The lateral wall and the floor of the orbit are separated posteriorly by the inferior orbital fissure which transmits the zygomatic branch of the maxillary nerve and the ascending branches from the pterygopalatine ganglion. The infraorbital vessels are found in the inferior orbital fissure, and travel down the infraorbital groove into the infraorbital canal and exit through the infraorbital foramen. Inferior division of ophthalmic vein passes through the inferior orbital fissure. Thepterygopalatinefossaandtheinferioror- bitalfissurehaveauniquerelationship.Thein- ferior orbital fissure, its long axis forming an angle of about 458 with the head's sagittal plane, is located between the lateral wall and flooroftheorbit,withthezygomaticboneform- ingitsanteriormargin.Importantanatomicre- lationships of the inferior orbital fissure are demonstratedwhentheskullisviewedlaterally and slightly posteriorly (Fig 2)
The inferior orbital wall is made weaker by the presence of the infraorbital groove and is the most common site of a fracture. The fracture fragment can displace inferiorly into the maxillary sinus, resulting in herniation of intraorbital fat, and/or extraocular muscles. The trapdoor blowout fracture, which is more common in pediatric age group, occurs when the hinge fragment springs back into place often trapping the inferior rectus muscle. Entrapment of the inferior rectus. laterally: communicates with the masticator space (or infratemporal fossa) via the pterygomaxillary fissure anteriorly: communicates with the orbit via the inferior orbital fissure (superiorly) posteriorly and superiorly: communicates with the Meckel cave and cavernous sinus (of the middle cranial fossa) via the foramen rotundu (c) Axial CT image: 1 = inferior orbital fissure, 2 = sphenoid sinus, 3 = foramen ovale, 4 = foramen spinosum, 5 = foramen lacerum, 6 = carotid canal, 7 = clivus, 8 = jugular foramen, 9 = PCF. (d) Coronal CT image: 1 = orbital plate, 2 = cribriform plate, 3 = fovea ethmoidalis, 4 = ethmoid sinus, 5 = lamina papyracea, 6 = maxillary sinus, 7 = orbit, 8 = nasal cavity, 9 = anterior cranial fossa Coronal unenhanced CT image shows a displaced blowout fracture of the left inferior orbital wall with resultant entrapment of the inferior rectus muscle (arrow), which appears rounded in comparison with the normal right inferior rectus muscle. The fracture extends through the inferior orbital canal (arrowhead)
Hassler WE, Eggert H: Extradural and intradural microsurgical approaches to lesions of the optic canal and the superior orbital fissure. Acta Neurochir (Wien) 1985;74: 87-93. Acta Neurochir. Owing to the inferior orbital fissure (IOF) connecting the orbit with surrounding pterygopalatine fossa (PPF), infratemporal fossa (ITF), and temporal fossa, the idea of eTOA to anterolateral skull base through IOF is postulated. The aim of this study is to access its practical feasibility. METHODS: Anatomical dissections were performed in five human cadaveric heads (10 sides) using 0-degree and 30-degree endoscopes. A stepwise description of eTOA to anterolateral skull base through IOF was. Superior orbital fissure ; Optic canal; Foramen ovale; Foramen spinosum; Foramen lacerum; Carotid canal; Internal Auditory Canal (IAC) Jugular foramen; Hypoglossal canal ; Pterygopalatine fossa openings (total of 6): 1. Inferior orbital fissure. 2. Sphenopalatine foramen. 3. Pterygomaxillaryfissure. 4. Foramen rotundum. 5. Vidian/Pterygoid canal. 6. Pterygopalatine canal (greater and lesser palatine foramina
Fig. 6: Axial post contrast CT images showing ill defined heterogeneously and markedly enhancing retroorbital lesion on left side with erosion of the medial wall of orbit and extending along the inferior wall with another similar smaller lesion is also noted on left side extending in the infraorbital fissure. Both lesions are extending into the inferior orbital fissure into bilateral cavernous. .3 - CT scan of a blowout fracture of the eye, through the inferior wall. The contents of the orbit have herniated into the maxillary sinus. Orbital rim fracture - This is a fracture of the bones forming the outer rim of the bony orbit. It usually occurs at the sutures joining the three bones of the orbital rim - the maxilla, zygomatic and frontal. Computed tomography (CT) scans may help examine paranasal sinuses' anatomy and detect abnormalities(10). Moreover, a CT scan gives a greater definition of the sinuses(11). It is more sensitive than typical radiography tools in detecting sinus pathology, especially within the sphenoid and ethmoid sinuses
