Branches and Distribution of the Maxillary

Total Page:16

File Type:pdf, Size:1020Kb

Branches and Distribution of the Maxillary Table 3.2: Branches and Distribution of the Maxillary Artery of the Alpaca, Vicugna pacos Artery Origin Course Distribution Majority of cranial arterial distribution; Supplies brain, Anterior continuation of the ECA; Nomenclature meninges, pterygoid, palate, shifts following the departure of the superficial nasal cavity, oral cavit, External Carotid Maxillary Artery temporal artery/common auricular artery from the ethmoidal region, frontal Artery dorsal surface of the ECA. Three segments, region, cranial sinuses, the face including proximal, orbital, and distal. above the maxillary tuberosity, the dentary, and the lower lip and chin Ventral branch of maxillary a.; enters mandibular canal via mandibular foramen; courses through Alveoli of mandibular dentition; Inferior Alveolar Maxillary canal, supplying alveoli of mandibular dentition; chin exits mental foramen Dorsal to the inferior alveolar a., masseteric separates from the MA and perfuses the masseter masseter; lateral zygomatic Masseteric Maxillary after hooking around the neck of the condylar region; TMJ process; extensive branching within lateral facial region; dorsal termination supplies TMJ From superior surface of the maxillary a., deep to posterior border of the Caudal Deep Temporal Maxillary the coronoid process; caudal deep temporal follows temporalis posterior border of coronoid superiorly Departs maxillary a. near pterygoid crest; Maxillary/CR/Oph. immediately caudal to ophthalmic rete, artery Rostral Deep Temporal anterior border of temporalis m. Rete proceeds superiorly, following the anterior temporal line Extensive branching in region of foramen Ramus anastomoticus Maxillary Carotid and orbital retia orbitorotundum Occupies lateral sellar compartment of cranium; Carotid Rete Maxillary forms smooth floor of braincase / internal surface Cerebrum and cerebellum of the basisphenoid Orbital Rete Maxillary Proximal portion of external opththalmic Eyeball and some periorbita Internal surface MA, short course before reaching pterygoid bone; branches extensively into Pterygoid Branches Maxillary pterygoid muscle and bone pterygoid muscles; small branch enters foramen on posterior surface pterygoid process small, lateral branch of IMA, departs deep to coronoid process; courses toward malar; ventral to pterygoid, maxillary, and Buccal Maxillary zyg. pr of maxillary bone, splits into ventral and buccinator muscles; lower superior branches; part of superior = inferior eyelid palpebral; ventral branch toward buccinator From buccal artery, courses under orbital process (Caudal) Lateral Nasal Buccal Lateral nasal region and traverses crista facialis Rami from maxillary a. to carotid and ophthalmic rete = extensive, largely indistinguishable; Ext. Maxillary/Opthalmic External Ophthalmic ophthalmic forms extensive rete, crosses and Periorbita and ethmoidal region Rete supplies periorbita, extraocular muscles, and ethmoidal region Small lateral division of internal maxillary; slightly proximal to carotid + ophthalmic rete; courses Lacrimal Maxillary lacrimal gland, superior eyelid laterally toward post-orbital bar, where divides into lacrimal and superior palpebral branches Lateral division of the anterior terminal branches of maxillary; MA bifurcates into palatine and IOA near common orbital tendinous ring; courses ventral to periorbita with few branches; dorsal Infra-Orbital Maxillary Lateral facial region nasal departs prior to entry of parent artery into IO canal; courses through IO canal, exits facial IO foramen and branches extensively in lateral nasal/superior labial region Departs G. Pal between malar and pterygoid; Descending Palatine Greater Palatine Caudal hard palate, soft palate descends into caudal palatal region Part of the anterior terminal bifurcation of the internal maxillary artery; IMA is shorter in alpacas than for other mammals; division occurs near Greater Palatine Maxillary common tendinous orbital ring; exits orbital region through pterygopalatine foramen (medial foramen on the maxilla); courses through hard palate and enters oral cavity through greater palatine foramen Superomedial division of Greater palatine; courses Nasopalatine Greater Palatine along the floor of the nasal cavity and nasal septum toward the incisive fossa .
