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Background Botulinum toxin A (BoNT-A) has grown tremendously in aesthetic dermatology since 2002 when the United States Food and Drug Administration (FDA) first approved its use for treating moderate-to-severe glabellar lines. Blepharoptosis, due to local spread of toxin, is a reported side effect of BoNT-A which, although rare, more frequently occurs among inexperienced practitioners. Objectives The purpose of this review is to highlight the causes and management of eyelid ptosis secondary to BoNT-A administration including new anatomic pathways for BoNT-A spread from the brow area to the levator palpebrae superioris muscle. Methods A literature search was conducted using electronic databases (PubMed, Science Direct, MEDLINE, Embase, CINAHL, EBSCO) regarding eyelid anatomy and the underlying pathogenesis, presentation, prevention, and treatment of eyelid ptosis secondary to BoNT-A. Anatomic dissection has been performed to assess the role of neurovascular pedicles and supraorbital foramen anatomic variations. Results Blepharoptosis occurs due to weakness of the levator palpebrae superioris muscle. Mean onset is 3-14 days after injection and eventually self-resolves after the paralytic effect of BoNT-A wanes. Administration of medications, such as oxymetazoline hydrochloride or apraclonidine hydrochloride eye drops, anticholinesterase agents, or transdermal BoNT-A injections to the pre-tarsal orbicularis, can at least partially reverse eyelid ptosis. Anatomic study shows that a supraorbital foramen may be present in some patients and constitutes a shortcut from the brow area directly into the orbital roof, following the supraorbital neurovascular pedicle. Conclusion Providers should understand the anatomy and be aware of the causes and treatment for blepharoptosis when injecting BoNT-A for the reduction of facial wrinkles. Thorough anatomic knowledge of the supraorbital area and orbital roof is paramount to preventing incorrect injection into "danger zones," which increase the risk of eyelid ptosis.

The purpose of this study is to investigate the applicability of the current surgical guideline stating that the main facial foramina that transmit cutaneous nerves to the face (supraorbital notch/foramen, infraorbital foramen, and mental foramen) are equidistant from the midline in European and Hispanic populations. Previous studies suggest this surgical guideline is not applicable for all ethnicities; however, to our knowledge, no data have been published regarding the accuracy of this guideline pertaining to the Hispanic population. An experimental study was performed on 67 cadavers donated to the Human Anatomy Program at UT Health San Antonio. The supraorbital, infraorbital, and mental foramina were dissected and midline structures including the crista galli, internasal suture, anterior nasal spine, and mandibular symphysis were identified. The distance from each foramen to midline was recorded using a digital caliper. For all cadavers/ethnicities studied, the supraorbital, infraorbital, and mental foramina were 25.32 mm, 29.57 mm, and 25.55 mm to the midline, respectively. Thus, the infraorbital foramen is located significantly more lateral compared to the supraorbital (p < 0.0001) and mental foramina (p < 0.0001). After dividing the sample based on ethnicity, this relationship was also true for the European sample and tended to be true for the Hispanic sample. Significant anatomical variations exist in the current surgical guideline stating that the supraorbital foramen, infraorbital foramen, and mental foramen are equidistant from the midline. Clinicians may need to adjust their methodology during surgical procedures of the face in order to optimize patient care.

Objective: This research was aimed at telling the anatomical characteristics of the accessory supraorbital foramen (ASOF) in relation to the main supraorbital foramen (SOF), which is necessary in clinical situations that require regional surgical procedures. Methods: A total dedicated to the presence and location of 72 dry Indian adults of unknown age and sex were investigated. In each skull, the ASOF location was measured on both sides with a Vernier caliper metal case, with the SOF as the reference point. The total number of accessory foramen was also noted. Results: Accessory infraorbital foramens (IOFs) were seen only in 4.16% in our study and all seen were single in number. Half of those accessory foramen were present on medial and rest half were present on superomedial position as compared to the main IOF. Half among present accessory foramens were located at a distance of