. The optic foramen is the ventral termination of the optic canal, situated at the medial margin of the superior orbital fissure ( Figs. 9.1. IOC is a bony canal that is the continuity of the inferior orbital fissure (Figure 1-2), and it opens in to infraorbital foramen (IOF) (Figure 3).It is located in the floor of the orbit, and in the superolateral wall of the maxillary sinus. IOC contains infraorbital nerve (ION) and infraorbital artery (IOA) Compare to the image of the CT scan that captures the optic canal below Figure 3: CT scan above the opening for the nasolacrimal duct in the lacrimalfossa and includes the inferior orbital fissure. 4. zygoma 5. inferior orbital fissure (note that the fissure is oriented medially and narrows slightly posteriorly). 6 THE SUPERIOR ORBITAL FISSURE/ORBITAL APEX SYNDROME This fissure lies at the back of the orbit between the lesser and great wing of the sphenoid. It curves downwards and medially widening at the orbital apex containing the superior ophthalmic vein, ophthalmic division of the trigeminal nerve and branches (lacrimal, frontal, supraorbital Die Fissura orbitalis superior ist ein Spaltraum des menschlichen Schädels, der zwischen dem großen und kleinen Flügel des Keilbeins (Os sphenoidale) liegt. Er verbindet die mittlere Schädelgrube (Fossa cranii media) mit der Augenhöhle (Orbita). 2 Anatomie Die Fissura orbitalis superior ist etwa 2 cm lang und bis zu 6 mm breit
To report a case of an accessory canal arising from the floor of the foramen rotundum (FR) and extending to the infratemoral fossa. This case report describes the imaging findings of FR duplication on high-resolution CT in multiple planes. The FR is formed when the foramen anterius lacerum is divided into the superior orbital fissure and the FR inferiorly by an osseous spur arising from the. Forming a short single trunk, it passes between the two heads of the Rectus lateralis and through the medial part of the superior orbital fissure, and ends in the cavernous sinus. The ethmoidal veins drain into the superior ophthalmic vein. Vorticose veins also drain into the superior ophthalmic vein. Clinical relevanc The oculomotor nerve enters the orbit through the superior orbital fissure. It then divides into two branches between the lateral rectus: superior and inferior rami. The oculomotor nerve is inferior to the trochlear nerve and the nasociliary nerve runs in between the two rami The orbital apex incorporates the optic canal and the superior orbital fissure. The optic canal transmits the optic nerve (surrounded by meninges) and the ophthalmic artery to the cranial fossa. The superior orbital fissure is anatomically lateral to the optic canal which can be divided into the superior, middle, and inferior portions by the common tendinous ring comprised of the thickened. The superior orbital fissure is a 22-mm cleft that runs lateral, anterior, and superior from the apex of the orbit. This fissure, which separates the greater and lesser wings of the sphenoid and lies between the optic foramen and the foramen rotundum, provides passage to the three motor nerves to the extraocular muscles of the orbit: oculomotor nerve (CN III), trochlear nerve (CN IV), and abducens nerve (CN VI). The ophthalmic division of the trigeminal nerve (CN V1) also enters the orbit.
CT scan above the opening for the nasolacrimal duct in the lacrimal fossa and includes the inferior orbital fissure. 4. zygoma 5. inferior orbital fissure (note that the fissure is oriented medially and narrows slightly posteriorly). 6. greater wing of the sphenoid 7. nasolacrimal duct 8. inferior rectus muscle click on picture for enlarged view. Number 7 here demonstrates the superior orbital. OBJECTIVE To show imaging findings of inferior orbital fissure (IOF) and groove (IOG) on axial CT scans and to discover their anatomic variations, so as to avoid misdiagnosing them as orbital fracture. METHODS 25 normal skull were used to investigate the configurations of IOF and IOG. Five skulls were performed axial CT scans. 20 normal orbital axial scans were studied as well
FISSURES, FORAMINA, AND CANALSThe major fissures, foramina, and canals within and adjacent to the orbits are the optic canal (OC), superior orbital fissure (SOF), inferior orbital fissure (IOF), foramen rotundum (FR), superior orbital foramen (SF), infraorbital foramen (IF), foramen ovale (FO), and the nasolacrimal canal (NC) (see Fig. 1; Fig. 2). Optic CanalThe OC is located in the lesser. . Key surrounding structures include the superior orbital fissure, the optic canal, and the cavernous sinus containing among other things the carotid artery. Importantly, any dehiscence (little to no bony coverage) of these structures should be noted, because damage may be done during the FESS. Normal variations. The sinuses have frequent anatomic variations. Some variations may cause recurrent.