Recommended publications
  • Branches of the Maxillary Artery of the Domestic
    Table 4.2: Branches of the Maxillary Artery of the Domestic Pig, Sus scrofa Artery Origin Course Distribution Departs superficial aspect of MA immediately distal to the caudal auricular. Course is typical, with a conserved branching pattern for major distributing tributaries: the Facial and masseteric regions via Superficial masseteric and transverse facial arteries originate low in the the masseteric and transverse facial MA Temporal Artery course of the STA. The remainder of the vessel is straight and arteries; temporalis muscle; largely unbranching-- most of the smaller rami are anterior auricle. concentrated in the proximal portion of the vessel. The STA terminates in the anterior wall of the auricle. Originates from the lateral surface of the proximal STA posterior to the condylar process. Hooks around mandibular Transverse Facial Parotid gland, caudal border of the STA ramus and parotid gland to distribute across the masseter Artery masseter muscle. muscle. Relative to the TFA of Camelids, the suid TFA has a truncated distribution. From ventral surface of MA, numerous pterygoid branches Pterygoid Branches MA Pterygoideus muscles. supply medial and lateral pterygoideus muscles. Caudal Deep MA Arises from superior surface of MA; gives off masseteric a. Deep surface of temporalis muscle. Temporal Artery Short course deep to zygomatic arch. Contacts the deep Caudal Deep Deep surface of the masseteric Masseteric Artery surface of the masseter between the coronoid and condylar Temporal Artery muscle. processes of the mandible. Artery Origin Course Distribution Compensates for distribution of facial artery. It should be noted that One of the larger tributaries of the MA. Originates in the this vessel does not terminate as sphenopalatine fossa as almost a terminal bifurcation of the mandibular and maxillary labial MA; lateral branch continuing as buccal and medial branch arteries.
    [Show full text]
  • Treatment of Congenital Ptosis
    13 Review Article Page 1 of 13 Treatment of congenital ptosis Vladimir Kratky1,2^ 1Department of Ophthalmology, Queen’s University, Kingston, Canada; 21st Medical Faculty, Charles University, Prague, Czech Republic Correspondence to: Vladimir Kratky, BSc, MD, FRCSC, DABO. Associate Professor of Ophthalmology, Director of Ophthalmic Plastic and Orbital Surgery, Oculoplastics Fellowship Director, Queen’s University, Kingston, Canada; 1st Medical Faculty, Charles University, Prague, Czech Republic. Email: [email protected]. Abstract: Congenital ptosis is an abnormally low position of the upper eyelid, with respect to the visual axis in the primary gaze. It can be present at birth or manifest itself during the first year of life and can be bilateral or unilateral. Additionally, it may be an isolated finding or part of a constellation of signs of a specific syndrome or systemic associations. Depending on how much it interferes with the visual axis, it may be considered as a functional or a cosmetic condition. In childhood, functional ptosis can lead to deprivation amblyopia and astigmatism and needs to be treated. However, even mild ptosis with normal vision can lead to psychosocial problems and correction is also advised, albeit on a less urgent basis. Although, patching and glasses can be prescribed to treat the amblyopia, the mainstay of management is surgical. There are several types of surgical procedure available depending on the severity and etiology of the droopy eyelid. The first part of this paper will review the different categories of congenital ptosis, including more common associated syndromes. The latter part will briefly cover the different surgical approaches, with emphasis on how to choose the correct condition.