This study presents an up-to-date determination of the position of the openings of the facial skull of a mature human skull depending on gender. The study was performed on 52 skull bone preparations and 60 CT scans of Caucasian males and females. Conventional instruments were used to perform craniometric studies on skull bone preparations. Craniometric studies and analysis on CT images in DICOM format were performed using the DICOM Vidar Dicom Viewer 3.0 program, installed on the virtual anatomical table Anatomage table, located on the Department of Human Anatomy, KhNMU. The following were determined: minimum and maximum value; arithmetic mean ( X ), standard deviation (σ), mean error (m). It was found that the increase in the distance from the supraorbital foramen (SOF) to the midline in females: on the right is X ±σ=21.43±4.192 mm; on the left – X ±σ=21.51±3.213 mm, while in males it is on the right X ±σ=20.45±3.143 mm; left – X ±σ=21.17±2.478 mm. Defi nitely the distance from the orbit (IOF) to the midline, which is more important in males than in females and is right X ±σ=22.45±3.782 mm; left – X ±σ=23.39±2.478 mm; at the same time at females: on the right it is equal X ±σ=22,12±2,034 mm; left – X ±σ=23.17±1.890 mm. When examining the distance from the chin to the midline on both sides in both men (right: X ±σ=21.36±1.857 mm; left: X ±σ=22.99±2.423 mm) and women (right: X ±σ=20.96±1.884 mm, left: X ±σ=22.08±2.124 mm) there is also an increase in these indicators, especially in males., У дослідженні наведено актуальне визначення положення отворів лицевого відділу черепа людини зрілого віку залежно від статі. Дослідження проводили на 52 кісткових препаратах черепів та 60 КТ-знімках людей європеоїдної раси зрілого віку чоловічої та жіночої статі. Під проведення краніометричних досліджень на кісткових препаратах черепів використовували загальноприйняті інструменти. Краніометричні дослідження та аналіз на КТ-знімках у форматі DICOM проводили за допомогою програми DICOM Vidar Dicom Viewer 3.0, яка встановлена на віртуальному анатомічному столі Anatomage table, що розміщений на базі кафедри анатомії людини ХНМУ. Були визначенні: мінімальне та максимальне значення; середня арифметична( X ), середнє квадратичне відхилення (σ), помилка середнього (m). Встановлено збільшення відстані від надочноямкового отвору (НОО) до серединної лінії в осіб жіночої статі: праворуч дорівнює X ±σ=21,43±4,192 мм; ліворуч – X ±σ=21,51±3,213 мм, при цьому в осіб чоловічої статі становить праворуч X ±σ=20,45±3,143 мм; ліворуч – X ±σ=21,17±2,478 мм. Визначена відстань від підочноямкового отвору (ПОО) до серединної лінії, яка у представників чоловічої статі має більші значення, ніж у жіночої та становить праворуч ±σ=22,45±3,782 мм; ліворуч – X ±σ=23,39±2,478 мм; при цьому в осіб жіночої статі: праворуч дорівнює X ±σ=22,12±2,034 мм; ліворуч – X ±σ=23,17±1,890 мм. При дослідженні відстані від підборідного отвору до серединної лінії з обох боків як у чоловіків (пр.: X ±σ=21,36±1,857 мм; лів.: X ±σ=22,99±2,423 мм), так і в жінок (пр.: X ±σ=20,96±1,884 мм; лів.: X ±σ=22,08±2,124 мм) також просліковується збільшення цих показників саме в осіб чоловічої статі.

