Analysis of the nerve branches to the orbicularis oculi muscle of the lower eyelid in fresh cadavers.

Abstract:

BACKGROUND:Scleral show or ectropion is a known complication of lower eyelid surgery. It is particularly problematic after lower eyelid blepharoplasty when the orbicularis oculi muscle is transected or after other procedures are performed that denervate the lower eyelid. The purpose of this study was to determine whether a dominant motor branch exists to the lower lid orbicularis oculi muscle, using anatomic dissection and histologic analysis. METHODS:Sixteen fresh facial cadaver halves were dissected using the operative microscope to identify and measure nerve branches. The nerves were then harvested, sectioned, and stained with toluidine blue dye for histomorphometric analysis. Nerves were categorized as either lateral or medial to a vertical line marked at the lateral edge of the limbus of the eye. RESULTS:Eighty-seven percent and 47 percent of cadaver halves had one and two nerve branches lateral to the limbus, respectively. Eighty percent and 47 percent of cadaver halves had one and two nerve branches medial to the lateral limbus, respectively. The nerve branches entered the inferior edge of the orbicularis oculi muscle between 0.88 cm (+/-0.36 cm) and 2.73 cm (+/-0.46 cm) from the lateral canthus. There was no correlation noted between fascicular counts and distance from the lateral canthus. CONCLUSIONS:Multiple motor nerves exist to the lower eyelid. Branches are found medial and lateral to the lateral limbus, and no nerve branch is dominant.

journal_name

Plast Reconstr Surg

authors

Lowe JB 3rd,Cohen M,Hunter DA,Mackinnon SE

doi

10.1097/01.prs.0000186532.29557.96

subject

Has Abstract

pub_date

2005-11-01 00:00:00

pages

1743-9; discussion 1750-1

issue

6

eissn

0032-1052

issn

1529-4242

pii

00006534-200511000-00028

journal_volume

116

pub_type

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