Superior orbital fissure

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Superior orbital fissure
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Orbit seen from the front, with bones labeled in different colors, and superior orbital fissure at center as an "hour-glass" formation.
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Details
Part of Sphenoid bone
System Skeletal
Identifiers
Latin fissura orbitalis superior
TA98 A02.1.05.023
A02.1.00.083
TA2 488
FMA 54799
Anatomical terms of bone

The superior orbital fissure is a foramen or cleft of the skull between the lesser and greater wings of the sphenoid bone. It gives passage to multiple structures, including the oculomotor nerve, trochlear nerve, ophthalmic nerve, abducens nerve, ophthalmic veins, and sympathetic fibres from the cavernous plexus.

Contents

Structure

Superior orbital fissure. Slide2rome.JPG
Superior orbital fissure.

The superior orbital fissure is usually 22 mm wide in adults, [1] and is much larger medially. Its boundaries are formed by the (caudal surface of the) lesser wing of the sphenoid bone, and (medial border of the) greater wing of the sphenoid bone. [2]

Contents

The superior orbital fissure is traversed by the following structures:

The superior orbital fissure is divided into 3 parts from lateral to medial:[ citation needed ]

Clinical significance

Multiple anatomical structures pass through the fissure, and can be damaged in orbital trauma, particularly blowout fractures through the floor of the orbit into the maxillary sinus.[ citation needed ]

The abducens nerve is most likely to show signs of damage first, with the most common complaints retro-orbital pain and the involvement of cranial nerves III, IV, V1, and VI without other neurological signs or symptoms. This presentation indicates either compression of structures in the superior orbital fissure or the cavernous sinus.[ citation needed ]

Superior orbital fissure syndrome

Superior orbital fissure syndrome, also known as Rochon-Duvigneaud's syndrome, [4] [5] is a neurological disorder that results if the superior orbital fissure is fractured. Involvement of the cranial nerves that pass through the superior orbital fissure may lead to diplopia, paralysis of extraocular muscles, exophthalmos, and ptosis. Blindness or loss of vision indicates involvement of the orbital apex, which is more serious, requiring urgent surgical intervention. Typically, if blindness is present with superior orbital syndrome, it is called orbital apex syndrome.[ citation needed ]

See also

Related Research Articles

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Articles related to anatomy include:

<span class="mw-page-title-main">Oculomotor nerve</span> Cranial nerve III, for eye movements

The oculomotor nerve, also known as the third cranial nerve, cranial nerve III, or simply CN III, is a cranial nerve that enters the orbit through the superior orbital fissure and innervates extraocular muscles that enable most movements of the eye and that raise the eyelid. The nerve also contains fibers that innervate the intrinsic eye muscles that enable pupillary constriction and accommodation. The oculomotor nerve is derived from the basal plate of the embryonic midbrain. Cranial nerves IV and VI also participate in control of eye movement.

<span class="mw-page-title-main">Trochlear nerve</span> Cranial nerve IV, for eye movements

The trochlear nerve, also known as the fourth cranial nerve, cranial nerve IV, or CN IV, is a cranial nerve that innervates a single muscle - the superior oblique muscle of the eye. Unlike most other cranial nerves, the trochlear nerve is exclusively a motor nerve.

<span class="mw-page-title-main">Internal carotid artery</span> Artery of the human brain

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<span class="mw-page-title-main">Orbit (anatomy)</span> Cavity or socket of the skull in which the eye and its appendages are situated

In anatomy, the orbit is the cavity or socket/hole of the skull in which the eye and its appendages are situated. "Orbit" can refer to the bony socket, or it can also be used to imply the contents. In the adult human, the volume of the orbit is 30 millilitres, of which the eye occupies 6.5 ml. The orbital contents comprise the eye, the orbital and retrobulbar fascia, extraocular muscles, cranial nerves II, III, IV, V, and VI, blood vessels, fat, the lacrimal gland with its sac and duct, the eyelids, medial and lateral palpebral ligaments, cheek ligaments, the suspensory ligament, septum, ciliary ganglion and short ciliary nerves.

<span class="mw-page-title-main">Extraocular muscles</span> Seven extrinsic muscles of the eye

The extraocular muscles, or extrinsic ocular muscles, are the seven extrinsic muscles of the eye in humans and other animals. Six of the extraocular muscles, the four recti muscles, and the superior and inferior oblique muscles, control movement of the eye. The other muscle, the levator palpebrae superioris, controls eyelid elevation. The actions of the six muscles responsible for eye movement depend on the position of the eye at the time of muscle contraction.

<span class="mw-page-title-main">Cavernous sinus</span> Sinus in the human head

The cavernous sinus within the human head is one of the dural venous sinuses creating a cavity called the lateral sellar compartment bordered by the temporal bone of the skull and the sphenoid bone, lateral to the sella turcica.

