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The Triple Heater (TH)
Published in Narda G. Robinson, Interactive Medical Acupuncture Anatomy, 2016
Specifically, the lacrimal nerve, a branch of the ophthalmic division (V1) conveys sensation from the lateral upper lid, conjunctiva, and lacrimal gland. Secretomotor (postganglionic, parasympathetic) fibers from the facial nerve (CN VII) travel briefly with the lacrimal nerve in its distal portion. The nerve then enters the orbit between the lateral rectus muscle and the orbital roof to join the nasociliary and frontal nerves at the superior orbital fissure. The lacrimal nerve communicates with the zygomaticotemporal nerve, which also travels in the company of postganglionic parasympathetic fibers from the facial nerve, destined for the lacrimal gland. The zygomatico-temporal nerve joins with the zygomaticofacial nerve to form the zygomatic nerve that courses along the orbit’s floor to join the maxillary nerve after it enters the inferior orbital fissure. These interneural connections illustrate why TH 23 occupies a key location for stimulation in conditions involving impaired lacrimal secretion, such as dry and itching eyes.3
Local Anesthetics
Published in Jeffrey R. Marcus, Detlev Erdmann, Eduardo D. Rodriguez, Essentials of CRANIOMAXILLOFACIAL TRAUMA, 2014
Alexander C. Allori, Dunya M. Atisha, Jeffrey R. Marcus
The zygomatic nerve, a branch of V2, bifurcates into the zygomaticotemporal and zygomaticofacial nerves to supply the temporal scalp and malar eminence, respectively. The zygomaticotemporal nerve blockade is accomplished by inserting the needle behind the lateral orbital and advancing to approximately 1 cm inferior to the lateral canthus. The zygomaticofacial nerve is blocked where it exits through a foramen in the zygoma less than 1 cm inferolateral to the junction of the inferior and lateral orbital rims.6
Temporal Region and Lateral Brow
Published in Ali Pirayesh, Dario Bertossi, Izolda Heydenrych, Aesthetic Facial Anatomy Essentials for Injections, 2020
Krishan Mohan Kapoor, Alberto Marchetti, Hervé Raspaldo, Shino Bay Aguilera, Natalia Manturova, Dario Bertossi
The ZTN: Is one of the two terminal branches of the zygomatic nerve, which is a branch of the maxillary division of the trigeminal nerve (V2).The zygomatic nerve: Enters the orbit via the inferior orbital fissure.Travels along the lateral orbital wall.Divides into the zygomaticofacial nerve (ZFN) and ZTN.The ZTN provides sensation to the temporal skin and parasympathetic innervation to the lacrimal gland.The ZTN exits the lateral orbit via a bony canal and emerges in the temporal fossa via a bony foramen, the localization of which has considerable ethnic variation.After exiting the orbit, the ZTN enters the deep aspect of the temporalis muscle or travels between the temporal periosteum and the temporalis muscle before piercing the deep temporal fascia.Injury of the ZTN may cause temporary paresthesia and anesthesia in the temporal region.
Management of periocular cutaneous squamous cell carcinoma with perineural invasion: a case series and literature review
Published in Orbit, 2022
Thomas J. E. Clark, Gerald J. Harris
In the evaluation of patients with suspicious periocular cutaneous lesions, especially those overlying named branches of the trigeminal system (e.g., infraorbital, supraorbital, zygomaticotemporal, or zygomaticofacial nerves), symptoms and signs of PNI should be elicited. These include paresthesias (e.g. formication, burning, tingling, shooting/stabbing or “electric shock” sensation), frank pain, hypesthesia, anesthesia, and/or motor weakness.3,40 These queries should be made both at the initial visit and in post-treatment follow-up, since neurologic symptoms may precede visual evidence of tumor recurrence.40 It should be noted, however, that neurologic symptoms are typically late findings, since the distensibility of potential peri- and endoneural spaces generally prevents compressive effects until there has been substantial tumor expansion.3 External examination should include assessment of deep fixation to periosteum/bone and palpation of regional lymph nodes. Palpable lymphadenopathy should prompt imaging and referral to a head and neck surgeon for possible fine-needle aspiration or core biopsy. Risk factors for SCC, including history of organ transplantation, immune compromise (e.g. lymphoproliferative disorder, HIV-AIDS, pharmacologic immunosuppression), and xeroderma pigmentosum should be elicited.24
Complications and outcomes of grafting of posterior orbital fat into the lower lid-cheek junction during orbital decompression
Published in Orbit, 2018
Andre S. Litwin, Cornelia Poitelea, Petrina Tan, Kimia Ziahosseini, Raman Malhotra
There were no intra- or peri-operative complications. Complications related to FG orbital decompression are summarized in Table 2. Postop worsening of diplopia occurred in three patients (17.6%), although one had pre-existent diplopia. Two of these patients had medial wall and fat decompression; the third patient underwent 2-wall decompression and fat. Two patients (11.8%) reported improvement of pre-existent diplopia. Temporary numbness of the zygomaticofacial nerve was reported in two patients, which settled within 3 months. No visual loss or intra-orbital hemorrhage was recorded for any patient.