The small foramina of the orbit and periorbital region: assessment with multi detector computed tomography.

BACKGROUND: Familiarity with the variants of the foramina of the orbit and periorbital region is important in planning anesthesiological blocks and during orbital and maxillofacial surgery to avoid damage to nerves and vessels. PURPOSE: To assess the visibility and the incidence of variants of the small foramina of the orbit by multidetector computed tomography (MDCT). MATERIAL AND METHODS: The MDCT scans of 400 orbits from 200 patients were evaluated retrospectively. Slice thickness of the reconstructed images were in the range of 0.5-1.0 mm. The visibility and the variants of the foramen supraorbitale, the foramen infraorbitale, the foramen zygomaticofaciale, the foramen ethmoidale anterius et posterius, and the foramen cranio-orbitale were assessed using three-dimensional reconstruction tools. RESULTS: The foramen infraorbitale (100%; n = 400), foramen supraorbitale (99.5%, n = 398), foramen zygomaticofaciale (76.5%; n = 307), and foramen zygomatico-orbitale (74.5%; n = 298) were most reliably detected by MDCT, while the foramen ethmoidale anterius (58.7%; n = 235) et posterius (56.7%; n = 225) were depicted less frequently. The foramen cranio-orbitale could not be identified in any case. Doubling was found for the foramen supraorbitale in 3.25% (n = 13), the foramen infraorbitale in 1.75% (n = 7), the foramen zygomaticofaciale in 16% (n = 64), and the foramen zygomatico-orbitale 14% (n = 56). Three foramina zygomatico-orbitale and foramina infraorbitale were found in 1.5% (n = 6) and in 0.5% (n = 2) of orbits, respectively. CONCLUSION: The foramina supraorbitale, infraorbitale, zygomatico-orbitale, and zygomaticiofaciale and their variants are well visible on MDCT. Knowledge of the exact number of these small foramina is relevant for preoperative evaluation.

Visibility of sutures of the orbit and periorbital region using multidetector computed tomography.

OBJECTIVE: Knowledge of cranial suture morphology is crucial in emergency medicine, forensic medicine, and maxillofacial reconstructive surgery. This study assessed the visibility of sutures of the orbit and periorbital region on multidetector computed tomography. MATERIALS AND METHODS: Multidetector computed tomography scans of 200 patients (127 males, 73 females; mean age 51.3 years; range, 6-92 years) were evaluated retrospectively. The slice thicknesses varied from 0.5 to 1 mm, and the tube current from 25 to 370 mAs, depending on the CT indication. The visibility of sutures was estimated according to a 4-point scale from "not visible" to "well visible". The chi-squared test was used to test the association of the visibility of sutures with the slice thickness, tube current, and age of patients. Statistical significance was assumed at p < 0.05. RESULTS: Overall, best visibility was found for the sutura frontozygomatica (98%), sutura frontonasalis (88.5%), and sutura sphenozygomatica (71.5%), followed by the sutura zygomaticomaxillaris (65.8%), sutura temporozygomatica (41.8%), sutura frontomaxillaris (44.5%), and sutura sphenofrontalis (31%). Poor visibility was found for the sutura frontolacrimalis (16.8%) and sutura frontoethmoidalis (1.3%). The sutura ethmoidomaxillaris, sutura lacrimomaxillaris, and sutura ethmoidolacrimalis were not visible. CONCLUSION: Although the sutures of the superior, lateral, and inferior orbit are well visible, those of the medial orbit are poorly visible on CT scans.