-
[show abstract]
[hide abstract]
ABSTRACT: PURPOSE:: To determine the narrowest diameter of the bony nasolacrimal canal. METHODS:: Fifty-eight bony nasolacrimal canals from 29 Japanese cadavers (12 men and 17 women; average age at death, 83.4 years; range, 70-99 years) had been fixed in 10% buffered formalin before use. After exposing the medial (44 canals) or posterior half (14 canals) of the bony nasolacrimal canal, the part with the shortest anteroposterior or transverse diameter was determined on inspection. These positions from the canal entrance were measured, and the distance ratio, indicating where the shortest diameter was located in relation to the total length of the canal, was calculated. RESULTS:: The shortest anteroposterior and transverse diameters were at the entrance to the canal in 32 of 44 canals (72.7%) and in 9 of 14 canals (64.3%), respectively. In the other canals, the shortest anteroposterior and transverse diameters were located at an average of 3.6 and 5.6 mm from the entrance, and the distance ratios were 29.0% and 46.7%, respectively. The mean shortest anteroposterior and transverse diameters were 5.6 and 5.6 mm, respectively. CONCLUSIONS:: The shortest anteroposterior and transverse diameters were at the entrance of the canal in most of the bony nasolacrimal canals. These results are comparable with the rate of obstruction at the canal entrance in primary acquired nasolacrimal duct obstruction.
Ophthalmic plastic and reconstructive surgery 04/2013; · 0.69 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The eyelid and conjunctiva are main targets in ophthalmic plastic surgery. Although dry eyes are known to occasionally occur after ophthalmic plastic surgery, little attention has been paid to the secretory glands in the eyelid and conjunctiva. The secretary glands in the eyelid and conjunctiva contain the main lacrimal gland, accessory lacrimal glands of Wolfring and Krause, goblet cells, ciliary glands of Moll and Zeis, and the meibomian gland of the tarsal plate. Understanding the details of these glands is helpful in preventing and managing secretion reduction after oculoplastic procedures.
Ophthalmic plastic and reconstructive surgery 02/2013; · 0.69 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: PURPOSE:: To examine the horizontal orientation of the bony lacrimal passage. METHODS:: The orbits and bony nasolacrimal canals (BNLCs) from 28 Japanese cadavers (11 men and 17 women; average age at death, 83.6 years; range, 70-99 years) were fixed and exenterated before use. After exposing the posterior halves of the lacrimal fossa (LF) and the BNLC, the authors measured the angles of the longitudinal axes of the LF and the BNLC relative to the sagittal line. Based on these values, the relative horizontal orientation of the LF and the BNLC was determined (ΔBNLC-LF). Positive angles of LF and BNLC were defined when the LF and BNLC were directed laterally against the sagittal line. A positive ΔBNLC-LF was defined as having a greater angle for the LF than for the BNLC. RESULTS:: The mean LF and BNLC angles, and the ΔBNLC-LF were 11.9°, 0.1°, and 11.8°, respectively. The LF inclined laterally against the sagittal plane for all sides and the BNLC ran almost parallel to sagittal plane on average. The BNLC inclined inward against the sagittal line (0° or negative BNLC angle) for 28 sides (50.0%) and inclined outward (positive BNLC angle) for 28 sides (50.0%). The angle of the LF in women was statistically greater than that in men, though no gender BNLC angle or ΔBNLC-LF differences were determined. CONCLUSIONS:: The horizontal angle of the bony lacrimal passage differs among individuals, with an equal split between medial and lateral inclinations of the BNLC with reference to the sagittal line.
Ophthalmic plastic and reconstructive surgery 01/2013; · 0.69 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: PURPOSE:: To examine the relative positions of the lacrimal fossa (LF) and the bony nasolacrimal canal (BNLC) in relation to each other and a reference plane. METHODS:: Forty-two orbits and BNLCs from 21 Asian cadavers (9 men and 12 women; average age at death, 84.4 years; range, 70-99 years) had been fixed in 10% buffered formalin before use. After exposing the LF and the medial half of the BNLC, the authors measured the angles of the longitudinal axis of the LF and the BNLC relative to the aesthetic horizontal plane respectively. Based on these values, the relative orientation of the LF and the BNLC was determined and defined in terms of Δ BNLC-LF. A positive Δ BNLC-LF represents a nasolacrimal canal that descends posteriorly relative to the LF. RESULTS:: The mean LF, BNLC, and Δ BNLC-LF were 9.5°, 19.8°, and 10.3°, respectively. In 39 passages (92.9%), the Δ BNLC-LF was positive, representing a nasolacrimal canal that is more posteriorly oriented than the LF. In 3 passages (7.1%), the Δ BNLC-LF was equal to or less than 0°; 2 of them (4.8%) had a straight course and 1 passage (2.4%) had a negative value. CONCLUSIONS:: In most patients, the BNLC is directed more posteriorly than the LF. This finding may help in preventing an inadvertent false passage during probing and intubation in patients with epiphora.
