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Facial anatomy
Published in Michael Parker, Charlie James, Fundamentals for Cosmetic Practice, 2022
The maxillae are the bones which form the medial aspect of the cheek (Figure 3.4), positioned between the nasal bone and zygoma. They have three primary functions: Allowing a point of anchor for the upper teeth in the alveolar processForming the floor and lateral wall of the nasal cavityForming part of the medial wall of the orbit The point of fusion of the maxillae is at the midline immediately inferior to the nose at the intermaxillary suture. Aside from structural support, the maxillae contain sinuses which are important in both altering the depth of voice as well as keeping decreasing the weight of the facial bones. The maxilla is also the site of the infra-orbital foramen, which is located just below the infraorbital margin of the orbit, at an average distance of 6–10 mm inferiorly in the midline. The infraorbital foramen is important in the transmission of the infraorbital artery, vein and nerve, and therefore, this region must be respected, especially in the context of dermal filler administration as it is at risk of avascular necrosis, filler embolisation and neuronal damage.
Head and Neck
Published in Bobby Krishnachetty, Abdul Syed, Harriet Scott, Applied Anatomy for the FRCA, 2020
Bobby Krishnachetty, Abdul Syed, Harriet Scott
The infraorbital nerve is the terminal branch of the maxillary nerve (V2) and surfaces the face through the infraorbital foramen where it is blocked. Indications: cleft lip/palate repair, endoscopic sinus surgery, rhinoplasty and transsphenoidal hypophysectomy.Procedure: the infraorbital foramen is identified just below the orbital rim 3 cm from the midline of the face. In the intraoral approach, a 25G needle is inserted into the buccal mucosa at the level of the first premolar and directed upward and outward and 1–2 ml of local anaesthetic is injected after negative aspiration. Specific complications: haematoma, persistent paraesthesia and numbness of the upper lip, penetration of the foramen leading to damage of nerve and orbital contents.
Orbit
Published in Swati Goyal, Neuroradiology, 2020
The inferior orbital fissure, present between the floor and the lateral wall of the orbit, contains the inferior ophthalmic vein, the infraorbital artery, and the infraorbital nerve (a branch of the maxillary division of trigeminal nerve). The infraorbital foramen crosses the floor of the orbit and carries the infraorbital artery, vein, and nerve from the inferior orbital fissure.
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
To our knowledge, a transcutaneous approach for biopsy of the infraorbital nerve has not yet been described in the literature. As with all surgical procedures, it is important for the surgeon to counsel patients preoperatively and to be aware of the local anatomy. In this case series, four patients underwent minimally invasive transcutaneous infraorbital nerve biopsy, and findings from biopsy were sufficient for diagnosis of perineural invasion of squamous cell carcinoma. All patients had V2 hypoesthesia prior to surgery. If patients present with partial V2 hypoesthesia, they should be counseled that total hypoesthesia may be an expected sequela of the procedure. Postoperatively, all cases displayed good wound healing of the surgical site with no adverse events and no complaints of new or worsening symptoms. Understanding the anatomy of the infraorbital region and infraorbital nerve is necessary to guide the biopsy and prevent iatrogenic injury to surrounding structures.44–46 The infraorbital nerve can be located at its egress from the infraorbital foramen and is often palpable. When palpation is difficult, anatomic landmarks can help predict the location of the infraorbital foramen (Figure 3). Surgeons must be aware of the variations in infraorbital nerve anatomy. Multiple nerve foramina and offshoots of the infraorbital nerve have been reported, and knowledge of these possible variants will allow for proper localization and biopsy of the nerve.46,48
Complications associated with infraorbital filler injection
Published in Journal of Cosmetic and Laser Therapy, 2020
Shivani Reddy, Tuyet A. Nguyen, Nima Gharavi
Notable vasculature in this region include the infraorbital artery, angular artery, dorsal nasal artery, and zygomaticofacial artery (Figure 1). The infraorbital foramen, from which the infraorbital artery and nerve exit, is typically located medially 1/3 of the distance between the medial and lateral canthi, and on average between 6.3–10.9 mm below the infraorbital rim and is not reported to change significantly with age (6,7). The angular artery, a branch of the facial artery, courses along the medial periorbital area and anastomoses with the dorsal nasal artery here (6). This artery can have variations in location, and in some may be located more superficially in the subcutaneous tissue. The zygomaticofacial artery and nerve arise from a foramen at the lateral orbital rim about 0.5–1.0 cm below the horizontal line at the lateral canthus (8).