Surgical Anatomy of Deep Lateral Wall by Adults Cadavers and Computed Tomography

Doo Hwan Oh; Jeong Kyu Lee

doi:10.3341/jkos.2011.52.8.964

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Oh and Lee: Surgical Anatomy of Deep Lateral Wall by Adults Cadavers and Computed Tomography

Original Article

J Korean Ophthalmol Soc 2011;52(8):964-969.

Published online: 7 September 2011

DOI: https://doi.org/10.3341/jkos.2011.52.8.964

Surgical Anatomy of Deep Lateral Wall by Adults Cadavers and Computed Tomography

Doo Hwan Oh, MD, Jeong Kyu Lee, MD, PhD

Department of Ophthalmology, College of Medicine, Chung-Ang University, Seoul, Korea

Address reprint requests to Jeong Kyu Lee, MD, PhD Department of Ophthalmology, Chung-Ang University Hospital #224-1 Heukseok-dong, Dongjak-gu, Seoul 165-755, Korea Tel: 82-2-6299-1665, Fax: 82-2-825-1666, E-mail: lk1246@hanmail.net

Received 24 January 2011 Revised 7 March 2011 Accepted 31 May 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We investigated the surgical anatomy of the deep lateral orbital wall via dissection of Korean cadavers and analysis of the orbit in normal adults using computed tomography.

Methods

Twelve cadavers were used to determine the exact anatomic index of the orbital lateral wall, and computed tomography images of 20 patients were used for surgical anatomic measurements during deep lateral orbital wall decompression. Additionally, the anatomic indexes measured in the cadavers and in the computed tomography study were compared and analyzed.

Results

In the cadaver study, the mean distance from the orbital rim to the end of the superior orbital fissure was 36.7 ±1.98 mm, to the rim of the frontosphendoial suture was 18.2 ± 1.92 mm, and from the end of the superior orbital fissure to the inferior orbital fissure was 17.1 ± 1.19 mm. In the computed tomography study, the mean value from the orbital rim to the end of the superior orbital fissure was 39.2± 2.46 mm, and from the rim to the frontosphenoidal suture was 17.8 ± 1.56 mm.

Conclusions

The present study regarding the surgical index of the lateral orbital wall in Koreans will assist surgeons to safely and confidently perform deep lateral orbital wall decompression.

Keywords: Cadaver, Computed tomography, Deep lateral orbital wall, Thyroid orbitopathy

References

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Figure 1.

Right orbit. (A) Measuring the distance between the end of superior orbital fissure and the lateral orbit rim. (B) Measuring the distance between the end of inferior orbital fissure and lateral orbit rim.

Figure 2.

The measurement of 5 surgical index of distance for deep lateral wall decompression in lateral orbit wall of cadavers. SOF = superior orbital fissure; FZS = frontozygomaticsuture; ZSS = zygomaticosphnoidal suture; GWS = greater wing of sphe-noid; IOF = inferior orbital fissure; ZFF = zygomaticofacial foramen; SOFD = superior orbital fissure distance; FSSD = frontosphenoidal suture distance; OFD = orbital fissure distance; IOFD = inferior orbital fissure distance; IFD = interfissure distance.

Figure 3.

The measurement of 4 surgical indexes for deep lateral wall decompression in orbital computed tomography. (A) The measurement of 3 surgical indexes in axial view of computed tomography. (B) The measurement of removal volume (arrow) of deep lateral wall decompression (GWSV) in axial view of computed tomography. GWST = greater wing of sphenoid thickness; GWSV = greater wing of sphenoid volume.

Table 1.

Sex and age of cadavers and computed tomography

	Cadavers			Computed tomography
	Cases	Age (mean ± SD, yr)	p-value^*	Cases	Age (mean ± SD, yr)	p-value^*
Male	7	58.85 ± 12.52	0.38	10	55.82 ± 12.78	0.28
Female	5	65.58 ± 9.42	0.38	10	62.56 ± 8.77	0.28

^* p-value; student t-test.

Table 2.

Mean distance measured in lateral orbit wall of cadavers

Index	Distance (mean ± SD, mm)			Significance p-value^*
Index	Male	Female	Total	Significance p-value^*
SOFD	37.89 ± 2.55	35.55 ± 1.58	36.72 ± 1.98	0.15
FSSD	18.78 ± 1.58	17.64 ± 2.25	18.21 ± 1.92	0.11
IFD	18.05 ± 0.98	16.25 ± 1.33	17.15 ± 1.19	0.09
OFD	37.25 ± 1.88	36.71 ± 2.18	36.98 ± 2.15	0.21
IOFD	16.12 ± 1.76	14.58 ± 1.95	15.35 ± 1.91	0.07

SOFD = superior orbital fissure distance; FSSD = frontosphenoidal suture distance; IFD = interfissure distance; OFD = orbital fissure distance; IOFD = inferior orbital fissure distance.

^* p-value; student t-test.

Table 3.

Mean value measured in lateral orbit wall from orbital computed tomography

Index	Mean value (mean ± SD)			Significance p-value^*
Index	Male	Female	Total	Significance p-value^*
SOFD (mm)	39.99 ± 2.15	38.51 ± 2.47	39.25 ± 2.46	0.28
FSSD (mm)	18.11 ± 1.05	17.51 ±2.05	17.81 ± 1.56	0.25
GWST (mm)	5.54 ± 1.85	4.96 ± 1.35	5.25 ± 1.22	0.35
GWSV (cm³)	2.95 ± 1.28	2.73 ± 1.11	2.84 ± 0.94	0.21

SOFD = superior orbital fissure distance; FSSD = frontosphenoidal suture distance; GWST = greater wing of sphenoid thickness; GWSV = greater wing of sphenoid volume.

^* p-value; student t-test.

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