    [Show full text]
  • Anatomical Characteristics and Visibility of Mental Foramen and Accessory Mental Foramen: Panoramic Radiography Vs
    Med Oral Patol Oral Cir Bucal. 2015 Nov 1;20 (6):e707-14. Radiographic study of the mental foramen variations Journal section: Oral Surgery doi:10.4317/medoral.20585 Publication Types: Research http://dx.doi.org/doi:10.4317/medoral.20585 Anatomical characteristics and visibility of mental foramen and accessory mental foramen: Panoramic radiography vs. cone beam CT Juan Muinelo-Lorenzo 1, Juan-Antonio Suárez-Quintanilla 2, Ana Fernández-Alonso 1, Jesús Varela-Mallou 3, María-Mercedes Suárez-Cunqueiro 4 1 PhD Student, Department of Stomatology, Medicine and Dentistry School, University of Santiago de Compostela, Spain 2 Associate Professor, Department of Anatomy, Medicine and Dentistry School, University of Santiago de Compostela, Spain 3 Professor and Chairman. Department of Social Psychology, Basic Psychology and Methodology, Psychology School, University of Santiago de Compostela, Spain 4 Associate Professor, Department of Stomatology, Medicine and Dentistry School, University of Santiago de Compostela, Spain Correspondence: Stomatology Department Medicine and Dentistry School University of Santiago de Compostela C/ Entrerrios S/N 15872 Muinelo-Lorenzo J, Suárez-Quintanilla JA, Fernández-Alonso A, Va- Santiago de Compostela, Spain rela-Mallou J, Suárez-Cunqueiro MM. Anatomical characteristics and [email protected] visibility of mental foramen and accessory mental foramen: Panoramic radiography vs. cone beam CT. Med Oral Patol Oral Cir Bucal. 2015 Nov 1;20 (6):e707-14. http://www.medicinaoral.com/medoralfree01/v20i6/medoralv20i6p707.pdf Received: 05/01/2015 Accepted: 05/05/2015 Article Number: 20585 http://www.medicinaoral.com/ © Medicina Oral S. L. C.I.F. B 96689336 - pISSN 1698-4447 - eISSN: 1698-6946 eMail: [email protected] Indexed in: Science Citation Index Expanded Journal Citation Reports Index Medicus, MEDLINE, PubMed Scopus, Embase and Emcare Indice Médico Español Abstract Background.
    [Show full text]
  • Anatomy of Maxillary and Mandibular Local Anesthesia
    Anatomy of Mandibular and Maxillary Local Anesthesia Patricia L. Blanton, Ph.D., D.D.S. Professor Emeritus, Department of Anatomy, Baylor College of Dentistry – TAMUS and Private Practice in Periodontics Dallas, Texas Anatomy of Mandibular and Maxillary Local Anesthesia I. Introduction A. The anatomical basis of local anesthesia 1. Infiltration anesthesia 2. Block or trunk anesthesia II. Review of the Trigeminal Nerve (Cranial n. V) – the major sensory nerve of the head A. Ophthalmic Division 1. Course a. Superior orbital fissure – root of orbit – supraorbital foramen 2. Branches – sensory B. Maxillary Division 1. Course a. Foramen rotundum – pterygopalatine fossa – inferior orbital fissure – floor of orbit – infraorbital 2. Branches - sensory a. Zygomatic nerve b. Pterygopalatine nerves [nasal (nasopalatine), orbital, palatal (greater and lesser palatine), pharyngeal] c. Posterior superior alveolar nerves d. Infraorbital nerve (middle superior alveolar nerve, anterior superior nerve) C. Mandibular Division 1. Course a. Foramen ovale – infratemporal fossa – mandibular foramen, Canal -> mental foramen 2. Branches a. Sensory (1) Long buccal nerve (2) Lingual nerve (3) Inferior alveolar nerve -> mental nerve (4) Auriculotemporal nerve b. Motor (1) Pterygoid nerves (2) Temporal nerves (3) Masseteric nerves (4) Nerve to tensor tympani (5) Nerve to tensor veli palatine (6) Nerve to mylohyoid (7) Nerve to anterior belly of digastric c. Both motor and sensory (1) Mylohyoid nerve III. Usual Routes of innervation A. Maxilla 1. Teeth a. Molars – Posterior superior alveolar nerve b. Premolars – Middle superior alveolar nerve c. Incisors and cuspids – Anterior superior alveolar nerve 2. Gingiva a. Facial/buccal – Superior alveolar nerves b. Palatal – Anterior – Nasopalatine nerve; Posterior – Greater palatine nerves B.
