Comparison of lateral and medial rectus muscle in human: an anatomical study with particular emphasis on morphology, intramuscular innervation pattern variations and discussion on clinical significance

Haładaj, Robert

doi:10.1007/s00276-019-02400-x

Cited by 10 publications

(14 citation statements)

References 31 publications

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“…In the presented study the mean number of muscular sub-branches reaching the medial rectus muscle was 5.7 (median = 6). However, in one recent study based on Sihler's stain, the number of nervous branches reaching the medial rectus muscle from 4 to 8 (mean = 5.4, median = 5) [13]. to reach its target muscle.…”

Section: Discussionmentioning

confidence: 93%

Anatomical study on branching pattern and variations of orbital segment of the oculomotor nerve

2021

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Background: This study aims to revisit the anatomy of orbital segment of the CN III. The study also involved morphometric measurements of CN III muscular branches. Detailed description of observed anatomical variations and their incidence was also included. The study supplements earlier findings with detailed observations of the neuromuscular relations. Materials and methods:The study was conducted on 52 orbits taken from 26 cadaveric heads (10 males and 16 females; Central European population).Results: Anatomical variations of the orbital segment of the CN III observed on the examined material involved both the superior and inferior branch of this nerve. The muscular branch innervating the levator palpebrae superioris muscle occasionally pierces the superior rectus muscle. The nerve to the inferior oblique muscle may pierce and innervate the inferior rectus muscle. In rare instances, duplication of the parasympathetic root of the ciliary ganglion may also occur. Among the muscular branches, the smallest diameter reached the branch to the levator palpebrae superioris muscle. Among the three muscular branches derived from the inferior branch of the CN III, the nerve to the inferior oblique was the longest one; Its length varied from 28.9 mm to 37.4 mm. The shortest was the muscular branch to the inferior rectus muscle. Its length varied from 0 mm (when muscular sub-branches arose directly from the nerve to the inferior oblique muscle) to 7.58 mm. Conclusions:This study presented the characteristic of orbital segment of the CN III, including anatomical variations and morphometric measurements relevant to intraorbital procedures.

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Section: Discussionmentioning

confidence: 93%

Anatomical study on branching pattern and variations of orbital segment of the oculomotor nerve

2021

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“…First, we obtained the local bioethics committee's approval for the study, which was conducted on 70 (32 left and 38 right) cadaveric hemiheads. The bony dissections were performed using protocols described previously [19][20][21][22][23]. The roof and a large part of the orbit's lateral wall were removed on both sides using a Luer bone rongeur and bone chisel.…”

Section: Methodsmentioning

confidence: 99%

“…This technique allowed the muscles' detailed intramuscular innervation pattern to be visualized. Based on our earlier experience, the concentration of individual chemicals was adjusted for a small muscle mass [21][22][23]. During the procedure's first stage, maceration and depigmentation, isolated muscles were immersed in a reduced concentration of KOH solution (2.5% versus 3% according to the original recipe) [21][22][23].…”

Section: Methodsmentioning

confidence: 99%

“…Whole mount nerve staining was performed using standard "Sihler's solution II" [15,16]; this stage took up to two weeks. During the last stage (destaining), a lower concentration of acetic acid in "Sihler's solution I" was used to control the destaining process better (0:5 : 1:5 : 6 = glacial acetic acid : glycerin : 1%aqueous chloral hydrate) [21][22][23]. The course of each stage varied among individual specimens depending on the sample's quality.…”

Section: Methodsmentioning

confidence: 99%

“…However, the location of muscular subbranches' terminal endings seems to vary slightly among the muscles and the mean distance between the muscle's insertion. The nerves' subbranches' anterior-most terminations referenced (a quotient) to the muscle's total length may be estimated at 37.8% for the inferior rectus muscle, 40.9% for the superior rectus muscle, 43.3% (based on Haładaj et al [21]) or 42.8% (based on Haładaj [23]) for the lateral rectus muscle, and 43.7% for the medial rectus muscle (based on [23]).…”

