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J Neurol Surg B Skull Base 2020; 81(04): 319-332
DOI: 10.1055/s-0040-1715096
Orbital Anatomy
Review Article

Anatomy of the Orbit

Stefan Lieber
1   Department of Neurosurgery, Stanford University Medical Center, Palo Alto, California, United States
,
Juan C. Fernandez-Miranda
1   Department of Neurosurgery, Stanford University Medical Center, Palo Alto, California, United States
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Abstract

The orbit is a paired, transversely oval, and cone-shaped osseous cavity bounded and formed by the anterior and middle cranial base as well as the viscerocranium. Its main contents are the anterior part of the visual system, globe and optic nerve, and the associated neural, vascular, muscular, glandular, and ligamentous structures required for oculomotion, lacrimation, accommodation, and sensation.

A complex stream of afferent and efferent information passes through the orbit, which necessitates a direct communication with the anterior and middle cranial fossae, the pterygopalatine and infratemporal fossae, as well as the aerated adjacent frontal, sphenoidal, and maxillary sinuses and the nasal cavity.

This article provides a detailed illustration and description of the microsurgical anatomy of the orbit, with a focus on the intrinsically complex spatial relationships around the annular tendon and the superior orbital fissure, the transition from cavernous sinus to the orbital apex. Sparse reference will be made to surgical approaches, their indications or limitations, since they are addressed elsewhere in this special issue. Instead, an attempt has been made to highlight anatomical structures and elucidate concepts most relevant to safe and effective transcranial, transfacial, transorbital, or transnasal surgery of orbital, periorbital, and skull base pathologies.

Keywords

orbit - microsurgical anatomy - extraocular muscles - annular tendon - annulus of Zinn - skull base - cranial nerves - optic nerve - oculomotor nerve - trochlear nerve - abducens nerve - trigeminal nerve - facial nerve - optic canal - superior orbital fissure - orbital apex - ciliary ganglion - ophthalmic artery


Publication History

Article published online:
17 September 2020

Georg Thieme Verlag KG
Stuttgart · New York

 

  • References

  • 1 Lang J. Skull Base and Related Structures, 2nd ed. New York: Schattauer; 2001
    Google Scholar
  • 2 Rhoton A. Cranial Anatomy and Surgical Approaches. Philadelphia, PA: Lippincott; 2003
    Google Scholar
  • 3 Felding UA, Karnov K, Clemmensen A. et al. An applied anatomical study of the ethmoidal arteries: computed tomographic and direct measurements in human cadavers. J Craniofac Surg 2018; 29 (01) 212-216
    CrossrefPubMedGoogle Scholar
  • 4 Leblanc A. The Cranial Nerves, 2nd ed. Berlin: Springer; 1995
    CrossrefGoogle Scholar
  • 5 Lasjaunias P, Berenstein A, terBrugge KG. Surgical Neuroangiography, 2nd ed. Vol. 1. New York: Springer; 2001
    Google Scholar
  • 6 Dutton J. Atlas of Oculoplastic and Orbital Surgery, 2nd ed. Philadelphia, PA: Lippincott; 2019
    Google Scholar
  • 7 De Battista JC, Zimmer LA, Theodosopoulos PV, Froelich SC, Keller JT. Anatomy of the inferior orbital fissure: implications for endoscopic cranial base surgery. J Neurol Surg B Skull Base 2012; 73 (02) 132-138
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Renn WH, Rhoton Jr AL. Microsurgical anatomy of the sellar region. J Neurosurg 1975; 43 (03) 288-298
    CrossrefPubMedGoogle Scholar