Anatomy of the lateral orbital wall: A topographic investigation for identification of the lateral canthal attachment.
Anatomy
Head and neck
Lateral canthus and bionic implants
Lateral orbital wall
Whitnall's tubercle
Journal
Journal of plastic, reconstructive & aesthetic surgery : JPRAS
ISSN: 1878-0539
Titre abrégé: J Plast Reconstr Aesthet Surg
Pays: Netherlands
ID NLM: 101264239
Informations de publication
Date de publication:
06 2022
06 2022
Historique:
received:
03
11
2021
accepted:
09
01
2022
pubmed:
17
2
2022
medline:
16
6
2022
entrez:
16
2
2022
Statut:
ppublish
Résumé
There is a growing effort to develop implantable bionics for restoring eye closure in paralytic lagophthalmos. Knowledge of the natural eyelid attachments is important for active implants that mobilise these attachments or replace them with a sling. Whitnall's tubercle (WT) is traditionally used to identify lateral canthal attachments; however, it is not always present. This study seeks an alternative means of identifying the insertion of the lateral canthus to aid the application of bionic implants. Complete CT head scans of patients in the Sydney Head and Neck Cancer Institute database were retrieved for analysis. The CT scans were segmented using bone and soft-tissue thresholding and then reconstructed. The location of WT and the lateral canthal insertion were recorded and their relation to key anatomical landmarks assessed. Ninety orbits from 45 complete head scans were analysed. WT could be identified bilaterally in 18/45 (40%) samples. The average distance from WT to zygomaticofrontal suture and to lateral orbital margin was 10.8 ± 0.4 mm and 4.4 ± 0.2 mm, respectively. The average height of the lateral canthal insertion from the Jugale point was 13.9 ± 1.8 mm. On regression analysis, the height of lateral canthal insertion was strongly predicted by the height of lateral orbital wall as the determined by the maximum distance of the ZFS from the Jugale point (p = <0.001). In the absence of WT, the height of the lateral orbital wall can be reliability used to localise the insertion site of the lateral canthus.
Sections du résumé
BACKGROUND
There is a growing effort to develop implantable bionics for restoring eye closure in paralytic lagophthalmos. Knowledge of the natural eyelid attachments is important for active implants that mobilise these attachments or replace them with a sling. Whitnall's tubercle (WT) is traditionally used to identify lateral canthal attachments; however, it is not always present. This study seeks an alternative means of identifying the insertion of the lateral canthus to aid the application of bionic implants.
METHODS
Complete CT head scans of patients in the Sydney Head and Neck Cancer Institute database were retrieved for analysis. The CT scans were segmented using bone and soft-tissue thresholding and then reconstructed. The location of WT and the lateral canthal insertion were recorded and their relation to key anatomical landmarks assessed.
RESULTS
Ninety orbits from 45 complete head scans were analysed. WT could be identified bilaterally in 18/45 (40%) samples. The average distance from WT to zygomaticofrontal suture and to lateral orbital margin was 10.8 ± 0.4 mm and 4.4 ± 0.2 mm, respectively. The average height of the lateral canthal insertion from the Jugale point was 13.9 ± 1.8 mm. On regression analysis, the height of lateral canthal insertion was strongly predicted by the height of lateral orbital wall as the determined by the maximum distance of the ZFS from the Jugale point (p = <0.001).
CONCLUSION
In the absence of WT, the height of the lateral orbital wall can be reliability used to localise the insertion site of the lateral canthus.
Identifiants
pubmed: 35168924
pii: S1748-6815(22)00027-4
doi: 10.1016/j.bjps.2022.01.011
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1988-1992Informations de copyright
Copyright © 2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.