valor medio de la distancia entre los planos sagitales a lo largo de los márgenes lateral y medial de la órbita y las proporciones entre la distancia desde FSO/E al plano sagital a lo largo del lado lateral de la órbita fueron de 1,47±0,21 mm y 1,60±0,08, respectivamente, en los cráneos pertenecientes a la época bizantina y la era moderna. No encontramos diferencias significativas entre esta relación y la proporción áurea. El valor medio de las relaciones entre la distancia de la FSO/E al plano a lo largo de la línea mediana del cráneo y la distancia de la FSO/E al plano sagital a lo largo de la pared lateral de la órbita fueron de 0,98±0,26 mm y 1,04±0,36 mm, respectivamente, en los cráneos pertenecientes a la era bizantina y la era moderna. No se encontró una diferencia significativa entre esta relación y la proporción áurea en ambos períodos históricos (la sociedad moderna y el periodo bizantino tardío) (p <0,005). La comparación de características anatómicas relevantes para el FSO/E son importantes para los antropólogos, donde un conocimiento integro de cálculos proporcionales con respecto a los valores morfométricos, mientras que para los cirujanos reconstructivos y los expertos en medicina forense es importante su ubicación.

Frontal Sinus Morphometry in Relation to Surgically Relevant Landmarks in the United States Population.

BACKGROUND: Knowledge of frontal sinus morphometry is important in bifrontal, pterional, orbitozygomatic, and supraorbital craniotomies. Inadvertent frontal sinus violation can lead to infection, cerebrospinal fluid fistula, and mucocele formation. In particular, knowledge of anatomy in relation to surgically relevant landmarks can help surgeons perform these procedures more precisely and safely. We performed a descriptive radiographic analysis to better understand variations in frontal sinus anatomy. METHODS: Using 3-dimensional reconstructive software, we analyzed 162 normal cranial computerized tomographic angiograms (from 80 men and 82 women). A line between the supraorbital notches (SONs) was used as a horizontal reference line (HRL). We recorded the maximum sinus height and width from the HRL and midline, respectively. In addition, sinus width was measured in relation to the SON at 0, 1, and 2 cm above the HRL. RESULTS: The mean maximal sinus height from the HRL was 1.8 cm. The mean maximum sinus width was 2.6 cm (right and left) from midline and 0.46 cm (right) and 0.49 cm (left) from the SON. Less than 11% of sinuses were lateral to the SON at 2.0 cm above the HRL and <6% of sinuses were >1.5 cm lateral to the SON at 1.0 cm above the HRL. CONCLUSIONS: Planned surgical corridors >1.5 cm lateral to the SON and/or >3.0 cm above the HRL are most likely to avoid the frontal sinus based on our radiographic measurements of normal sinus anatomy. Careful radiographic study and appropriate planning for more medial and/or inferior corridors is suggested.

Confirmation of Supraorbital Nerve and Its Branch in the Supraorbital Notch with Ultrasound Guidance / 계명의대학술지

A 55-year-old female with severe herpes zoster related forehead pain radiating to anterior and posterior scalp visited our pain clinic. The right side forehead pain with numerical rating score of 7 had persisted in spite of antiviral and anticonvulsant medication. We blocked the right supraorbital nerve under ultrasound guidance, and obtained the proper pain relief. In this case, we would like to present the method to identify the supraorbital notch or foramen and possible visualization of the supraorbital nerve.

Can Sonography Distinguish a Supraorbital Notch From a Foramen?

Diagnostic tools for evaluating the supraorbital rim in preparation for nerve decompression surgery in patients with chronic headaches are currently limited. We evaluated the use of sonography to diagnose the presence of a supraorbital notch or foramen in 11 cadaver orbits. Sonographic findings were assessed by dissecting cadaver orbits to determine whether a notch or foramen was present. Sonography correctly diagnosed the presence of a supraorbital notch in 7 of 7 cases and correctly diagnosed a supraorbital foramen in 4 of 4 cases. We found that sonography had 100% sensitivity in diagnosing a supraorbital notch and foramen. This tool may therefore be helpful in characterizing the supraorbital rim preoperatively and may influence the decision to use a transpalpebral or endoscopic approach for supraorbital nerve decompression as well as the decision to use local or general anesthesia.

Supraorbital notch/foramen in Sri Lankan skulls: morphometry and surgical relevance / Escotadura/foramen supraorbitario en cráneos de Sri Lanka: morfometría y relevancia quirúrgica

