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Anatomy and Embryology of the Mouth and Dentition
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
The upper lip is supplied by the infraorbital branch of the maxillary nerve (Figure 41.9). Running along the floor of the orbit in the infraorbital canal, it enters the face at the infraorbital foramen, where its labial branch runs downwards to supply the upper lip. The mental nerve is a terminal branch of the inferior alveolar nerve and exits the mandible at the mental foramen to supply the lower lip (see Figure 41.9).
Disorders of the Orbit
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
Nithin D. Adappa, James N. Palmer
Start by elevating the periorbita off the medial orbital floor. Use a spoon curette to down fracture the medial aspect of the orbital floor. The bone of the orbital floor is significantly thicker than the medial orbital wall and requires increased force. The bone often fractures in one large piece at the infraorbital canal junction. Note that if the down fracturing is not performed bilaterally, there is an increased risk for post-operative diplopia, especially in the horizontal plane.
Nerve injuries and repair
Published in John Dudley Langdon, Mohan Francis Patel, Robert Andrew Ord, Peter Brennan, Operative Oral and Maxillofacial Surgery, 2017
A small round bur is used to create a groove around the infraorbital foramen. The bone around the foramen is carefully removed with Rongeur forceps. The infraorbital canal is carefully unroofed exposing the infraorbital nerve until 1 cm beyond the injury site, and may reach the orbital floor (Figure 7.10).
Immunoglobulin G4-related disease presenting with Raynaud’s phenomenon
Published in Scandinavian Journal of Rheumatology, 2021
A 55-year-old Japanese man presented with repeated white and cyanotic changes in his fingers. Three months prior to his visit, a sensation of facial puffiness was noted. Two weeks prior to admission, Raynaud’s phenomenon was noted. His medical history included hypertension, asthma, and chronic sinusitis. He was taking telmisartan and inhaled budesonide/formoterol. On physical examination, his blood pressure was 146/70 mmHg, pulse rate was 88 beats/min, respiratory rate was 16 breaths/min, and temperature was 36.8°C. He was alert and conscious. His bilateral lachrymal and submandibular glands were swollen. His right axillary and right inguinal lymph nodes were enlarged and palpable. His fingertips were cyanotic (Figure 1). Skin sclerosis was not observed in his fingers or forearms. The neurological examination results were normal. Laboratory findings showed that the complete blood cell count, electrolyte panel, and serum chemistry were normal. Serum IgG and IgG4 levels were elevated to 3855 mg/dL and 1420 mg/dL, respectively. The erythrocyte sedimentation rate was 99 mm/h and the C-reactive protein level was 0.62 mg/dL. Anti-nuclear antibody, rheumatoid factor, anti-neutrophil cytoplasmic antibodies, and cryoglobulin were negative. Computed tomography showed diffuse pansinusitis with mucosal thickening; multiple lymphadenopathies in the cervical, axillary, and mediastinal areas; swelling of the infraorbital and femoral nerve; intrapelvic nodules; and enlargement of the infraorbital canal (Figure 2).
Use of computer-assisted surgery in the orbit
Published in Orbit, 2022
Ashley A. Campbell, Nicholas R. Mahoney
CAS can be useful in identifying danger zones pre-operatively for avoiding them intra-operatively in orbital surgery. Manual object creation can be performed to mark structures such as the ethmoidal arteries, the infraorbital canal, aberrant neurovascular bundles, areas of particularly anteriorly tipped temporal lobes and large vascular channels in the sphenoid bone. Intra-operatively, the suction can be programmed to identify the area to be avoided and emit a sound when it is approached. Cases involving thin or dehiscent bone along the orbital roof (Figures 7 & 8) are particularly helped to avoid a cerebral spinal fluid leak.
A direct transcutaneous approach to infraorbital nerve biopsy
Published in Orbit, 2022
Kelly H. Yom, Brittany A. Simmons, Lauren E. Hock, Nasreen A. Syed, Keith D. Carter, Matthew J. Thurtell, Erin M. Shriver
Three patients underwent magnetic resonance imaging (MRI). One patient was unable to undergo MRI due to a cardiac pacemaker and was instead imaged with computed tomography (CT) (Figure 1). Of the three patients who underwent MRI, two showed enhancement of the infraorbital nerve with proximal extension along CN V and one patient had atrophy of the ipsilateral extraocular muscles. The patient who underwent CT had a mass lesion at the orbital apex and erosive bony changes in the infraorbital canal without clear enlargement or enhancement of the cranial nerves.