In this study, the current investigation of the adult facial skull orifi ces perfomed, depending on gender. The study conducted on 52 skull bones preparations and 60 CT scans of europian males and females. Conventional instruments were used to perform craniometric studies on skull bone preparations. Craniometrics studies on CT images were performed using a virtual Anatomage table of Human Anatomy Department of the Kharkiv National Medical University and on which the program Launching Table 6.0 Application is installed. In addition, the DICOM Vidar Dicom Viewer 3.0 program, which is widely used in medical and diagnostic institutions used to view and analyze CT scans in DICOM format. It was determined: minimum and maximum value; average arithmetic ( X ), standard deviation (σ), average error (m). It was found that the height of the supraorbital foramen on both sides is higher in males than in females, because the height of the supraorbital foramen on the right in men is X ±σ=2.30±0.657 mm; in women – X ±σ=2.13±0.586 mm. On the left in the male is equal to X ±σ=2.55±0.634 mm; in females – X ±σ=2.01±0.480 mm. There is a wide range of width and height of the infraorbital foramen as well. Thus, the minimum width for men is 2.2 mm, the maximum width is 6.4 mm, for women the minimum width is 1.8 mm, the maximum – 5.1 mm. Height in males varies from 2.0 mm to 7.0 mm, in females – 1.5 mm to 4.9 mm. The width of the mental foramen on both sides in males reaches X ±σ=3.39±0.844 mm (right) and X ±σ=3.63±0.902 mm (left), the height of this opening in males on the right X ±σ=2.72±0.795 mm, on the left – X ±σ=2.76±0.787 mm. In conclusion all, that the openings of the facial skull have diff erent diameters, we fi rst determined the latitudinal and height values of the supraorbital, infraorbital and mental foramens, which had su ffi cient variability and the size of which was predominant in male gender., В данном исследовании представлено исследование отверстий лицевого отдела черепа человека зрелого возраста в зависимости от пола. Исследование проводилось на 52 костных препаратах черепов и 60 КТ-снимках людей европеоидной расы зрелого возраста мужского и женского пола. При проведении краниометрических исследований на костных препаратах черепов использовали общепринятые инструменты. Краниометрические исследования на КТ-снимках проводились с помощью виртуального анатомического стола Anatomage table, размещенного на базе кафедры анатомии человека Харковского национального медицинского университета и на котором установлена программа Launching Table 6.0 Application. Также, для просмотра и анализа КТ-снимков в формате DICOM использовалась программа DICOM Vidar Dicom Viewer 3.0., которой широко пользуются в лечебно- диагностических учреждениях. Нами были определены: минимальное и максимальное значение; среднее арифметическое ( X ), среднее квадратическое отклонение (σ), ошибка среднего (m). Установлено, что высота надглазничного отверстия с обеих сторон имеет высшее значение у мужского пола, чем у женского, так как высота надглазничного отверстия справа у мужчин составляет X ±σ=2,30±0,657 мм; у женщин – X ±σ=2,13±0,586 мм. Слева у мужского пола равняется X ±σ=2,55±0,634 мм; у женского пола – X ±σ= 2,01±0,480 мм. Можно утверждать о наличии большого диапазона ширины и высоты подглазничного отверстия. Так, минимальная ширина его у мужчин составляет 2,2 мм, максимальная ширина равна 6,4 мм, у женщин минимальная ширина составляет 1,8 мм, максимальная – 5,1 мм. Высота у мужчин варьирует от 2,0 мм до 7,0 мм, у женщин от 1,5 мм до 4,9 мм. Ширина подбородочного отверстия с обеих сторон у мужчин достигает X ±σ=3,39±0,844 мм (справа) и X ±σ=3,63±0,902 мм (слева), высота этого отверстия у мужского пола составляет справа X ±σ=2,72±0,795 мм, слева – X ±σ=2,76±0,787 мм. Учитывая, что отверстия лицевого отдела черепа имеют разный диаметр, нами в первую очередь были определены широтные и высотные значения надглазничного, подглазничного и подбородочного отверстий, которые имели достаточную вариабельность и размеры которых преобладали у мужского пола.&nbsp, У даному дослідженні наведено визначення отворів лицевого відділу черепа людини зрілого віку залежно від статі. Дослідження проводили на 52 кісткових препаратів черепів та 60 КТ-знімках людей європеоїдної раси зрілого віку чоловічої та жіночої статі. Під час проведення краніометричних досліджень на кісткових препаратах черепів використовували загальноприйняті інструменти. Краніометричні дослідження на КТ-знімках проводились за допомогою віртуального анатомічного столу Anatomage table, що розміщений на базі кафедри анатомії людини Харківського національного медичного університету та на якому встановлена програма Launching Table 6.0 Application. Також, для перегляду та аналізу КТ-знімків у форматі DICOM використовувалась програма DICOM Vidar Dicom Viewer 3.0., якою широко користуються в лікувально- діагностичних закладах. Нами були визначенні: мінімальне та максимальне значення; середня арифметична ( X ), середнє квадратичне відхилення (σ), помилка середнього (m). Встановлено, що висота надочноямкового отвору з обох сторін має вище значення у чоловічої статі ніж у жіночої, адже висота надочноямкового отвору праворуч у чоловіків становить X ±σ=2,30±0,657 мм; у жінок – X ±σ=2,13±0,586 мм. Ліворуч у чоловічої статі дорівнює X ±σ=2,55±0,634 мм; у жіночої статі – X ±σ=2,01±0,480 мм. Можна стверджувати про наявність великого діапазону ширини та висоти підочноямкового отвору. Так, мінімальна ширина його у чоловіків становить 2,2 мм, максимальна ширина дорівнює 6,4 мм, у жінок мінімальна ширина становить 1,8 мм, максимальна – 5,1 мм. Висота у чоловіків коливається від 2,0 мм до 7,0 мм, у жінок – від 1,5 мм до 4,9 мм. Ширина підборідного отвору з обох боків у чоловіків досягає X ±σ=3,39±0,844 мм (праворуч) та X ±σ=3,63±0,902 мм (ліворуч), висота цього отвору у чоловічої статі становить праворуч X ±σ=2,72±0,795 мм, ліворуч – X ±σ=2,76±0,787 мм. Враховуючи, що отвори лицевого відділу черепа мають різний діаметр, нами в першу чергу були визначені широтні та висотні значення надочноямкового, підочноямкового та підборідного отворів, що мали достатню варіабельність та розміри яких переважали у чоловічої статі.

Objective: This study aimed to evaluate the relations between orbit-related structures and sex, age and skeletal deformities using cone-beam computed tomography (CBCT). Methods: This retrospective study evaluated 216 consecutive CBCT scans of patients, who were divided according to: sex (male, n=105; female, n=111), age (A1: 18-32 years, n=71; A2: 33-47 years, n=78; A3: 48-62 years, n=67), and skeletal deformities (Class I, n=70; Class II, n=75; Class III, n=71). The supraorbital foramen (SOF) location, volume of orbit, optic canal (OC) and infraorbital canal (IOC) were evaluated. Results were analyzed using the Gamma model test. The Tukey-Kramer post-hoc test was used to compare the variables with three factors (p