    [Show full text]
  • Inferior Alveolar Nerve Trajectory, Mental Foramen Location and Incidence of Mental Nerve Anterior Loop
    Med Oral Patol Oral Cir Bucal. 2017 Sep 1;22 (5):e630-5. CBCT anatomy of the inferior alveolar nerve Journal section: Oral Surgery doi:10.4317/medoral.21905 Publication Types: Research http://dx.doi.org/doi:10.4317/medoral.21905 Inferior alveolar nerve trajectory, mental foramen location and incidence of mental nerve anterior loop Miguel Velasco-Torres 1, Miguel Padial-Molina 1, Gustavo Avila-Ortiz 2, Raúl García-Delgado 3, Andrés Ca- tena 4, Pablo Galindo-Moreno 1 1 DDS, PhD, Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain 2 DDS, MS, PhD, Department of Periodontics, College of Dentistry, University of Iowa, Iowa City, USA 3 Specialist in Dental and Maxillofacial Radiology. Private Practice. Granada, Spain 4 PhD, Department of Experimental Psychology, School of Psychology, University of Granada, Granada, Spain Correspondence: School of Dentistry, University of Granada 18071 - Granada, Spain [email protected] Velasco-Torres M, Padial-Molina M, Avila-Ortiz G, García-Delgado R, Catena A, Galindo-Moreno P. Inferior alveolar nerve trajectory, mental foramen location and incidence of mental nerve anterior loop. Med Oral Received: 07/03/2017 Accepted: 21/06/2017 Patol Oral Cir Bucal. 2017 Sep 1;22 (5):e630-5. http://www.medicinaoral.com/medoralfree01/v22i5/medoralv22i5p630.pdf Article Number: 21905 http://www.medicinaoral.com/ © Medicina Oral S. L. C.I.F. B 96689336 - pISSN 1698-4447 - eISSN: 1698-6946 eMail: [email protected] Indexed in: Science Citation Index Expanded Journal Citation Reports Index Medicus, MEDLINE, PubMed Scopus, Embase and Emcare Indice Médico Español Abstract Background: Injury of the inferior alveolar nerve (IAN) is a serious intraoperative complication that may occur during routine surgical procedures, such as dental implant placement or extraction of impacted teeth.
    [Show full text]
  • Ortho Part II
    Ortho Part II Paul K. Chu, DDS St. Barnabas Hospital November 21, 2010 REVIEW FROM LAST LECTURE 1 What kinds of steps are the following? Distal Mesial Distal Mesial Moyer’s Analysis Review 1) Take an impression of a child’s MANDIBULAR arch 2) Measure the mesial distal widths of ALL permanent incisors 3) Take the number you get and look at the black row 4) The corresponding number is the mesial distal width you need for the permanent canine- 1st premolar- 2nd premolar i .e . the 3 - 4 -5 ***(Black row) ----this is the distance you measure**** 2 Moyer’s Analysis Review #1) measure the mesial distal incisal edge width of EACH permanent incisor and add them up **Let’s say in this case we measured 21mm.** Step 1 Moyer’s Analysis Review Maxilla Look at the chart Mandibular Since The resulting number measured should give you needed 21mm we look widths of the maxilla or here. mandibular space needed for permanent canines and 1st and 2nd premolars. Step 2 3 Moyer’s Analysis Review Maxilla You also use the added Mandibular measurements of the mandibular incisors to get predicted MAXILLARY measurements as well! Step 2 The Dreaded Measurements Lecture 4 What Are We Trying to Accomplish? (In other words) Is the patient Class I, II, III skeletal? Does the patient have a skeletal open bite growth pattern, or a deep bite growth pattern, or a normal growth pattern? Are the maxillary/mandibular incisors proclined, retroclined or normal? Is the facial profile protrusive, retrusive, or straight? Why? Why? Why? Why does this patient have increased
    [Show full text]
  • Macroscopic Anatomy of the Nasal Cavity and Paranasal Sinuses of the Domestic Pig (Sus Scrofa Domestica) Daniel John Hillmann Iowa State University