Submitting a human head to CT, they identified the eye and the superior orbital fissure as a possible gateway to the ambient light to reach the midbrain, setting the stage for a more detailed study of the relationship between light exposure and Parkinson's disease, and highlighting the role of artificial light sources in this disease . Through the new evaluation systems, we studied a technique. . Fascial sheath of eyeball (Tenon) : Extraocular muscles; Extrinsic muscles of eyeball . Choroid blood vessels . Choroid : Arteries . Eye : Arteries . Veins (Orbit&Eye) Cranial nerves : Optic nerve [II]/Nerves III - IV - VI/Ophthalmic nerve; Ophthalmic division [Va; V1] Orbit : Nerves . Ophthalmic nerve; Ophthalmic.
The inferior orbital fissure transmits the infraorbital and zygomatic branches of the maxillary nerve, the inferior ophthalmic vessels, and orbital branches of the pterygopalatine ganglion. Its length is reported to vary from 25 to 35 mm (mean 29) and it lies between the greater wing of the sphenoid bone laterally and the maxillary and palatine bones medially. The anterior margin lies between. Orbital foramina. Axial (a, b) and coronal (c) CT bone-window images demonstrate the superior orbital fissure (arrow, blue overlay in a), optic canal (arrow, brown overlay in b), and infraorbital canal (arrow, yellow over-lay in c). Contents of each foramen are shown in Table 2 Paranasal Sinuses. Paranasal sinuses refer to a group of air-filled spaces around the nasal cavity (a system of air channels that connect the nose with the back of the throat) (1).They facilitate the circulation of the air breathed in and out of the respiratory system (2).. Paranasal sinuses have four different pairs: maxillary sinuses, frontal sinuses, sphenoidal sinuses, and ethmoidal.
The orbit is a conical structure, with its base facing anterolaterally and its apex originating medially as the inlet of all vital neural and vascular structures via the optic foramen, superior orbital fissure, and inferior orbital fissure. The anterior rim of the bony orbit, the orbital rim, is formed by orbital processes from the maxilla, z.. For zygomatic complex and orbital floor fractures, preoperative CT scans in axial and coronal slices are standard. Additional sagittal or oblique parasagittal slices are often very helpful in the assessment of the orbital roof and orbital floor. 3-D reconstructions are also helpful to understand the pattern of displacement and/or rotation Compare to the image of the CT scan that captures the optic canal below Figure 3: CT scan above the opening for the nasolacrimal duct in the lacrimalfossa and includes the inferior orbital fissure. 4. zygoma 5. inferior orbital fissure (note that the fissure is oriented medially and narrows slightly posteriorly). 6. greater wing of the sphenoid 7. nasolacrimal duct 8. inferior rectus muscl METHODS:The area of the superior orbital fissure (SOF), the distance between the ocular skin and the substantia nigra and the distance between the superior orbital fissure and the substantia nigra using CT and 3D-CT images. RESULTS:Normative data stratified for age and gender were obtained. The data here reported show that some degree of variability in SOFA, D-SS and D-SOF-S measurements can.
Superior orbital fissure syndrome (SOFS) is a clinical diagnosis characterized by ophthalmoplegia, ptosis, proptosis, dilation of the pupil, and hypesthesia of the eyelid and forehead. Hirschfield first described this syndrome in 1858 in the context of trauma. In 1896, André Rochon-Duvignaud described the syndrome secondary to syphilis. The differential diagnosis includes trauma, neoplasm. The orbital apex incorporates the optic canal and the superior orbital fissure. The optic canal transmits the optic nerve (surrounded by meninges) and the ophthalmic artery to the cranial fossa. The superior orbital fissure is anatomically lateral to the optic canal which can be divided into the superior, middle, and inferior portions by the common tendinous ring comprised of the thickened.