Objective The taxonomic affiliations can be detected via the skull morphology. The objective of this study was to give a detailed gross anatomical and radiographic description of the bones and foramina of the skull and mandible of the lion. This information could be used in the identification of the skull and mandible of the lion, which is of great importance in taxonomic affiliation and to help the zoo veterinarians to detect, diagnose, and treat head conditions. Materials and Methods The current work was conducted on two skulls and mandibles of lions. The skulls and mandible were prepared using standard boiling and maceration technique. The gross and radiographic photos of the bones and foramina of the skull and mandible were taken using a Kodak digital camera and Siemens mobile full wave X-ray machine (Siemens Medical Solutions, Erlangen, Germany). Results The skull of the lion comprised of facial and cranial parts. The nasal openings were large, and the bony orbit was incomplete. The supraorbital foramen was absent. The zygomatic arch was large. The frontal region had a deep longitudinal depression dorsally. The mandible was a paired bone with movable articulation, and it had strongly excavated masseteric fossa with a well-developed crest. The dental formula was 30 teeth consisting of small incisors, long canines and carnassial premolars. Conclusion The current study showed that the osteology and foramina of the skull and mandible of the lion were similar to those of other mammals. The information is important for taxonomic affiliation, and wildlife forensic as well as to help the zoo veterinarians to manage clinical head diseases in this species.

BACKGROUND A needle or a cannula can be safely used during filler injection procedures to correct a sunken upper eyelid. To date, there are no precise injection points recommended that are based on an anatomical study. OBJECTIVE This study systematically investigated the vascular pattern and depth of forehead arteries at the periorbital area of upper eyelid. METHODS Twenty cadavers were dissected in this study. Additional data were obtained from 30 healthy volunteers using Doppler ultrasound imaging with high-frequency probe. RESULTS The ophthalmic artery divided into two opposite primary branches: the superior and inferior orbitoglabellar arteries running along the orbital rim. After the supratrochlear artery arose from the superior orbitoglabellar artery at the medial eyebrow, the supraorbital artery either divided from this artery near the supraorbital foramen or emerged as an individual artery from the supraorbital notch. The inferior orbitoglabellar artery gave off the radix artery superior to the medial canthal tendon. The radix artery divided into two opposite branches: the dorsal nasal artery going to the nose and the paracentral artery going to the glabella. Ultrasound imaging revealed a subcorrugator space that a cannula can safely pass through. At the supraorbital foramen/notch, the supraorbital artery traveled very close to the bone. Based on the anatomical data collected, the following injection points for a needle and a cannula technique are recommended. CONCLUSION Correction of a sunken upper eyelid is a dangerous procedure which should be performed only by experienced physicians. However, with precise anatomical knowledge and correct techniques, optimal outcomes can be safely achieved.

The supraorbital notch/foramen involving the segment of the supraorbital nerve (SON) and the supraorbital artery (SOA) has little been explored with magnetic resonance imaging (MRI). Therefore, we explored these structures using MRI. A total of 90 patients underwent thin-sliced contrast MRI. In addition, eight sides of the orbits were dissected in four cadaveric heads. Cadaver dissections showed that the SOA coursed consistently beneath and in close proximity to the SON and reached the supraorbital notch/foramen. On axial MRI images, the supraorbital notch/foramen was identified in 98% on the right side and in 99% on the left. The distance from the midline to the midpoint of the supraorbital notch/foramen and depth from the skin surface to the supraorbital foramen/exit were measured. The median distance was 22.6 ± 3.08 mm on the right side and 22.8 ± 3.07 mm on the left, whereas the depth was 7.7 ± 1.39 mm on the right and 7.7 ± 1.43 mm on the left. Eighty percent of the sagittal images showed well-developed diploic veins in the supraorbital rim. Of these, 8.3% had anastomotic channels with the subcutaneous veins through the anterior wall of the supraorbital rim, 11.8% through the inferior wall, and 9% through the SOF. The SON and SOA segments passing through the supraorbital exit can be reliably located using contrast MRI. The supraorbital rim may function as the intracranial to extracranial anastomotic channel.

Facial feminization surgery is an increasingly performed component of gender affirmation surgery for transgender women. Preoperative facial CT is performed to plan the adjustment of the patient's masculine characteristics to feminine and to plan operative navigation around specific readily identifiable anatomic structures. In the upper face, surgery is performed to reduce the prominence of the brow and increase the nasofrontal angle; the radiology report should indicate the frontal sinus and supraorbital foramen anatomy. In the midface, rhinoplasty is performed to increase the nasofrontal and nasolabial angles; the radiology report should indicate the presence of a dorsal hump and septal deviation or spurring. In the lower face, the prominence of the chin and squareness of the jaw are adjusted via genioplasty and mandible contouring, respectively; the radiology report should describe the location and potential anatomic variations of the inferior alveolar nerve and mental foramina as well as the presence of dental abnormalities that directly inform the surgical approach. CT may also be performed if there is clinical suspicion for postoperative complications such as hardware fracture or osteotomy through the supraorbital or mental foramen. Familiarity with these findings will facilitate improved communication between radiologists and surgeons, thereby contributing to the care of transgender women.

