Clinical Implications in Orbital and Pterional Flap Surgeries as Well as Radioimaging Studies to Determine Topographical Prevalence and Characterization of Meningo-Orbital Foramen in Orbits of the Indian Population

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Mehandi Vinayak Mahajan; A. Anupriya; G.Durga Devi; Nita A Tanna;Nitin Radhakishan Mudiraj & Sangeeta Das

Summary

The pear-shaped bony orbit connects with intracranial cavity via foramina’s and fissures. The Meningo-orbital Foramen(MOF) is usually present in greater wing of sphenoid close to lateral edge of Superior orbital fissure. It provides a route for an anastomosis between the orbital branch of the middle meningeal artery(MMA) and recurrent meningeal branch of Ophthalmic Artery(OA) and hence, risk of damage during surgeries can occur. To verify occurrence and location, with morphology of MOF in dry orbits and the impending clinical hazards in surgeries pertaining to the orbit, document and analysis it to determine a standardized guideline. The presence for MOF was studied in 446 dry orbits with its location from the supra orbital margin (SOM), front zygomatic suture (FZS), the lateral tubercle of Whitnall (WT)and the lateral end of superior orbital fissure(SOF) along with its patency, laterality and number of foramina’s present. Nylon probes, long divider/pins, compass and Vernier callipers was used to check the patency and various parameters. The study noted the percentage prevalence of MOF as 69 % with communication with middle cranial fossa(MCF) being 76 % of 69 % and the average distance from SOM, FZS, WT and lateral end of SOF being 35.58 mm, 24.9 mm, 26.6 mm and 0.92 mm. On comparison with various population studies, certain similarities and differences with regards to different parameters were noted. Prevalence of MOF was mostly unilateral and showed multiple foramina, that can act as channels for arteries, a variant of MMA or OA, that supply orbital structures or tumour growths. Thus, awareness of this variation is of prime importance to ophthalmologists and neurosurgeons as well as interventional radiologists, in preventing haemorrhagic condition which could further raise the difficulties in operative procedures and surgical outcomes.

KEY WORDS: Meningo-orbital foramen; Superior orbital fissure; Frontozygomatic suture; Whitnall tubercle; Orbit; Pterional flap.

How to cite this article

MAHAJAN, M. V.; ANUPRIYA, A.; DEVI, G. D.; TANNA, N. A.; MUDIRAJ, NITIN R. & DAS, S. Clinical implications in orbital and pterional flap surgeries as well as radioimaging studies to determine topographical prevalence and characterization of meningo-orbital foramen in orbits of the indian population. Int. J. Morphol., 38(6):1810-1817, 2020.