Orbital fat herniation is primarily in a subconjunctival location. However, herniation through the inferior orbital fissure (IOF) has been scantly reported. Here, we report a cadaveric case of herniation of orbital fat through the inferior orbital Superior orbital fissure (SOF): This crack in the middle cranial fossa, that lies just posterior and lateral to the optic canal, can be better appreciated if viewed from the front, as it lies at the back of the eye orbit or socket. As mentioned earlier, a fissure is usually located between two structures, and in this case, the superior orbital fissure is located between the lesser and greater. Whole body CT scan showed metastasis in ribs, scapula and in pelvic bones. He was diagnosed to have superior orbital fissure syndrome due to metastatic prostatic malignancy and was offered steroids and radiotherapy. Keywords: Ptosis, Prostate, Metastasis. I. INTRODUCTION Superior orbital fissure syndrome (SOFS) is a rarely encountered entity in clinical practice. It can be caused due to trauma. The inferior tier is formed by the inferior orbital fissure (IOF), which provides direct communication between the orbital apex and the pterygopalatine fossa, a vertically oriented space directly behind the maxillary sinus. Finally, the optic canal has no direct communication with any of the aforementioned spaces and should be considered to lie above the SOF and CS, exiting the orbit in a. The area of the superior orbital fissure (SOF), the distance between the ocular skin and the substantia nigra and the distance between the superior orbital fissure and the substantia nigra using CT and 3D-CT images. Normative data stratified for age and gender were obtained. The data here reported show that some degree of variability in SOFA, D-SS and D-SOF-S measurements can be observed.
superior orbital fissure (SOF) The optic canal (OC) opens into the superomedial corner of the orbital apex at the junction of the roof and medial wall. It is separated from the superior orbital fissure (SOF) by the optic strut ( OS ), a bridge of bone, also referred to as the posterior root of the lesser wing, which extends from the lower margin of the base of the anterior clinoid process to. siemens.teamplay.end.text. Home Searc
CT; MRI: Pathology: Soft tissue mass extending into the inferior orbital fissure. Disease/Diagnosis: Adenoid cystic carcinoma: Treatment: XRT; Antineoplastic agents: References: 1. Andres KH: Kautzskyr Die Fruhentwicklung der vegetativen Hals und Krpfganglien des Menschen. Z Anat EntwGesch 119:55-84, 1955. 2. Botelho SY, Hisada M, Fuenmayor N: Functional innervation of the lacrimal gland in. Presentation the same as superior orbital fissure syndrome. All differentiating features are subtle and relative. Characteristically, responds well to corticosteroids. Colnagi S, Versino M, Marchioni E, et al. ICHD-11 diagnostic criteria for Tolosa-Hunt Syndrome in idiopathic inflammatory syndrome of the orbit and/or the cavernous sinus
We present a case of superior orbital fissure syndrome which is made more interesting by the fact that there were no associated orbital fractures demonstrated on imaging or other lesions to explain. Investigating the cause of the superior orbital fissure syndrome, we found a narrow superior orbital fissure using computed tomography (CT) scans on the affected side. Gliederung. Case description. THE SUPERIOR ORBITAL FISSURE/ORBITAL APEX SYNDROME. This fissure lies at the back of the orbit between the lesser and great wing of the sphenoid. It curves downwards and medially widening at the orbital apex containing the superior ophthalmic vein, ophthalmic division of the trigeminal nerve and branches (lacrimal, frontal, supraorbital, supratrochlear and nasocillary), and the nerves to the.
ObjectiveOur aim was to provide normative data concerning superior orbital fissure area (SOFA), ocular skin and the substantia nigra (D-SS) and orbital fissure and the substantia nigra (D-SOF-S) distances by CT scan in adult Caucasian populationMethodsThe area of the superior orbital fissure (SOF), the distance between the ocular skin and the substantia nigra and the distance between the. The CT showed a well-delineated, enhancing, postseptal mass measuring approximately 2.9 cm x 1.2 cm in the right orbit along the right lateral rectus and superior rectus muscles. The mass was extending into the right cavernous sinus through the superior orbital fissure and into the sella, displacing the pituitary gland. There was medial displacement of the optic nerve (Figure 1). On MRI, the. Passing through the anulus of Zinn via the optic canal are the optic nerve and ophthalmic artery and via the superior orbital fissure are cranial nerves III (superio The superior orbital fissure is a narrow cleft that links the orbit and cavernous sinus of the middle cranial fossa. It is a functionally important structure located between the greater and lesser wings of the body of the sphenoid bone, and has the oculomotor, trochlear, nasociliary, and abducent nerves, the three branches of the ophthalmic nerve, the orbital branch of the meningeal artery. Structures in the orbital apex have complex anatomic relations. The four rectus muscles originate from the anulus of Zinn, a tendinous ring that encircles the optic foramem and the medial end of the superior orbital fissure. Passing through the anulus of Zinn via the optic canal are the optic nerve and ophthalmic artery and via the superior orbital fissure are cranial nerves III (superior and.