Clinical research suggests that transcranial direct current stimulation (tDCS) at bilateral supraorbital foramen and inferior orbital rim and nose intersections may facilitate rehabilitation after stroke. However, the underlying neurobiological mechanisms of tDCS remain poorly understood, impeding its clinical application. Here, we investigated the effect of tDCS applied after stroke on neural cells.Middle cerebral arterial occlusion (MCAO) reperfusion was induced in rats. Animals with comparable infarcts were randomly divided into MCAO group and MCAO + tDCS group. Recovery of neurological function was assessed behaviorally by modified neurological severity score (mNSS). Ischemic tissue damage verified histologically by TTC and HE staining. Immunohistochemical staining, real-time qPCR, and western blot were applied to determine the changes of neural cells in ischemic brains.The results reveal that tDCS treated by multilead brain reflex instrument can promote the recovery of neurological function, remarkably reduce cerebral infarct volume, promote brain tissue rehabilitation, and can effectively inhibit astrocytosis and enhance neuronal survival and synaptic function in ischemic brains.Our study suggests that tDCS treated by multilead brain reflex instrument could be prospectively developed into a clinical treatment modality.

CBCT (Cone Beam Computed Tomography) has fast become a key to produce 3D images in orthodontic and maxilla-facial surgery. Our purpose in this study is to develop a new approach for automatic localization of the region of supraorbital and infraorbital foramina using CBCT images. 19 CBCT images of Moroccan patients were used to validate the proposed algorithm. The automatic algorithm is based on geometric and anatomic information of maxillo-facial structures. The local priori information of supraorbital and infraorbital foramina was used to design the automatic algorithm. The detection rate for supraorbital foramina was 90% and 85% for right and left sides respectively, while the detection rate for infraorbital foramina was 79% and 74% for right and left sides respectively. This study has shown the relevance of local criteria such as geometric and anatomic knowledge in the automation of localization of supraorbital and infraorbital region. This work has gone some way towards the automation of morphometric and anthropometric measurements using CBCT images.

Significant variations exist in the occurrence, form, and position of supraorbital nerve exits through the frontal bone. Detailed knowledge of the positional variations of supraorbital exits is important to ensure safe and successful regional anesthesia, and to avoid iatrogenic nerve injuries during surgery of the orbitofacial region. Supraorbital nerve exits from 116 sides of 58 dry intact adult skulls (37 male and 21 female) in a Sri Lankan population were examined to determine the morphological features and the precise position in relation to the facial midline, temporal crest of frontal bone, and frontozygomatic suture. A majority of supraorbital nerve exits existed as notches (73.8%) and the rest as foramina (26.2%). Accessory exits were seen in 18.9% skulls. Of the skulls examined, 55.1% displayed bilateral supraorbital notches, 8.6% had bilateral supraorbital foramina, and 36.3% had a notch on one side and a foramen on the contralateral side. In males, the supraorbital nerve exit was located 23.64±3.49 mm laterally from the facial midline, 27.86±2.76 mm medially from the temporal crest of the frontal bone, 28.66±2.56 mm from the frontozygomatic suture, and 2.12±1.07 mm above the supraorbital margin in the case of a foramen, and in females 22.69±3.28 mm laterally from the facial midline, 26.32±3.02 medially from temporal crest of frontal bone, 27.29±3.05 from the frontozygomatic suture, and 2.99±1.49 mm above the supraorbital margin when it existed as a foramen. The observations made in this study will be useful when planning a supraorbital nerve block and surgery in the supraorbital region.

Currently, interventions with anesthetic substances have been an alternative for headache treatment. There are some regions that are targeted for the application of anesthetics, such as the upper margin of the orbit, where two critical nerves, supratrochlear and supraorbital, pass. The objective of this study is to present some anatomical features characteristic of the superior orbital border and passage of the supraorbital nerve through a foramen or more often notch. Dry skulls from male and female individuals were used, measures were taken to compare the distance between the foramen and the median line of the skull. The length was measured and compared between the sexes, obtaining the following results in men (2.27 ± 0.29 cm) and women (2.18 ± 0.41 cm). The collected data are of extreme importance to understand the anatomy of the region and intervention in procedures of infiltrations and treatment of headache.

The present study was conducted to ascertain the shape, size, presence of accessory foramina, direction, and the precise position of the infraorbital foramen (IOF) in relation to the inferior orbital margin (IOM), anterior nasal spine (ANS), nasion (Na), maxillary teeth, and supraorbital foramen/notch (SOF/N) in adult skulls in a Sri Lankan population. Fifty-four skulls (42 males and 12 females) were analyzed. The IOF was oval in shape (38.6% and 36.3% on the right and left side, resp.) in a majority of skulls. The direction of the IOF was mostly medially downward (48.6%). Accessory foramina were found in 7.4% of the skulls. The infraorbital foramina were located at a mean distance of 6.52 ± 2.03 mm and 7.30 ± 1.57 mm, vertically below the IOM on the right and left side, respectively; 33.81 ± 2.68 mm and 34.23 ± 2.56 mm from the ANS on the right and left side, respectively; and 42.37 ± 3.52 mm and 42.52 ± 3.28 mm from the Na on the right and left side, respectively. In relation to the upper teeth the majority of IOF (37.5% and 55.9% on the right and left side, resp.) were located in the same vertical axis as the tip of the buccal cusp of the maxillary second premolar tooth.