Section: Superior and Inferior Rectus Muscles' Innervationmentioning

confidence: 99%

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Comparison of the Superior and Inferior Rectus Muscles in Humans: An Anatomical Study with Notes on Morphology, Anatomical Variations, and Intramuscular Innervation Patterns

Haładaj

Polguj

Tubbs

2020

BioMed Research International

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A comparison of the superior and inferior rectus muscles was performed to determine whether they have similar structures and innervation attributable to their participation in the same type of, although antagonistic, eye movements. The study was conducted on 70 cadaveric hemiheads, and the anatomical variations in the superior and inferior rectus muscles were assessed. Sihler’s whole mount nerve staining technique was used on 20 isolated superior and 20 isolated inferior rectus muscle specimens to visualize the intramuscular distribution of the oculomotor nerve subbranches. In two cases (~2.8%), variant muscular slips were found that connected the superior and inferior rectus muscles. In 80% of cases, muscular branches arising directly from the inferior branch of the oculomotor nerve innervated the inferior rectus muscle, while in 20% of cases, the nerve to the inferior oblique muscle pierced the inferior rectus muscle and provided its innervation. In 15 of 70 specimens (21.4%), a branch to the levator palpebrae superioris muscle pierced the superior rectus muscle. The distance between the specific rectus muscle’s insertion and the anterior-most terminations of the nerves’ subbranches with reference to the muscle’s total length ranged from 26.9% to 47.2% for the inferior rectus and from 34.8% to 46.6% for the superior rectus, respectively. The superior rectus muscle is slightly longer and its insertion is farther from the limbus of the cornea than is the inferior rectus muscle. Both muscles share a common general pattern of intramuscular nerve subbranches’ arborization, with characteristic Y-shaped ramifications that form the terminal nerve plexus located near half of the muscles’ length. Unexpected anatomical variations of the extraocular muscles may be relevant during orbital imaging or surgical procedures.

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Efforts to improve the surgical outcome for exotropia and investigation of the insertion locations of the extraocular muscles

Lai

Chang

2023

The Kaohsiung J of Med Scie

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In our previous retrospective study, we found that using the strabismus surgery dosages established by western strabismus mentors tends to result in undercorrection of Taiwanese exotropia (XT) patients compared with those in western populations. We also discovered that the location of extraocular muscle (EOM) insertion could vary by ethnicity. In this study, using a generalized estimation equation model, we compared the XT surgery outcome between augmented and original strabismus surgery dosages in Taiwanese patients. We also conducted an observational study to investigate the horizontal EOM insertion location in a Taiwanese population and compared the data with Dr. Apt L.'s study. For Taiwanese XT patients, augmented surgical dosages resulted in significantly better outcome at 6 months and 1 year postoperatively compared with original surgical dosages (p = 0.003 and p < 0.001, respectively). The distance from the lateral recuts muscle (LR) insertion location to the limbus was significantly shorter in Taiwanese than in white Americans (6.5 vs. 6.9 mm, respectively, p = 0.0001). Furthermore, the medial rectus muscle and LR insertion locations differed significantly between males and females (p < 0.001 and p = 0.023, respectively). The patients' sex did not affect the surgery outcome. Augmented surgery doses modified from western strabismus mentors produce better surgery outcome for Taiwanese XT patients. Surgeons may require country‐specific guidelines for strabismus surgery dosage. We also demonstrated a simple method for young ophthalmologists to establish their own normograms to improve their surgical success rate. Our study confirms that LR insertion locations differ between Taiwanese and White Americans.

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Comparison of lateral and medial rectus muscle in human: an anatomical study with particular emphasis on morphology, intramuscular innervation pattern variations and discussion on clinical significance

Cited by 10 publications

References 31 publications

Anatomical study on branching pattern and variations of orbital segment of the oculomotor nerve

Anatomical study on branching pattern and variations of orbital segment of the oculomotor nerve

Comparison of the Superior and Inferior Rectus Muscles in Humans: An Anatomical Study with Notes on Morphology, Anatomical Variations, and Intramuscular Innervation Patterns

Efforts to improve the surgical outcome for exotropia and investigation of the insertion locations of the extraocular muscles

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