<span class="mw-page-title-main">Maxillary nerve</span> Branch of the trigeminal nerve responsible for the mid-face

In neuroanatomy, the maxillary nerve (V2) is one of the three branches or divisions of the trigeminal nerve, the fifth (CN V) cranial nerve. It comprises the principal functions of sensation from the maxilla, nasal cavity, sinuses, the palate and subsequently that of the mid-face, and is intermediate, both in position and size, between the ophthalmic nerve and the mandibular nerve.

<span class="mw-page-title-main">Ophthalmic nerve</span> Sensory nerve of the face

The ophthalmic nerve (CN V1) is a sensory nerve of the head. It is one of three divisions of the trigeminal nerve (CN V), a cranial nerve. It has three major branches which provide sensory innervation to the eye, and the skin of the upper face and anterior scalp, as well as other structures of the head.

<span class="mw-page-title-main">Nasociliary nerve</span> Branch of the ophthalmic nerve

The nasociliary nerve is a branch of the ophthalmic nerve (CN V1) (which is in turn a branch of the trigeminal nerve (CN V)). It is intermediate in size between the other two branches of the ophthalmic nerve, the frontal nerve and lacrimal nerve.

<span class="mw-page-title-main">Superior ophthalmic vein</span> Vein of the orbit around the eye

The superior ophthalmic vein is a vein of the orbit that drains venous blood from structures of the upper orbit. It is formed by the union of the angular vein, and supraorbital vein. It passes backwards within the orbit alongside the ophthalmic artery, then exits the orbit through the superior orbital fissure to drain into the cavernous sinus.

<span class="mw-page-title-main">Greater wing of sphenoid bone</span> Large part of the skull front behind the eye socket

The greater wing of the sphenoid bone, or alisphenoid, is a bony process of the sphenoid bone, positioned in the skull behind each eye. There is one on each side, extending from the side of the body of the sphenoid and curving upward, laterally, and backward.

<span class="mw-page-title-main">Lesser wing of sphenoid bone</span>

The lesser wings of the sphenoid or orbito-sphenoids are two thin triangular plates, which arise from the upper and anterior parts of the body, and, projecting lateralward, end in sharp points [Fig. 1].

<span class="mw-page-title-main">Middle cranial fossa</span>

The middle cranial fossa is formed by the sphenoid bones, and the temporal bones. It lodges the temporal lobes, and the pituitary gland. It is deeper than the anterior cranial fossa, is narrow medially and widens laterally to the sides of the skull. It is separated from the posterior cranial fossa by the clivus and the petrous crest.

<span class="mw-page-title-main">Infratemporal fossa</span> Cavity that is part of the skull

The infratemporal fossa is an irregularly shaped cavity that is a part of the skull. It is situated below and medial to the zygomatic arch. It is not fully enclosed by bone in all directions. It contains superficial muscles, including the lower part of the temporalis muscle, the lateral pterygoid muscle, and the medial pterygoid muscle. It also contains important blood vessels such as the middle meningeal artery, the pterygoid plexus, and the retromandibular vein, and nerves such as the mandibular nerve (CN V3) and its branches.

<span class="mw-page-title-main">Outline of human anatomy</span> Overview of and topical guide to human anatomy

The following outline is provided as an overview of and topical guide to human anatomy:

References

  1. Weinzweig, Jeffrey; Taub, Peter J.; Bartlett, Scott P. (2010). "46 - Fractures of the Orbit". Plastic Surgery Secrets Plus (2nd ed.). Chicago: Mosby. pp. 299–307. doi:10.1016/B978-0-323-03470-8.00046-6. ISBN   978-0-323-03470-8.
  2. 1 2 3 4 5 6 Barral, Jean-Pierre; Crobier, Alain (2009-01-01). "9 - Manipulation of the plurineural orifices". Manual Therapy for the Cranial Nerves. Churchill Livingstone. pp. 51–57. doi:10.1016/B978-0-7020-3100-7.50012-4. ISBN   978-0-7020-3100-7.{{cite book}}: CS1 maint: date and year (link)
  3. Patel, Swetal (2015). "20 - The Oculomotor Nerve". Nerves and Nerve Injuries. Vol. 1: History, Embryology, Anatomy, Imaging, and Diagnostics. Academic Press. pp. 305–309. doi:10.1016/B978-0-12-410390-0.00021-4. ISBN   978-0-12-410390-0.
  4. synd/3387 at Who Named It?
  5. A. Rochon-Duvigneaud. Quelques cas de paralysie de tous les nerfs orbitaires (ophthalmoplegie totale avec amaurosse en anesthésie dans le domaine de l’ophthalmique d’origine syphilitique). Archives d'ophthalmologie, Paris, 1896, 16: 746-760.