Endoscopic approaches to the supraorbital nerve for migraine surgery has been shown to be superior to direct transpalpebral approaches. This modification to the endoscopic approach, with the use of a D-knife blade, can be employed in patients with a long forehead or severe frontal bossing, which may normally lead to difficult access and visualization of the supraorbital foramen.

Background. Primary V1 trigeminal neuralgia is a common refractory neuralgia in clinical practice, lacking effective treatments. Radiofrequency therapy has certain treatment efficacy, but its long-term efficacy remained poor and the disease might relapse. Objective. To compare the effects of different types of supraorbital foramen variations on the treatment efficacy of radiofrequency therapy for V1 trigeminal neuralgia. Methods. Data of 54 patients with V1 trigeminal neuralgia who underwent treatment in the First Hospital of Jiaxing, Zhejiang, were retrospectively analyzed. All these patients received CT-guided radiofrequency thermocoagulation of supraorbital nerve. According to the CT images, the supraorbital foramen of the patients was categorized as holes (hole group) or notches (notch group). The patient characteristics, including Numerical Rating Scale (NRS) score and effective treatment rates before and 1 d, 0.5 y, 1 y, and 2 y after operation, and numbness degree at day 1 and 2 y after the operation were compared. The short- and long-term complications during postoperative follow-up period were also recorded. Results. Among the 54 patients, 25 patients were grouped into the hole group and 29 into the notch group. The NRS scores before and at 1 d, 0.5 y, 1 y, and 2 y after operation showed no significant differences between the two groups. However, the NRS scores at the remaining time points after operation were significantly decreased when compared with scores before operation (P<0.05). The numbness and numbness degree after operation showed no significant differences between the two groups. The numbness degree at 2 y after operation was significantly lower than 1 d after operation (P<0.05). The effective rate at 1 d, 0.5 y, and 1 y after operation showed no significant differences between the hole and notch groups. However, the effective rate at 2 y after operation was significantly lower in the notch group than hole group (P<0.05). No severe short- or long-term complications were found in either group. Conclusion. The short- and long-term effective rates of radiofrequency therapy during V1 trigeminal neuralgia treatment are relatively high in patients with different types of supraorbital foramen variations. However, the effective rate is even higher in patients with hole-type supraorbital foramen. No other severe complications, except numbness, were found, and the acceptability rate remained high in patients.

The supraorbital nerve passes through the supraorbital foramen. II supplies the upper eyelid, the conjunctiva of the eye, and the skin of the forehead (Figs. 12.1, 12.2, and 12.3).

In archaeological, forensic, clinical and surgical fields, it is important to decide the gender of an individual and to know the facial asymmetry. The objective of this study is to ascertain the asymmetry of the skull and to predict the gender based on the shape and dimensions of the infraorbital foramina (IOF) and its position in relation to maxillary teeth, supraorbital foramen (SOF) and clinically relevant anatomical landmarks. Linear discriminant analysis (LDA), binary logistic regression (BLR), support vector machine (SVM) and bagging CART algorithms were used to predict the gender and results were validated using 10-fold cross-validation technique. A significant variation on the position of IOF in relation to anatomical landmarks was observed and the relative position of the IOF varies between the genders. Moreover, the left side measurements were larger than the right-side measurements and hence human skull is asymmetric. The outcome of the study proposes the classification-based approach to predict the gender of the individuals. The Bagging CART model performed well in terms of both accuracy and precision when compared with other methods.

WOS: 000379751100040, The aim of the present study is to determine the frequency of the occurrence of supraorbital foramen/notch (SOF/N) in the skulls of the people who lived in the modern era and the late Byzantine era, to determine the symmetry and the asymmetry between the two halves of the skulls by measuring the linear distance to various landmarks, to check the consistency between the location of the SOF/N and the golden ratio by calculating the ratio between linear distances and to evaluate the differences between the skulls from both historical periods. In the study, the frequency of the occurrence of the supraorbital notch in the skulls from the Byzantine era was found to be 26.60 % on the right and 13.30 % on the left while it was 14.30 % on the right and 9.52 % on the left in the skulls belonging to modern humans. In the skulls belonging to the Byzantine era, the average distance between SOF/N and the sagittal axis passing along the lateral orbital wall was found to be 34.81 +/- 2.51 mm and 32.99 +/- 2.81 mm respectively on the right and the left while it was 33.14 +/- 2.19 mm and 33.39 +/- 2.06 mm in the skulls belonging to modern era. The average distance between the SOF/N and the sagittal plane passing along the midline of the skull was found to be 24.55 +/- 2.79 mm and 21.57 +/- 2.44 mm on the right and the left respectively in the skulls belonging to the Byzantine era while it was 0.04 +/- 3.30 mm and 20.96 +/- 2.37 mm in the skulls belonging to the modern era. The average distance between the SOF/N and sagittal plane passing along the medial orbital wall was found to be 23.78 +/- 3.60 mm and 23.81 +/- 3.20 mm on the right and the left respectively in the skulls belonging to the Byzantine era while it was found to be 22.23 +/- 3.29 mm and 23.97 +/- 1.93 mm in the skulls belonging to the modern era. The average value of the distance between the sagittal planes passing along the lateral and medial sides of the orbit and the ratios between the distance from SOF/N to the sagittal plane passing along the lateral side of the orbit was found to be 1.47 +/- 0.21 mm and 1.60 +/- 0.08 mm respectively in the skulls belonging to the Byzantine era and the modern era. No significant difference was found between this ratio and the golden ratio; the average value of the ratios between the distance from the SOF/N to the sagittal plane passing along the midline of the skull and the distance from the SOF/N to the sagittal plane passing along the lateral side of the orbit was found to be 0.98 +/- 0.26 mm and 1.04 +/- 0.36 mm respectively in the skulls belonging to the Byzantine era and the modern era. A significant difference was found between this ratio and the golden ratio for both historical periods (modern society and late Byzantine period) (p < 0.005). The comparison of the relevant anatomic characteristics of the SOF/N is very important for anthropologists while a broad knowledge on proportional calculations regarding morphometric values and the location are important for reconstructive surgeons and the experts in forensics and pain control.