Diagnosis: Orbital blow out fracture inferior (CT, ) Axial noncontrast CT of the head in a young child demonstrates acute blood in the interhemispheric fissure (A and D, white arrows) as well as subdural and subarachnoid collections overlying the right frontal lobe (A and C, black arrows). Furthermore, acute blood is seen in the posterior aspect of the left globe (B, arrow), consistent. The labeled structures are (excluding the correct side): foramen magnum medulla oblongata vertebral artery cerebellar tonsil premedullary cistern internal jugular vein basilar artery sigmoid sinus petrous internal carotid artery in the c.. Ct Anatomy of Orbit - Free download as Powerpoint Presentation (.ppt / .pptx), PDF File (.pdf), Text File (.txt) or view presentation slides online. CT ANATOMY OF ORBIT WITH LABELLED IMAGES OF AXIAL,SAGITTAL SECTIONS Because of this superior quadrant involvement, anywhere from 16-24% of orbital schwannomas can extend into the superior orbital fissure. CT imaging shows iso- or hypodensity compared to gray matter, with a smooth, ovoid, orbital, retrobulbar mass
Postoperative CT Orbit approached through transconjunctival incision with lateral canthotomy. MatrixMIDFACE Preformed Orbital Plate, large, left, placed without modification except slight bending and trimming of some fixation holes. The implant was fixed to the inferior orbital rim with two MatrixMIDFACE Screws. Coronal preoperative Axial preoperative Coronal postoperative Axial postoperative. Located below the superior orbital fissure between the lateral wall and the floor of the orbit with access to the pterygopalatine and inferotemporal fossa; Transmits the infraorbital and zygomatic branches of the CN V, (maxillary division), orbital nerve from the pterygopalatine fossa, and the inferior ophthalmic vein ; Orbital contents. Periorbita; The periosteal covering of the orbital bones. CT is inferior to MRI in the visualization of the cranial nerves themselves, due to its low contrast resolution. Therefore, it can be use-ful to evaluate the intraosseous segments of cranial nerves and the possible associated bony changes. Particularly, CT is optimal to study the bony foramina of the skull base (Table 3,Fig.2) and bony traumatic lesions . Anatomy Nuclei of cranial nerves. On CT, the lacrimal gland is isodense to the muscle. The medial border is outlined by or-bital fat and the lateral border by orbital bone (Fig. 1C). Calcifications and bony changes are well seen on CT (Fig. 2), and normal glands show symmetric contrast enhancement. The superior resolution of MRI permits better as-sessment of the extent of glandular and peri-glandular involvement. Normal. puted tomography (CT) images of 20 patients (10 male, 10 female) were used for volumetric cal-culations. RESULTS. Mean values were 14.5 mm for the orbital rim to inferior orbital fissure distance, 23.3 mm for rim to trigone distance, 13.0 mm for width of the trigone base, 5.8 mm for trigone to or-bital apex distance, and 12.3 mm for trigone height. The width of the narrowest section of the.
orbital fissure. Dr Yati Gothwal Coronal CT of head Orbit lies: Inferior to cranial cavity Above to. maxillary sinus. 3 Dr Yati Gothwal Horizontal CT of head Orbit lies: Lateral to nasal cavity and Para nasal sinuses Medial to infratemporal fossa Eyeball is ori. Orbits are angled 450 outward Dr Yati Gothwal Horizontal CT of head Orbit lies: Lateral to nasal cavity and Para nasal sinuses Medial. Trauma to the frontal bar of the superior orbital rim can cause a buckling of this bone in addition to fractures of the contralateral orbit. Orbital emphysema is common when the frontal sinus is involved. In addition, extension of fractures of the cranial vault may involve the roof of the orbit with subsequent cerebral spinal fluid leakage. Delayed findings can include pulsatile exophthalmos. orbital fissure: Etymology: L, orbita, wheel track, fissura, cleft the space between the floor and lateral wall of the orbit, serving as a conduit for nerves and blood vessels Systemic evaluation of ocular and orbital structures on CT scan • Orbital dimensions: • Vertical and horizontal should be measured on coronal scans • Medial ,lateral wall, sup.orbital fissure, optic canal evaluated on axial scan. • Orbital roof and floor on coronal scan. 49
Lateral, inferior, and superior orbital ridge fracture typically occurs with other facial fractures; Naso-orbito-ethmoid fracture Associated with force applied to nasal bridge ; Often accompanied by injury to lacrimal duct, dural tears, and traumatic brain injury; Clinical Features. Inferior rectus highlighted in blue. Entrapment of muscle causes upward gaze diplopia. Orbital fracture with. The superior orbital fissure is the communication between the cavernous sinus and the apex of the orbit. It is straddled by the tendinous ring which is the common origin of the four rectus muscles (extraocular muscles). Gross anatomy Boundaries.. . Results: The results indicated that the width was 3.73 ± 1.64 mm in the CT scans of patients and 3.21 ± 1.09 mm in the cadavers. There was no significant difference between the width in the CT scans and cadavers. Improvements in vision have been reported in cases that underwent decompression several days following injury and spontaneous improvements in the superior orbital fissure syndrome component are reported up to several months following injury . If vision remains worse than 20/400, an APD is present, the CT demonstrates medially impacted lateral orbital wall fragments, external ophthalmoplegia is. IOF - Inferior Orbital Fissure. MRI Magnetic Resonance Imaging; CT Computed Tomography; CBC Complete Blood Count; BP Blood Pressure; ICP Intracranial Pressure; RLQ Right Lower Quadrant; WFNS World Federation of Neurological Surgeons; GCS Glasgow Coma Scale; TBI Traumatic Brain Injury; AVM Arteriovenous Malformation; CSF Cerebrospinal Fluid; IVC Inferior Vena Cava; ACL Anterior Cruciate.