Evidence supports the ethnic and sex variation in the form and position of the supraorbital foramen. Therefore, detailed knowledge of the population specific data on biometric features of the supraorbital foramen will facilitate diagnostic, local anesthetic and surgical manipulations in the maxillo-facial region. The goal of this study was to elucidate the morphological features and precise anatomical position of the supraorbital foramen with reference to surrounding surgically encountered anatomical landmarks in an adult Sri Lankan population. A total of one hundred and eight adult dry skulls of known sex were assessed to determine the number, shape, orientation, vertical and transverse diameters of the supraorbital foramen, transverse distance from the supraorbital foramen to the nasal midline and the zygomatico-maxillary suture and the vertical distance from the supraorbital foramen to the supraorbital rim and infraorbital foramen. The position of the supraorbital foramen was determined in relation to the infraorbital foramen. Data were evaluated between sides and sex. The supraorbital notch (64.81%) was found more frequently than the supraorbital foramen (35.19%). Of the skulls investigated, 55.56% displayed bilateral supraorbital notches, whereas 20.37% had bilateral supraorbital foramina and 24.07% had a notch on one side and a foramen on the contralateral side. The incidence of multiple supraorbital foramina was 6.48%. Sex variations were observed in the relative position of supraorbital notch/foramen from nasal midline (male: 26.12±3.89; female: 24.40±2.76), temporal crest of the frontal bone (male: 32.74±3.94; female: 30.87±4.18) and infraorbital foramen (male: 44.86±3.35; female: 43.26±3.63). The modal position for the infraorbital foramen was lateral to the lateral margin of the supraorbital notch/foramen (68.52%) and supraorbital and infraorbital foramina were lying in the same sagittal plane only in 24.07% of the skulls. The results of this study highlight the racial and sex differences and emphasize the need for meticulous preoperative evaluation of the supraorbital foramen to define the optimal locations in patients who are candidates for maxillo-facial surgeries and regional block anesthesia.

La evidencia señala que existe dimorfismo étnico y sexual en la forma y posición del foramen supraorbitario. Por lo tanto, el conocimiento detallado de los datos específicos de una población sobre las características biométricas del foramen supraorbitario facilitará el diagnóstico, anestesia local y procedimientos quirúrgicos en la región maxilofacial. El objetivo fue determinar las características morfológicas y posición anatómica exacta del foramen supraorbitario con referencia a los referencias anatómicas circundantes encontradas quirúrgicamente en una población adulta de Sri Lanka. Ciento ocho cráneos adultos secos de sexo conocido se evaluaron para determinar el número, forma, orientación, diámetros vertical y transversal del foramen supraorbitario, distancia transversal desde el foramen supraorbitario a la línea mediana nasal y sutura cigomático-maxilar y distancia vertical desde el foramen supraorbitario hasta el margen supraorbitario y foramen infraorbitario. La posición del foramen supraorbitario se determinó en relación al foramen infraorbitario. Los datos fueron evaluados según lado y sexo. La incisura supraorbitaria (64,81%) se encontró con mayor frecuencia que el foramen supraorbitario (35,19%). El 55,56% de las incisuras supraorbitarias y 20,37% de los forámenes supraorbitarios fueron bilaterales; mientras que el 24,07% de las incisuras fueron unilaterales con un foramen en el lado contralateral. La incidencia de los forámenes supraorbitarios múltiples fue del 6,48%. Se observaron variaciones sexuales en la posición relativa de la incisura/foramen supraorbitario respecto a la línea mediana nasal (hombres= 26,12±3,89; mujeres: 24,40±2,76), cresta temporal del hueso frontal (hombres= 32,74±3,94; mujeres: 30,87±4,18) y foramen infraorbitario (hombres= 44,86±3,35; mujeres= 43,26±3,63). La posición modal para el foramen infraorbitario fue lateral al margen lateral de la incisura/foramen supraorbitario (68,52 %), y los forámenes supraorbitario e infraorbitario se ubicaron en el mismo plano sagital sólo en el 24,07% de los cráneos. Los resultados muestran las diferencias raciales y sexuales y enfatizan la necesidad de una evaluación preoperatoria minuciosa del foramen supraorbitario para definir su posición en pacientes que son candidatos a cirugías maxilofaciales y bloqueo anestésico regional.

Anatomical Location and Distribution of Supraorbital Notch and Foramen Evaluations Using Facial 3D Computed Tomography

PURPOSE: To evaluate anatomical locations and distributions of supraorbital notch and foramen using facial 3D computed tomography in the Korean adult population. METHODS: The study sample was composed of 87 adult patients with no history of trauma or ocular disease. The horizontal position of the supraorbital foramen or notch was recorded in relation to a vertical line defined by a reproducible hypothetical point, such as the nasion and mid-maxilla and the midpoint of the horizontal supraorbital plane. The distance and angle for each supraorbital foramen and notch were calculated from the defined vertical line. Furthermore, vertical distance from supraorbital plane, which was established using the highest points of both supraorbital rims, was obtained from the supraorbital foramen. RESULTS: The mean age of the 87 patients was 45.44 +/- 8.34 years (range, 30-59 years). There were 66 eyes in the supraorbital notch and 108 eyes in the supraorbital foramen. There were no distributional differences between the 2 sides. The mean horizontal distance of both types was 23.95 +/- 3.93 mm (range, 16.41-38.94 mm). The horizontal distance of male patients was longer than the female patients (25.18 +/- 4.16 mm vs. 22.63 +/- 3.19 mm, p < 0.001, based on independent t-test) and the horizontal distance of supraorbital notch was shorter than the supraorbital foramen (22.59 +/- 3.18 mm vs. 26.18 +/- 4.04 mm, respectively, p < 0.001, based on independent t-test). The mean vertical distance and mean angles of the supraorbital foramen were 3.02 +/- 1.119 mm and 6.81 +/- 2.31 degrees (degrees), respectively. CONCLUSIONS: The present study described the anatomical location of each supraorbital opening type in Korean adults. According to horizontal distance, a surgeon can avoid iatrogenic injury of the supraorbital neurovascular complex, especially during brow surgery. In addition, the anatomy can aid in targeting supraorbital neurovascular complex in cases of nerve block.