Las órbitas óseas son cavidades del esqueleto situadas a cada lado de la nariz. Se conocen las diferencias raciales en las medidas orbitales. El objetivo del presente estudio era determinar las distancias de varias fisuras y foramen en la órbita en relación a ciertos puntos de referencia óseos / quirúrgicos sobre los márgenes orbitales en la población india, lo que puede ser útil durante la cirugía orbital. La distancia de canal óptico (OC), fisura orbitaria superior (SOF), fisura orbital inferior (IOF) y forámenes lagrimales (LF) se mide a partir de puntos de referencia como cresta lacrimal anterior (ALC) para la pared medial, muesca/foramen supra orbital (SN) para la pared superior, sutura cigomática frontal (FZ) de la pared lateral y un punto en el margen inferior (OIM) justo encima del agujero infraorbitario. Se midió la distancia del foramen etmoidal anterior y posterior (AEF y PEF) de ALC. Se observó la presencia de foramen etmoidal media (MEF) y forámenes lagrimales (LF).La distancia media de OC fue 39,71 ±2,67 mm(deALC), 45,11 ±3,4 mm(de SN) , 48,32 ±2,8 mm(de FZ ) y 45,97 ±3,9 mm(de OIM). La distancia segura para el nervio óptico para cada pared orbital se calcula restando5 mmde la distancia más corta medida. The bony orbits are skeletal cavities located on either side of the nose. Racial differences in orbital measurements are known. The aim of the present study was to determine the distances of various fissures and foramen in the orbit with reference to certain bony / surgical landmarks on the orbital margins in Indian population which can be useful during various surgical procedures. The distance of optic canal (OC), superior orbital fissure (SOF), inferior orbital fissure (IOF), lacrimal foramen (LF) were measured from landmarks like anterior lacrimal crest (ALC) for medial wall, supraorbital foramen/ notch (SON) for superior wall, fronto-zygomatic suture (FZ) for lateral wall and a point on inferior margin (IOM) just above the infraorbital foramen. Distance of anterior and posterior ethmoidal foramen (AEF and PEF) from ALC was measured. The incidence of middle ethmoidal foramen (MEF) and lacrimal foramen (LF) was noted. The mean distance of OC was 39.71 ±2.67 mm(from ALC), 45.11 ±3.4 mm(from SN), 45.97 ±3.9 mm(from FZ) and 48.32 ±2.8 mm(from IOM). The safe distance for optic nerve for each orbital wall was derived by subtracting5 mmfrom the shortest measured distance.

Common opossums (Didelphis marsupialis) are found throughout the Caribbean island of Trinidad and Tobago. The present work was conducted on 10 skulls and mandibles of the common opossum to describe the osteology and foramina of these skulls and mandibles grossly and radiographically. The information that is garnered can be used to detect, diagnose, and treat head affections, as well as for comparative studies with the skulls and mandibles of other similar species. The skulls and mandibles were prepared and cleaned using standard method. All of the characteristic features of various standards views of the skulls bones, including dorsal, lateral, caudal and midsagittal, and the lateral and caudal views of the mandibles as well as the foramina of the skulls and mandibles were described and discussed. Each skull was divided into long facial and short cranial regions. No supraorbital foramen was observed in the skulls. The tympanic bulla was absent while there was the tympanic process of the alisphenoid. The temporal process of the zygomatic bone, zygomatic process of maxilla, and zygomatic process of the squamosal bone formed the zygomatic arch. The dental formula was confirmed. The bones and foramina of the skull and mandible were similar to other marsupial species and were homologue to that of other mammals.

