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Head and Neck Muscles
Published in Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Handbook of Muscle Variations and Anomalies in Humans, 2022
Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Warrenkevin Henderson, Hannah Jacobson, Noelle Purcell, Kylar Wiltz
Orbicularis oculi is comprised of orbital, palpebral, and lacrimal parts and a ciliary bundle (Standring 2016). The fibers of the orbital part form complete ellipses around the orbit and originate from the nasal part of the frontal bone, the frontal process of the maxilla, and the medial palpebral ligament (Standring 2016). These fibers form depressor supercilii (Macalister 1875; Standring 2016). The fibers of the palpebral part originate from the medial palpebral ligament, course across the eyelids, and end as the lateral palpebral raphe (Standring 2016). The fibers of the lacrimal part originate from the lacrimal bone and insert into the tarsi of the eyelids and the lateral palpebral raphe (Standring 2016).
Adult skull fractures
Published in Helen Whitwell, Christopher Milroy, Daniel du Plessis, Forensic Neuropathology, 2021
Linear frontal fractures are also encountered in the context of accelerated falls to the front of the head. As with occipital fractures, they are commonly associated with external injuries such as lacerations and bruising. Frontal fractures are most commonly vertically oriented and extend towards the face inferiorly and the parietal skull posteriorly. Most fractures remain ipsilateral to the point of contact with the ground. However, it is not uncommon to find that the fractures curve posteriorly and cross the midline away from the region of impact. They may also terminate within the sutures, causing these sutures to spring (frontal or sagittal). With linear fractures of the frontal bone, shorter emanating fractures may be identified. Inferiorly the fracture may extend in a variety of directions: into the roof of the orbit through the supraorbital ridge, posteriorly across the anterior cranial fossa (Figure 7.4). The fracture may also extend down the inside of the orbit across its medial wall, through the lacrimal bone and down into the maxilla (Figure 7.5). These fractures may also involve the hard palate. Again, as with occipital fractures, it is important to establish the point of contact for the initial blunt force trauma. Occasionally a frontal fracture may represent a secondary impact, after injury to the posterior scalp. These accelerating forces may be associated with a depressed fracture which may be comminuted.
Head and Neck
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
The orbital margin is formed by the frontal bone superiorly, zygomatic bone laterally (which includes the frontal process and temporal process) and the maxillary bone (or maxilla) medially, which also spans a good portion of the skull. The maxilla includes a frontal process along this orbital margin, an alveolar process above the teeth, an anterior nasal spine located at the bottom of the nasal region protruding out, an incisive foramen, and palatine process along the roof of the oral cavity, an anterior lacrimal crest bordering the anterior portion of the lacrimal groove, an infraorbital groove located on the floor of the orbit, and an infraorbital foramen just inferior to the orbital margin. The anterior nasal aperture is bounded by the nasal bones and maxillae. The nasal septum and the lacrimal bone (which includes the posterior lacrimal crest and lacrimal groove, all so-named because of their proximity to the lacrimal duct, which drains the tears of happiness that you will shed on completing your degree) can be seen in a frontal view of the anterior nasal aperture (Plates 3.7a and c and 3.8a and c).
Flap suturing endonasal dacryocystorhinostomy assisted by ultrasonic bone aspirator
Published in Acta Oto-Laryngologica, 2022
Hirohiko Tachino, Hiromasa Takakura, Hideo Shojaku, Michiro Fujisaka, Shinsuke Ito, Yutaro Oi, Anh Tram Do, Chiharu Fuchizawa, Tatsuya Yunoki, Atsushi Hayashi
The lacrimal sac sits in the lacrimal fossa, which is formed from the hard frontal process of the maxilla anteriorly and the thin lacrimal bone posteriorly. As the bone not only overlying the lacrimal sac but also underlying the anterior nasal mucosa is very thick, powered instruments such as drills have been widely used to remove the hard bone tissue. The inherent danger in using these devices is the possibility of injury to the underlying lacrimal sac or nearby nasal mucosa, which may result in failure of flap suturing. The ultrasonic bone aspirator (UBA), as a piezoelectric device, uses metal cutting tips oscillating at an ultrasonic frequency between 25 and 30 kHz. It selectively emulsifies the bone while displacing and preserving adjacent soft tissues [9]. The UBA may preserve delicate nasal mucosa during the DCR and facilitate the creation of lacrimal sac-nasal mucosal flaps [9,10]. Therefore, the purpose of the present study was to assess the advantage of the UBA during the osteotomy compared with the diamond burr in our new modified technique.
Lacrimal Fossa Bony Changes in Chronic Primary Acquired Nasolacrimal Duct Obstruction and Acute Dacryocystitis
Published in Current Eye Research, 2021
Mohammad Javed Ali, Dilip Kumar Mishra, Nandini Bothra
Primary acquired nasolacrimal duct obstruction (PANDO) is a common lacrimal drainage disorder usually managed with a dacryocystorhinostomy (DCR). Acute dacryocystitis and its sequelae can be complications of a pre-existing nasolacrimal duct obstruction and can be managed either medically first followed by surgery or a direct endoscopic DCR.1 The histopathological changes in the lacrimal sac in cases of PANDO and acute dacryocystitis are well known. However, the same is not true of the changes in the overlying bony lacrimal fossa. Since the lacrimal sac is housed in the bony lacrimal fossa (LF), it is only natural to be curious to know changes in the vicinity when the lacrimal drainage is diseased. Lacrimal bone involvement has been reported in tuberculous dacryocystitis.2 However, to the best of the authors’ knowledge, only three studies reported the bony findings in patients with PANDO earlier but with conflicting results.3–5 Of these, only one study was focused on bony changes.3 The current study has attempted to assess the bony lacrimal fossa changes in chronic cases of primary acquired nasolacrimal duct obstruction and acute dacryocystitis and add to the existing sparse literature on this topic.
Radiological findings of orbital blowout fractures: a review
Published in Orbit, 2021
Ma ReginaPaula Valencia, Hidetaka Miyazaki, Makoto Ito, Kunihiro Nishimura, Hirohiko Kakizaki, Yasuhiro Takahashi
The bony elements of the lacrimal passage (the lacrimal sac fossa and bony nasolacrimal canal) can be involved in patients with craniofacial trauma (Figure 3a). A previous study demonstrated that 9.5% of patients with craniofacial trauma had a fracture of the bony lacrimal passage. However, most of them were classified as Le Fort II or III fractures, or naso-orbito-ethmoid complex fracture, and none of them had a pure orbital blowout fracture.21 Another study also reported that none of the 25 patients with bony lacrimal passage fracture had pure orbital blowout fracture.22 In a study from Singapore, a bony nasolacrimal canal fracture has been associated with medial wall and floor fractures and medial and inferior orbital rim fractures because of the anatomical proximity of these structures. Moreover, bony nasolacrimal canal fracture is also related to lateral orbital wall and superior rim fractures, which may reflect severe blunt trauma.14 In our experience, a bony lacrimal system fracture is generally accompanied by an anterior medial orbital wall blowout fracture. As the lacrimal fossa consists of a thick maxillary bone and a thin lacrimal bone,23,24 lacrimal fossa fracture often occurs in the lacrimal bone (Figure 3a). On the other hand, since the bony nasolacrimal canal has a thin wall, any part of the canal can be fractured (Figure 3a). Surgical outcomes are better with confirmation of a fracture site using dacryoendoscope during fracture reduction and lacrimal tube insertion.25