Anatomic characteristics of supraorbital foramina in korean using three-dimensional model.

BACKGROUND: The aims of this study were to analyze the anatomic variations of supraorbital foramina/notches in Koreans and to compare the results with those of previous studies examining other races. We evaluated the three-dimensional computed tomography (3D-CT) images of human faces using multidetector computed tomography (MDCT). METHODS: A total of 395 adults (232 men and 163 women) were enrolled and the 3D-CT images of their faces were reviewed in this study. In this study, the data from the images included the presence, shape, width and distance from the nasion to the supraorbital foramina/notches. ANOVA was used to assess the main effects of gender and side (right or left foramen/notch), and comparisons of the means were done by paired t-test. RESULTS: The most common shapes in Koreans were a single notch (39.5%) on the right hand side and a single foramen (42.3%) on the left hand side. The incidence of a single foramen in Koreans was high compared to other races. The mean foramen diameter was 2.34 ± 0.78 mm, and the mean distance from the nasion was 27.19 ± 4.03 mm. The mean notch diameter was 3.37 ± 1.71 mm, and the mean distance from the nasion was 23.42 ± 2.45 mm. CONCLUSIONS: This is the first study on the variations of supraorbital foramina/notches in Koreans using 3D-CT images of faces. The anatomic characteristics of the supraorbital foramina/notch will help in performing nerve blocks and maxillofacial surgery.

Anatomic Characteristics of Supraorbital Foramina in Korean Using Three-Dimensional Model

BACKGROUND: The aims of this study were to analyze the anatomic variations of supraorbital foramina/notches in Koreans and to compare the results with those of previous studies examining other races. We evaluated the three-dimensional computed tomography (3D-CT) images of human faces using multidetector computed tomography (MDCT). METHODS: A total of 395 adults (232 men and 163 women) were enrolled and the 3D-CT images of their faces were reviewed in this study. In this study, the data from the images included the presence, shape, width and distance from the nasion to the supraorbital foramina/notches. ANOVA was used to assess the main effects of gender and side (right or left foramen/notch), and comparisons of the means were done by paired t-test. RESULTS: The most common shapes in Koreans were a single notch (39.5%) on the right hand side and a single foramen (42.3%) on the left hand side. The incidence of a single foramen in Koreans was high compared to other races. The mean foramen diameter was 2.34 +/- 0.78 mm, and the mean distance from the nasion was 27.19 +/- 4.03 mm. The mean notch diameter was 3.37 +/- 1.71 mm, and the mean distance from the nasion was 23.42 +/- 2.45 mm. CONCLUSIONS: This is the first study on the variations of supraorbital foramina/notches in Koreans using 3D-CT images of faces. The anatomic characteristics of the supraorbital foramina/notch will help in performing nerve blocks and maxillofacial surgery.

Morphological and morphometric analysis of supraorbital foramen and supraorbital notch: a study on dry human skulls.

OBJECTIVES: A clear knowledge of the location of the maxillo-facial foramina is essential for clinicians while performing endoscopic surgeries and regional nerve blocks. In the present study, a detailed analysis of the supraorbital foramen (SOF) and supraorbital notch (SON) of South Indian skulls is reported and the data are compared with those from other races and regions. METHODS: Anatomical variation of SOF/SON was studied in 83 adult human skulls bilaterally, using "travelling Vernier's microscope". The skulls belonged to the cadavers of South Indian origin. The parameters used were distanced between the SON/SOF and the nasal midline; distance between the SON/SOF and the frontozygomatic suture (FZS); shape and height of the SOF; transverse diameter of the SON; the presence of accessory foramina (ACF) and their number; as well as the location and distance from the main SON/SOF. RESULTS: SON was more frequently found than the SOF. The mean distance of SON/SOF to the nasal midline was 22.24 mm on the right side and 22.2 mm on the left side. The mean distance of SON/SOF to the frontozygomatic suture was 29.34 mm on the right side and 28.7 mm on the left side. While the mean height of SOF was 3.5 mm on the right side and 3.04 mm on the left side. Also, the mean transverse diameter of SON was 5.17 mm on the right side and 5.58 mm on the left side. The accessory supraorbital foramina were observed in 66.25% of cases. CONCLUSION: There is a difference in the position and dimensions of SOF /SON between different races and people of different regions. Anatomical knowledge of SON /SOF is important in facilitating local anesthetic, forehead lifting, blepharoplasty and other craniofacial surgical procedures.