Objectives. To determine safe distances within the orbit outlining reliable operative area on the basis of multislice computed tomography (MSCT) scans. Patients and Methods. MSCT of orbits of 50 Caucasian patients (26 males and 24 females, mean age 56) were analysed. Native scans resolutions were in all cases 0.625 mm. Measurements were done in postprocessing workstation with 2D and 3D reconstructions. The safe distances values were calculated by subtracting three standard deviations from the arithmetical average (X=AVG-3 STD). This method was chosen because this range covers 99.86% of every population. Results. The results of the measurements in men and women, respectively, are as follows (1) distance from optic canal to supraorbital foramen, mean 46,49 mm and 43,29 mm, (2) distance from the optic canal to maxillozygomatic suture at the inferior margin of the orbit mean 45,24 mm and 42,8 mm, (3) distance from the optic canal to frontozygomatic suture 46,15 mm and 43,58 mm, (4) distance from the optic canal to anterior lacrimal crest 40,40 mm and 38,39 mm, (5) distance from superior orbital fissure to the frontozygomatic suture 34,06 mm and 32,62 mm, and (6) distance from supraorbital foramen to the superior orbital fissure 42,32 mm and 39,39 mm. Conclusion. The most probable safe distances calculated by adopted formula were for the superior orbital fissure 23,39–30,58 mm and for the orbital opening of the optic canal 31,9–38,0 mm from the bony structures of the orbital entrance depending on the orbital quadrant.

Introduction: Supraorbital foramen is an important site for various surgical and anesthetic procedures. Accurate localization of the foramen holds the key to success, although racial variations exist in various population groups. The study included the morphometry of supraorbital foramen and its location with respect to nearby anatomical landmarks. Methods: A total of 100 dry skulls (60 male and 40 female) were collected and observed for the study. Various parameters in the sagittal and transverse planes were noted from supraorbital foramen on both sides, together with its vertical and horizontal dimensions. In addition, the location of supraorbital foramen with respect to midline and frontozygomatic suture were noted. Results: The study of 100 adult skulls revealed that the SON (71% on right and 70% on left) was found more frequently than the SOF (29% on right and 30% on left). The distance between centre of SOF/SON and midline was found to be statistically significant on right and left sides. Conclusions: This study makes possible the identification of exact position of supraorbital foramen and also discuss its racial variation.

To correlate the location and size of supraorbital notches (SON) and foramen (SOF) with migraine headache symptoms in a migraine patient population.A retrospective review was performed on consecutive patients who were candidates for frontal migraine surgery with available preoperative computed tomography (CT) images of the face/perinasal sinuses. The supraorbital anatomy from CT images was analyzed and correlated with presenting migraine headache symptoms. To assess for anatomic variations associated with migraine headaches, normative anatomic data were obtained by performing a meta-analysis.Fifty-six patients were included, 95% were female, aged 17-80 (mean = 47) years. Bilateral SON were present in 58.9% patients, combination of SON/SOF in 25%, and bilateral SOF in 16.1%. SOF mean diameter (1.22 mm) was 45% smaller than SON (2.20 mm, p 0.0001). The mean lateral distance from midline for SOF (2.74 cm) was ~0.5 cm farther than SON (2.25 cm, p 0.0001). Migraine patients with SOF had 178.6% longer mean migraine headache duration (p = 0.0020), 9.8% higher intensity (p = 0.0052), and 91.4% greater migraine headache index (p = 0.0498) compared to those without SOF. Compared to normative patient data, migraine patients are more likely to have SON/SOF (100% vs. 83%, p = 0.0047) and have mean SON and SOF diameters that are 34.3-41.5% smaller (p 0.0001).Nerve compression at SON and especially SOF contributes significantly to migraine headache symptoms, and these structures (if present) should be released during frontal migraine surgery. Given the variable presence and location of SON/SOF, analysis of available face/perinasal sinus CT images helps preoperative planning for foraminotomy and band release.

The meningo-orbital foramen (FMO) is an osteal opening, containing vessels providing an accessory blood supply to the orbit, situated close to the superior orbital fissure. Recent studies show FMO to be ubiquitous, with localization and occurrence varying, depending on a population, what may be due to environmental conditions (ie, temperature). It is often located near the operating area in surgeries in the orbital cavity, and its accurate localization allows avoiding unexpected bleeding during intervention. Because there is a lack of clarity in the literature concerning the morphology and the morphometry of the FMO, this study aimed to clarify the issue with clinical relevance. We studied dry adult human skulls (50 men and 33 women). The morphology and minimal distances between the FMO and standard anthropologic landmarks (nasion, frontomalare orbitale, supraorbital foramen, and zygomaticomaxillary suture) were measured, using MicroScribe G2L, a three-dimensional contact scanner. We compared the result with results of previous studies on populations from various climate zones. The FMO was present in 69.88% of the skulls (56.02% of orbits): in 60.34% of the skulls, the FMO was bilateral; and in 39.66%, unilateral. We observed 74 single, 10 double, and 2 triple foramina. The FMO was present mostly on the sphenoid and the frontal bone. There was no difference in minimal distances between the FMO and the anthropologic landmarks, depending on sex, except the distance to the nasion (shorter in women). The occurrence of the FMO in the population differed from that of other populations. The results show that it is possible that the morphology and the morphometry of the FMO depend on the climate zone or ambient temperature during growth, which should be considered before performing surgery in the orbital cavity.