    Iowa State University Capstones, Theses and Retrospective Theses and Dissertations Dissertations 1971 Macroscopic anatomy of the nasal cavity and paranasal sinuses of the domestic pig (Sus scrofa domestica) Daniel John Hillmann Iowa State University Follow this and additional works at: https://lib.dr.iastate.edu/rtd Part of the Animal Structures Commons, and the Veterinary Anatomy Commons Recommended Citation Hillmann, Daniel John, "Macroscopic anatomy of the nasal cavity and paranasal sinuses of the domestic pig (Sus scrofa domestica)" (1971). Retrospective Theses and Dissertations. 4460. https://lib.dr.iastate.edu/rtd/4460 This Dissertation is brought to you for free and open access by the Iowa State University Capstones, Theses and Dissertations at Iowa State University Digital Repository. It has been accepted for inclusion in Retrospective Theses and Dissertations by an authorized administrator of Iowa State University Digital Repository. For more information, please contact [email protected]. 72-5208 HILLMANN, Daniel John, 1938- MACROSCOPIC ANATOMY OF THE NASAL CAVITY AND PARANASAL SINUSES OF THE DOMESTIC PIG (SUS SCROFA DOMESTICA). Iowa State University, Ph.D., 1971 Anatomy I University Microfilms, A XEROX Company, Ann Arbor. Michigan I , THIS DISSERTATION HAS BEEN MICROFILMED EXACTLY AS RECEIVED Macroscopic anatomy of the nasal cavity and paranasal sinuses of the domestic pig (Sus scrofa domestica) by Daniel John Hillmann A Dissertation Submitted to the Graduate Faculty in Partial Fulfillment of The Requirements for the Degree of DOCTOR OF PHILOSOPHY Major Subject: Veterinary Anatomy Approved: Signature was redacted for privacy. h Charge of -^lajoï^ Wor Signature was redacted for privacy. For/the Major Department For the Graduate College Iowa State University Ames/ Iowa 19 71 PLEASE NOTE: Some Pages have indistinct print.
    [Show full text]
  • MBB: Head & Neck Anatomy
    MBB: Head & Neck Anatomy Skull Osteology • This is a comprehensive guide of all the skull features you must know by the practical exam. • Many of these structures will be presented multiple times during upcoming labs. • This PowerPoint Handout is the resource you will use during lab when you have access to skulls. Mind, Brain & Behavior 2021 Osteology of the Skull Slide Title Slide Number Slide Title Slide Number Ethmoid Slide 3 Paranasal Sinuses Slide 19 Vomer, Nasal Bone, and Inferior Turbinate (Concha) Slide4 Paranasal Sinus Imaging Slide 20 Lacrimal and Palatine Bones Slide 5 Paranasal Sinus Imaging (Sagittal Section) Slide 21 Zygomatic Bone Slide 6 Skull Sutures Slide 22 Frontal Bone Slide 7 Foramen RevieW Slide 23 Mandible Slide 8 Skull Subdivisions Slide 24 Maxilla Slide 9 Sphenoid Bone Slide 10 Skull Subdivisions: Viscerocranium Slide 25 Temporal Bone Slide 11 Skull Subdivisions: Neurocranium Slide 26 Temporal Bone (Continued) Slide 12 Cranial Base: Cranial Fossae Slide 27 Temporal Bone (Middle Ear Cavity and Facial Canal) Slide 13 Skull Development: Intramembranous vs Endochondral Slide 28 Occipital Bone Slide 14 Ossification Structures/Spaces Formed by More Than One Bone Slide 15 Intramembranous Ossification: Fontanelles Slide 29 Structures/Apertures Formed by More Than One Bone Slide 16 Intramembranous Ossification: Craniosynostosis Slide 30 Nasal Septum Slide 17 Endochondral Ossification Slide 31 Infratemporal Fossa & Pterygopalatine Fossa Slide 18 Achondroplasia and Skull Growth Slide 32 Ethmoid • Cribriform plate/foramina
    [Show full text]
  • Endoscopic Supraorbital Eyebrow Approach for the Surgical Treatment of Extraaxial and Intraaxial Tumors
