Intramuscular Nerve Distribution in the Medial Rectus Muscle and Its Clinical Implications

Shin, Hyun Jin; Lee, Shin‐Hyo; Ha, Tae-Jun; Koh, Ki‐Seok

doi:10.1080/02713683.2018.1562556

Cited by 14 publications

(21 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Skeletal muscles are not monolithic structures (Peng et al, ), and may contain neuromuscular compartments or functional zones that are responsible for different biomechanical functions (Demer et al, ; Oh et al, ; Mu and Sanders, ; Holtermann et al, ; Peng et al, ; Demer et al, 2011; Clark and Demer, ; Demer and Clark, ; Shin et al, , ). English et al () proposed a hypothesis with respect to muscles' compartmentalization that he referred to as “the partitioning hypothesis.” This hypothesis is based on the fact that neurovascular compartments “[…] are distinct subvolumes of a muscle, each innervated by an individual muscle nerve branch and each containing motor unit territories with a unique array of physiological attributes” (p. 857).…”

Section: Discussionmentioning

confidence: 99%

“…To visualize the abducens nerve's intramuscular distribution of subbranches, the isolated lateral rectus muscles were stained using Sihler's whole mount nerve staining technique using the procedure Mu and Sanders () described, which allowed the detailed lateral rectus intramuscular innervation pattern to be evaluated. Based on our earlier experience and on the current literature, the procedure was modified for a small muscle mass (Wysiadecki et al, , Shin et al, , ). The initial phase of Sihler's Stain (i.e., maceration and depigmentation) requires 3 to 5 weeks.…”

Section: Methodsmentioning

confidence: 99%

“…Moreover, different neuromuscular compartments within a single muscle may serve different biomechanical functions (Demer et al, ; Oh et al, ; Peng et al, ; Demer et al, ; Shin et al, , ). Theoretically, the characteristic intramuscular distribution of the nerve subbranches within the horizontal rectus extraocular muscles allows selective activation of specific areas (zones) that control specific movements or phases of movement (Goldberg et al, , ; Demer et al, ; Oh et al, ; Guthrie, ; Peng et al, ; Demer et al, 2011; Clark and Demer, ; Demer and Clark, ; Shin et al, , ). To take a specific example, although the main function of the lateral rectus muscle's is abduction of the eyeball, some data point to differential lateral rectus compartmental contraction during the vestibulo–ocular reflex (Clark and Demer, ), as well as during conjugate and converged ocular adduction (Demer and Clark, ).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Intramuscular innervation of the lateral rectus muscle evaluated using sihler's staining technique: Potential application to strabismus surgery

2019

View full text Add to dashboard Cite

The latest research suggests that the abducens nerve may be divided into subbranches that reach functionally distinct zones of the lateral rectus muscle. The goal of the study was to examine this muscle's innervation, including the detailed distribution of the intramuscular subbranches of the abducens nerve. Twentyfive lateral rectus muscle specimens were harvested (with the orbital segment of the abducens nerve), fixed in 10% formalin solution, and stained with Sihler's whole mount nerve staining technique. Subbranches running to the lateral rectus divided into two main groups: superior and inferior. Both groups of subbranches are distributed in a fan-shaped manner, show a characteristic "tree-like" branching pattern and form terminal plexus near the proximal half of the lateral rectus muscle. However, some smaller subbranches run as far as the muscle's insertion, and recurrent subbranches also reach its origin. With respect to their course to the muscle's origin or insertion, the smallest subbranches running within the muscle may be associated with innervation of the tendon. In the majority of cases (88%), superior and inferior subbranches of the abducens nerve overlapped in the central one-third of the lateral rectus muscle's width so that any clearly distinct anatomical segments of the muscle could be observed based on Sihler's technique. In the remaining 12% of specimens, superior and inferior groups of subbranches innervated two distinct compartments of the lateral rectus muscle with no overlapping. Dense, fan-shaped distribution of abducens nerve intramuscular subbranches can be observed within the lateral rectus muscle. Clin. Anat. 33:585-591, 2020.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Intramuscular innervation of the lateral rectus muscle evaluated using sihler's staining technique: Potential application to strabismus surgery

2019

View full text Add to dashboard Cite

show abstract

“…e statement of Farzavandi [1], who concluded that "An intimate knowledge of anatomy, including the extraocular muscles, periocular fascia, and orbit, is necessary to be an accomplished strabismus surgeon," became a motto of the presented review. Development of modern surgical techniques is associated with the need for a thorough knowledge of surgical anatomy and, in the case of ophthalmologic surgery, also functional aspects of extraocular muscles [1][2][3][4][5][6]. However, getting familiar with the numerous data that appear in various scientific journals may be difficult and time consuming.…”

Section: Introductionmentioning

confidence: 99%

Normal Anatomy and Anomalies of the Rectus Extraocular Muscles in Human: A Review of the Recent Data and Findings

Haładaj

2019

BioMed Research International

View full text Add to dashboard Cite

Development of modern surgical techniques is associated with the need for a thorough knowledge of surgical anatomy and, in the case of ophthalmologic surgery, also functional aspects of extraocular muscles. Thus, the leading idea of this review was to summarize the most recent findings regarding the normal anatomy and anomalies of the extraocular rectus muscles (ERMs). Particular attention was paid to the presentation of detailed and structured data on the gross anatomy of the ERMs, including their attachments, anatomical relationships, vascularization, and innervation. This issue of ERMs innervation was presented in detail, considering the research that has recently been carried out on human material using advanced anatomical techniques such as Sihler’s technique of the nerves staining. The text was supplemented with a carefully selected graphic material (including anatomical specimens prepared specially for the purpose of this review) and discussion of the clinical cases and practical significance of the presented issues.

show abstract

“…Occasionally, some deviations from the typical anatomy of the CN III may be observed. Anatomical variations of the CN III may have significant clinical importance both during surgical procedures carried out inside the orbit, and when diagnosing clinical symptoms of damage to CN III or its branches [4,7,15,23,26]. Thus, the goal of this work was to describe the anatomy of orbital segment of the CN III.…”

Section: Introductionmentioning

confidence: 99%

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

2021

View full text Add to dashboard Cite

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.

show abstract

Intramuscular Nerve Distribution in the Medial Rectus Muscle and Its Clinical Implications

Cited by 14 publications

References 16 publications

Intramuscular innervation of the lateral rectus muscle evaluated using sihler's staining technique: Potential application to strabismus surgery

Intramuscular innervation of the lateral rectus muscle evaluated using sihler's staining technique: Potential application to strabismus surgery

Normal Anatomy and Anomalies of the Rectus Extraocular Muscles in Human: A Review of the Recent Data and Findings

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

Contact Info

Product

Resources

About