Facial Nerve Supply to the Orbicularis Oculi around the Lower Eyelid: Anatomy and Its Clinical Implications

Abstract

In the lower eyelid, the vertical sensory and the oblique motor nerve supplies are independent and clearly distinguished in aspect of their own routes. The medial orbicularis motor line represents the motor route to the medial portion of the orbicularis oculi. These results might provide valuable knowledge about surgical anatomy for safe lower blepharoplasty with or without midface lift.

Variability in facial‐muscle innervation: A comparative study based on electrostimulation and anatomical dissection

“…The data also explain why the superior (frontalis muscle) and inferior (DAO, platysma) muscles show the highest incidences of postoperative palsy following facial surgery (Gaillard et al, ; Daane and Owsley, 2013). We also confirm that the orbicularis muscles (oris and mainly the oculi) are “anatomically” protected by multiple innervation and/or interconnections (Choi et al, ); complete palsy of these muscles is unusual. Furthermore, we now understand why full orbicularis oculi palsy is only seen in patients with total proximal nerve lesions, such as occurs following sectioning of the facial nerve trunk and rarely after an isolated lesion in the temporofacial trunk.…”

“…We focused on six different branches, as described in previous studies (Hwang et al, ; Sachs et al, ; Kurita et al, ; Davies et al, ; Chatellier et al, ; Righini et al, ; de Bonnecaze et al, ; Frigerio et al, ; Choi et al, ): the temporal, frontal, zygomatic, buccal, marginal mandibular, and cervical branches. In our dissections, the frontal branch was defined as the branch arising from the temporal branch and destined to the mimetic muscles of the fronto‐orbital region.…”

Septo-capsulopalpebral fascial recession flap technique in lower blepharoplasty: An experience of 453 consecutive cases and a review of the literature

“…To maintain the volume and tone of pretarsal OOM, it is important to preserve the innervation of the pretarsal portion of OOM. 7,10 In our method, while elevation of the skin-muscle flap, the muscular roll is separated and remained at the pretarsal portion of orbicularis oculi muscle, and a part of the preseptal portion was used to preserve the innervation of the muscular roll. The dissection area was carefully managed to avoid injuring the lower pretarsal branch of facial nerve at medial corner.…”

“…However, the medial canthal portion should be carefully dissected not to extend too much medially, to preserve the motor nerve innervation of the orbicularis oculi muscle. 7…”

The Monocle Sign in FDG-PET

“…The facial nerve innervates the mimic muscles, including the OOM. 1 This muscle is responsible for closing the eyelids and blinking. 2,3 Normal physiological uptake of the OOM is seen occasionally, however, uptake is typically bilaterally symmetric.…”