    See the corresponding editorial in this issue (E21). Neurosurg Focus 37 (4):E20, 2014 ©AANS, 2014 Endoscopic supraorbital eyebrow approach for the surgical treatment of extraaxial and intraaxial tumors ROBERTO GAZZERI, M.D.,1,2 YUYA NISHIYAMA, M.D., PH.D.,1,3 And CHARLES TEO, M.D.1 1Centre for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital, Sydney, Australia; 2Department of Neurosurgery, San Giovanni Addolorata Hospital, Rome, Italy; and 3Department of Neurosurgery, Fujita Health University School of Medicine, Toyoake, Japan Object. The supraorbital eyebrow approach is a minimally invasive technique that offers wide access to the anterior skull base region and parasellar area through a subfrontal corridor. The use of neuroendoscopy allows one to extend the approach further to the pituitary fossa, the anterior third ventricle, the interpeduncular cistern, the an- terior and medial temporal lobe, and the middle fossa. The supraorbital approach involves a limited skin incision, with minimal soft-tissue dissection and a small craniotomy, thus carrying relatively low approach-related morbidity. Methods. All consecutive patients who underwent the endoscopic supraorbital eyebrow approach were retro- spectively analyzed for lesion location, pathology, length of stay, complications, and cosmetic results. Results. During a 56-month period, 97 patients (mean age 58.5 years) underwent an endoscopic eyebrow ap- proach to resect extra- and intraaxial brain lesions. The most common pathologies treated were meningiomas (n = 41); craniopharyngiomas (n = 22); dermoid tumors (n = 7); metastases (n = 4); gliomas (n = 3); and other miscel- laneous frontal, parasellar, and midbrain (n = 23) lesions. The median length of postoperative hospital stay was 2.7 days (range 1–8 days).
    [Show full text]
  • Orbital Imaging in Thyroid-Related Orbitopathy
    Orbital imaging in thyroid-related orbitopathy Christopher Lo, MD, Shoaib Ugradar, MD, and Daniel Rootman, MD, MS SUMMARY A broad understanding of the different imaging modalities used to assess the physiologic changes seen in Graves’ orbitopathy complement clinical examination. Subtle applications of radiographic imaging techniques allow for a better understanding of the overall physiology of the orbit, quantify progression of disease, and differentiate it from orbital diseases with overlapping features. A nuanced approach to interpreting imaging features may allow us to delineate inactive from active thyroid eye disease, and advances within this field may arm clinicians with the ability to better predict and prevent dysthyroid optic neuropathy. ( J AAPOS 2018;22:256.e1-256.e9) rbital imaging plays a central role in the diag- mean inferior rectus width, 4.8 mm; medial rectus width, nosis and management of thyroid-related orbit- 4.2 mm; superior rectus width, 4.6 mm; and lateral rectus O opathy (TRO). Diagnostically, it is used to width, 3.3 mm.8,9 These numbers can be used as a guide; compliment a careful ophthalmic examination, laboratory however, they represent population averages, each with values, and ancillary studies to confirm the presence of significant variation. Overlap in populations exist, and TRO and/or dysthyroid optic neuropathy (DON). It can both diseased and nondiseased muscles can have widths also be helpful in surgical planning and understanding close to these values. In the end, there are no strict rules. the progression of thyroid myopathy. Computed tomogra- In terms of muscle involvement, clinical myopathy is phy (CT), magnetic resonance imaging (MRI), ultrasound, thought to most often involve the inferior rectus muscle, and nuclear medicine all have applications in the field.