Superior orbital fissure syndrome or orbital apex syndrome. The former consists of dysfunction of cranial nerves III, IV, V, and VI because of compression by fractured bony segments or hematoma. The latter consists of superior orbital fissure syndrome with optic nerve injury ( Figure 13-14 ) Transorbital intracranial injuries due to a wooden foreign body traversing superior orbital fissure is an extremely rare condition. A 9-year-old boy was struck by a tree branch in the left eye while playing in the garden two months ago. On physical examination, the patient had only a hypertrophic scar on his medial side of left upper eyelid at the admission. A history of recurrent cutaneous. CT imaging revealed gaseous hypodensities within the inferior orbital fissure and pterygopalatine fossa in addition to infection of the left masseter and temporalis muscle. Despite dental drainage, this rapidly progressed to orbital cellulitis with temporalis muscles abscess leading to compartment syndrome and globe tenting. He had an excellent outcome after canthotomy and cantholysis, urgent. The superior orbital fissure syndrome (SOFS) is a complex of impaired function of the cranial nerves (III, IV, V, and VI) that enter the orbit through the superior orbital fissure (SOF). Three major precipitating factors for SOFS are trauma, tumor, and inflammation. SOFS of traumatic origin was first described by Herschfeld in 1858
Superior orbital fissure syndrome (SOFS) is a rare condition presenting with a combination of ophthalmoplegia, ptosis, proptosis, anesthesia along V1, and a fixed dilated pupil. Causes may be inflammatory, infectious, neoplastic, vascular, and traumatic.1,2 We report a case of traumatic SOFS and review the literature on the pathogenesis and management of this unusual condition. Case Report A. Orbital apex Inferior orbital fissure Sphenopalatine foramen Pterygopalatine fossa Pterygomaxillary fissure Pterygoid plates sinus Middle turbinate Posterior nasal Sphenopalatine artery Christa ethmoidalis Posterior choana . 4 . Figure 10: V2, pterygopalatine ganglion and infraorbital nerve (pterygopalatine fossa in red) Preoperative Evaluation . Clinical Evaluation . A thorough history and. Design The 3 areas of bone in the deep lateral orbit were designated the lacrimal keyhole, the sphenoid door jamb, and the basin of the inferior orbital fissure. By means of digitized computed tomographic scans, these 3 areas of bone were analyzed by measuring preoperative and postoperative orbital volumes and predicted bony expansion volumes in 9 patients (17 orbits) who underwent deep. Superior orbital fissure syndrome is an infrequently encountered entity with a unique presentation and significant morbidity. This article reviews the background of the syndrome, treatments in the literature, and discusses a recent case with treatment strategy. Keywords trauma, midface, superior orbital fissure syndrome, zygomaticomaxillary complex fracture. References. 1. Kurzer, A Patel, MP. Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date. The MMA can enter the orbit (meningoophthalmic branch, curved arrow) The anteromedial branch of the ILT can collateralize through the superior orbital fissure. The anterior deep temporal branches can be transosseous (arrowhead) or muscular draped over the lateral orbital wall and get into the orbit that way to hook up with lacrimal branches of the ophthalmic. Angular branch of the facial.