Ophthalmic plastic and reconstructive surgery 10/2012; · 0.69 Impact Factor
-
Plastic and reconstructive surgery 09/2012; 130(3):494e-5e. · 2.74 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: : To clarify the causative factor of Asian double eyelid.
: Experimental anatomic study.
: Twenty-six upper eyelids (13 right and 13 left) from 17 Japanese cadavers (9 males and 8 females, mean age at death: 73.1 years).
: The specimens, obtained from the central part of the upper eyelids, were dehydrated, embedded in paraffin, cut into 7-μm thick slices and stained with Masson trichrome. Statistical analysis was based on the Mann-Whitney U test. Statistical significance was defined as p < 0.05.
: Orbicularis oculi muscle thickness and shape, with or without the levator extension, orbicularis oculi muscle bundle spacing, thickness of upper eyelid skin and subcutaneous tissue, fusional site between the levator aponeurosis and the orbital septum, with or without inferior drooping of fat tissue.
: The orbicularis muscle was thinner at the skin crease of a double eyelid than at 10 mm from the eyelid margin in the single eyelid group (p = 0.029). In 3 specimens the skin crease of double eyelid was at the tip of the bending orbicularis muscle, which was thick. Although the skin crease in the region of a double eyelid was thinner than in other parts of the skin, excluding the simple crease regions, other outcome measures were not shown as definite causative factors in creating the Asian double eyelid.
: The thickness of orbicularis oculi muscle or its bending shape, and the thickness of the skin at the skin crease, are major causative factors in Asian double eyelid formation.
Ophthalmic plastic and reconstructive surgery 09/2012; 28(5):376-81. · 0.69 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The anatomy of the lateral canthus is analogous to that of the medial canthus, but with a less defined structure. Although the lateral canthal tendon occupies the major part of the lateral canthal anatomy, the lateral rectus capsulopalpebral fascia and other structures also play a significant role. Appropriate comprehension and consideration of the lateral canthal anatomy enable safe and effective performance in the lateral canthal surgeries. In this review, we present the lateral canthal anatomy along with updated topics. We discuss the lateral canthal tendon, lateral orbital thickening, lateral palpebral raphe, lateral canthal muscle, lateral rectus capsulopalpebral fascia, lateral check ligament, lateral retinaculum, and orbitomalar ligament.
Orbit (Amsterdam, Netherlands) 06/2012; 31(4):279-85.
-
[show abstract]
[hide abstract]
ABSTRACT: A right orbit was exenterated from a male cadaver that was 85 years of age at death. It was microscopically shown for the first time that the lacrimal sac septum divided the lumen into two spaces. It consisted of fibrous tissue with a cavernous structure and was lined with stratified columnar epithelium similar to the lacrimal sac wall.
Orbit (Amsterdam, Netherlands) 05/2012;
-
[show abstract]
[hide abstract]
ABSTRACT: This study was designed to examine the anatomical relationship between Horner's muscle and the lacrimal sac at 3 representative levels of the lacrimal sac and to verify the contribution of Horner's muscle to lacrimal sac drainage.
Seven ocular specimens from 7 elderly Japanese cadavers, fixed in 10% buffered formalin, were analyzed. Axial sections were made parallel to the eyelid margin at 1 mm above the upper eyelid margin, 1 mm below the lower eyelid margin, and 3 mm below the lower eyelid margin. The vertical common fascial length, length of the lateral lacrimal sac wall, and the proportion between the 2 were measured for each specimen at the 3 levels.
The vertical common fascial length and its proportion to the length of the lateral lacrimal sac wall were statistically the same at all 3 levels of the lacrimal sac.
Based on the present anatomical findings, the activity of Horner's muscle may be the same for all sac levels, although this hypothesis should be examined by further experimental research, such as manometric studies of the sac at different levels along its length.
Ophthalmic plastic and reconstructive surgery 03/2012; 28(2):145-8. · 0.69 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To characterize the microscopic anatomy of the lacrimal punctum and canaliculi in relation to the tarsal plate, muscle of Riolan, and Horner muscle; and to report a novel technique to excise the horizontal canaliculus in severe dry eye patients.
Observational anatomic study and a retrospective case series.