    [Show full text]
  • Atlas of the Facial Nerve and Related Structures
    Rhoton Yoshioka Atlas of the Facial Nerve Unique Atlas Opens Window and Related Structures Into Facial Nerve Anatomy… Atlas of the Facial Nerve and Related Structures and Related Nerve Facial of the Atlas “His meticulous methods of anatomical dissection and microsurgical techniques helped transform the primitive specialty of neurosurgery into the magnificent surgical discipline that it is today.”— Nobutaka Yoshioka American Association of Neurological Surgeons. Albert L. Rhoton, Jr. Nobutaka Yoshioka, MD, PhD and Albert L. Rhoton, Jr., MD have created an anatomical atlas of astounding precision. An unparalleled teaching tool, this atlas opens a unique window into the anatomical intricacies of complex facial nerves and related structures. An internationally renowned author, educator, brain anatomist, and neurosurgeon, Dr. Rhoton is regarded by colleagues as one of the fathers of modern microscopic neurosurgery. Dr. Yoshioka, an esteemed craniofacial reconstructive surgeon in Japan, mastered this precise dissection technique while undertaking a fellowship at Dr. Rhoton’s microanatomy lab, writing in the preface that within such precision images lies potential for surgical innovation. Special Features • Exquisite color photographs, prepared from carefully dissected latex injected cadavers, reveal anatomy layer by layer with remarkable detail and clarity • An added highlight, 3-D versions of these extraordinary images, are available online in the Thieme MediaCenter • Major sections include intracranial region and skull, upper facial and midfacial region, and lower facial and posterolateral neck region Organized by region, each layered dissection elucidates specific nerves and structures with pinpoint accuracy, providing the clinician with in-depth anatomical insights. Precise clinical explanations accompany each photograph. In tandem, the images and text provide an excellent foundation for understanding the nerves and structures impacted by neurosurgical-related pathologies as well as other conditions and injuries.
    [Show full text]
  • Chapter 18 EYELID and ADNEXAL INJURIES
    Eyelid and Adnexal Injuries Chapter 18 EYELID AND ADNEXAL INJURIES KIMBERLY PEELE COCKERHAM, MD* INTRODUCTION HISTORY, EXAMINATION, AND ANCILLARY TESTING SURGICAL MANAGEMENT OF EYELID LACERATIONS Anesthesia Preoperative Preparation Superficial Eyelid Lacerations Eyelid-Margin Involvement Levator Injury Complex Eyelid Injuries Total Avulsion SURGICAL MANAGEMENT OF ADNEXAL INJURIES Eyebrow Injuries Canalicular Injuries Medial Canthal Injuries Lateral Canthal Injuries Lacrimal Sac and Lacrimal Gland Injuries POSTOPERATIVE WOUND CARE SUMMARY *Director, Ophthalmic Plastics, Orbital Disease and Neuro-Ophthalmology, Allegheny General Hospital, 420 East North Avenue, Pittsburgh, Pennsylvania 15212; Assistant Professor, Department of Ophthalmology, Drexel University College of Medicine, Philadelphia, Pennsylvania 19102; formerly, Major, Medical Corps, US Army; Director, Neuro-Ophthalmology, Orbital Disease, and Plastic Reconstruction, Depart- ment of Ophthalmology, Walter Reed Army Medical Center, Washington, DC 291 Ophthalmic Care of the Combat Casualty INTRODUCTION Eyelid lacerations are a common emergency injuries are not considered true emergencies, and room challenge. The primary repair, which should in triage settings, life-threatening and actual sight- be the definitive surgery, is too often performed by threatening injuries (ie, open globes) should take medical students or physicians without ophthalmo- precedence. Eyelid lacerations can be closed up to logical training.1 Whether the setting is a civilian 72 hours after the injury without a great impact on emergency room or a battlefield, ophthalmologists functional or aesthetic outcome. Canalicular injury should be involved as early as possible. Inadequate can also be delayed (up to 48 hours), allowing the repair can lead to ocular irritation, pain, and even all-important primary closure to be performed by loss of the eye in cases of severe eyelid dysfunc- an experienced ophthalmologist.
    [Show full text]