The lacrimal canaliculus and sac bordered by the Horner's muscle form the functional lacrimal drainage system.
ABSTRACT To clarify the relationship between the orbicularis oculi muscle, lacrimal canaliculus, and lacrimal sac and to propose a new theory of the lacrimal drainage system.
Sixteen Asian cadavers (29 upper eyelids).
Gross dissections of the orbicularis oculi muscle in the medial canthus of 10 Asian cadavers were performed, and the relationship between the orbicularis oculi muscle, lacrimal canaliculus, and lacrimal sac was examined. The upper eyelids of the remaining 6 cadavers were dissected grossly, and sections of the lacrimal sac, common lacrimal canaliculus, and upper canaliculus were examined microscopically. The relationship between the lacrimal passage and its surrounding tissues also was examined.
The lacrimal canaliculus and sac both were divided into 2 distinct compartments in relation to the Horner's muscle. The upper half of the lacrimal sac was related to the Horner's muscle through the posterior branch of the medial canthal tendon and connective tissue, and the lower half was related to the capsulopalpebral fascia and orbital fat. The lateral part of the lacrimal canaliculus was covered with the Horner's muscle. The medial part of the lacrimal canaliculus, namely the common lacrimal canaliculus, was not covered by the Horner's muscle, but was covered by the preseptal and orbital parts of the orbicularis oculi muscle on the anterior surface.
The lacrimal canaliculus and sac were divided into 2 distinct compartments by the Horner's muscle, and it is possible that both contribute to the lacrimal drainage system.
Article: On lacrimal drainage.Ophthalmologica 02/1972; 164(6):409-21. · 1.41 Impact Factor
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ABSTRACT: This study describes and tests in a cadaveric model a new method of fixation designed for potential stabilization of the posterior limb of the medial canthal tendon, using biodegradable Tag anchors. Study of the possibility of performing surgery to repair medial ectropion using biodegradable polyglyconate Tag anchors was commenced in the sheep cadaveric head model, and in the whole dry human skull model. This was then performed using five preserved human cadaveric whole heads, and pullout tensions were estimated in four of these. Computed tomography and magnetic resonance imaging were obtained for this model in the fifth head, and computed tomography was performed on the whole dry human skull. Dissections were carried out to establish the site of the bony defect in each of the heads. It was possible to obtain good Tag anchor fixation in bone overlying the maxillary and ethmoidal sinuses of the sheep, and in a young human skull. It was also possible to place adequately the anchor in the medial wall of the orbit close to the posterior lacrimal crest in all cases in the human cadaveric model. Pullout strengths were evaluated and found to range from 3.5 N to 12.4 N (mean, 7.5 N). Computed tomography and magnetic resonance imaging failed to demonstrate the biodegradable anchors in both the dry human whole skull and in the fifth cadaveric head, but did demonstrate the bony defects in the medial orbital walls through which the anchor passed. We have shown, for the first time, the stability of biodegradable Tag anchor fixation in a human cadaveric head model using pullout tensions and dissection studies. This method would allow adequate strength and stability to provide for control of fixation of the medial end of the lower eyelid in patients with medial ectropion and medial canthal tendon laxity.Ophthalmic Plastic and Reconstructive Surgery 02/2001; 17(1):28-35. · 0.67 Impact Factor
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ABSTRACT: The mechanism of lacrimal drainage under physiological conditions is controversial. The aim of this study was to analyze the three-dimensional architecture of human efferent tear ducts from functional and clinical points of view. A new theory of tear outflow is discussed. Thirty-two prepared lacrimal systems of adults were examined by histological, immunohistochemical and scanning electron microscopic techniques. The wall of the lacrimal sac is made up of collagen bundles, elastic and reticular fibers arranged in a helical pattern. Wide luminal vascular plexus are embedded in this helical system and connected to the cavernous tissue of the inferior turbinate in the region of Hasner's valve. Immunohistochemical analysis showed evidence of type I and type III collagen as well as chondroitin 4- and 6-sulfate. With blinking, the lacrimal part of the orbicularis muscle contracts. The fornix of the sac moves in a cranial-lateral direction. Thus the lacrimal sac distends and may be "wrung out" due to its medial attachment and helically arranged fibrillar structures. The vascular plexus may play an important role in the absorption and drainage of lacrimal fluid.Albrecht von Graæes Archiv für Ophthalmologie 10/1998; 236(9):674-8. · 1.93 Impact Factor