The Anatomical Relationships of the Ocular Motor Nerves with an Emphasis on Surgical Anatomy of the Orbit

Abstract

The surgical procedures directed to the orbit are invariably reported to be one of the most challenging procedures of the neurosurgery and it is very important to take measures to protect the ocular nerves. Many researchers have tried to identify safe approaches or safe regions in the orbit but the suggestions and results vary among published studies. The ocular motor nerves are under risk of injury during various approaches to the orbit. Simple but careful attention to potential variations in the origin and anatomical course of the ocular nerves and their relationships to the orbit may help to define "safe zones" during various approaches, thus, help to enhance clinical outcomes. The objective of this review, therefore, is to discuss the surgical anatomy of the orbit with special emphasis on oculomotor, trochlear, and abducens nerves and further emphasize their relationships with a surgical point of view during various approaches directed to the orbit. Anat Rec, 2018. © 2018 Wiley Periodicals, Inc.

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

“…The CN III provides motor innervation to the levator palpebrae superioris and almost all extraocular muscles except the superior oblique and lateral rectus muscle. It also carries preganglionic parasympathetic fibres to the sphincter pupillae and the ciliary muscles of the eye [1,10,22,24,27]. Those fibres enter the ciliary ganglion through the motor (parasympathetic) root of the ganglion.…”

Cranial Nerves: Phylogeny and Ontogeny

“…The morphology and clinical relevance volume includes gross anatomical and/or surgical approaches to cranial nerves III, IV, and VI (Apaydin et al, ); V including neuralgia (Ruiz‐Juretschke et al, ) and mandibular patterning (Sakaguchi et al, ); VII intracranial (Aristegui et al, ) and extracranial (Martinez Pascual et al, ); XI extracranial course (Sakamoto, ) and carotid sinus nerve (Porzionato et al, ); X focused on larynx innervation (Martin‐Oviedo et al, ); XI on topographical surgical relevance (Johal et al, ), and XII on its branching pattern (Sakamoto, ).…”

A Toast to the Cranial Nerves

“…Examples of all this morphological and functional complexity, with obvious consequences for the clinical aspects of the cranial nerves, are provided by the papers in this second volume of the Special Issue Cranial Nerves of The Anatomical Record . The papers provide perspectives about the surgical anatomy of the orbit, with special emphasis on oculomotor, trochlear, and abducens nerves (Apaydin et al, ), the importance of the variability of the facial nerve to other surrounding structures within the petrous portion of the temporal bone (Arístegui et al, ), as well as through the extra‐cranial course (Martínez Pascual et al, ), the vascular relationships of the trigeminal nerve in patients with classic trigeminal neuralgia (Ruiz‐Juretschke et al, ), the extra‐cranial course and branching pattern of the glossopharyngeal nerve (Sakamoto, ), the spatial relationships of the hypoglossal nerve with the tongue and associated muscles (Sakamoto, ), the clinical implications of the anatomy and function of the carotid sinus nerve (originated from the glossopharyngeal nerve, Porzionato et al, ), the innervation of the masticatory muscles (Akita et al, ), the morphology, embryology, surgical anatomy, and clinical manifestations of the accessory nerve (Johal et al, ), and the innervation of human larynx, describing the difficulty of carrying out laryngeal nerve reinnervation procedures (Martín‐Oviedo et al, ).…”