The microscopic anatomy was studied in 86 eyelids of 25 cadavers (age range: 45-96 years, mean: 79.5 years). Surgery was performed on 18 canaliculi of 7 patients with dry eyes (age range: 37-69 years, mean: 59.9 years). In the microscopic study, 32 eyelids were incised sagittally, 38 eyelids were incised horizontally (1 mm from the eyelid margin), and 16 eyelids were incised parallel to the tarsal plate. All specimens were stained with Masson trichrome. In the surgical group, probe-guided horizontal canalicular excision with incision of the Horner muscle to the lateral edge of the lacrimal caruncle was performed. Both canalicular stumps were cauterized.
In the microscopic anatomic study, the punctum and the vertical canaliculus were part of the tarsal plate with the muscle of Riolan, whereas the horizontal canaliculus was surrounded by the Horner muscle. In the surgical group, all the operated canaliculi were completely occluded without recanalization 12 months postoperatively. No complications were recorded.
Based on microscopic anatomic findings that the lacrimal punctum and the vertical canaliculus are part of the tarsal plate, and that the horizontal canaliculus is surrounded by the Horner muscle, excision of the horizontal canaliculus may be an effective technique to treat patients with severe dry eyes.
American journal of ophthalmology 02/2012; 153(2):229-237.e1. · 3.83 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We studied the horizontal location of the inferior oblique muscle (IOM) origin in relation to the ipsilateral ala nasi and compared the results between genders in 76 orbits of 38 Japanese cadavers. Consequently, the IOM origin was located 1.2 mm laterally to the vertical line through the lateral margin of the ipsilateral ala nasi. No significant difference was noted between genders (males, 1.3 mm; females, 0.9 mm; P = 0.257, Student t test) or between sides (right, 1.1 mm; left, 1.3 mm; P = 0.570, Student t test). In contrast, the mean interalae-nasi distance was 39.8 mm and was significantly greater in males than that in females (males, 40.8 mm; females, 38.6 mm; P = 0.049, Student t test). The ala nasi can be used as a reference point irrespective of gender or side for identifying the IOM origin during oculoplastic surgery.
Annals of plastic surgery 12/2011; · 1.29 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: This study was designed to examine the distance from the posterior lacrimal crest to the posterior margin of the Horner's muscle origin (the PLC-HMO distance), considering their complex anatomical relationship.
Eight macroscopic specimens from 8 Japanese cadavers and 7 microscopic specimens from 7 Japanese cadavers, fixed in 10% buffered formalin, were analyzed. Macroscopically, the PLC-HMO distance was measured at 2 mm superior to the most posterior point of the muscle origin (Group A), directly at the most posterior point (Group B) and 2 mm inferior to the most posterior point (Group C). Microscopically, the PLC-HMO distance was measured in axial sections at 1 mm above the upper eyelid margin (Group 1), 1 mm below the lower eyelid margin (Group 2), and 3 mm below the lower eyelid margin (Group 3).
In the macroscopic study, the average PLC-HMO distance was 2.94, 2.57, and 2.05 mm for Groups A, B and C, respectively. The distance for Group C was significantly smaller than that of Group A (p = 0.006). In the microscopic study, the average PLC-HMO distance was 3.62, 3.74, and 3.14 mm for Groups 1, 2 and 3, respectively (no significant difference).
The PLC-HMO distance was approximately 2-4 mm with some specimens showing a smaller distance inferiorly.
Ophthalmic plastic and reconstructive surgery 12/2011; 28(1):66-8. · 0.69 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The microscopic and macroscopic anatomy of the anterior and posterior Tenons capsule is described.
An observational anatomic study of twelve orbits of 6 cadavers (mean age 79.5 years) were examined microscopically and 8 orbits of 4 cadavers (mean age 76.8 years) were examined macroscopically. After orbital exenteration, an X-shaped incision was made in the specimens to include the posterior part of the globe. The sections were divided into four parts: superomedial; inferomedial; superolateral; and inferolateral. In the macroscopically examined specimens, the eyelids and globes were removed from the exenterated tissues and the appearance of Tenons capsule was studied.
In the microscopic study, Tenons capsule covered the sclera beneath the conjunctiva and contained smooth muscle fibres in the anterior area. This anterior fascia, which had a thick appearance, reached the globe equator. From there, the capsule of the orbital fat, which contained no smooth muscle fibres, enveloped the sclera and reached the optic nerve. This was defined as the posterior capsule. In the macroscopic specimens, Tenons capsule had a thick and fibrous white appearance in the anterior area. More posteriorly, the capsule was thinner and more translucent. This thin capsular part was generally larger in the lateral area than in the medial area.
Tenons capsule is composed of an anterior thick fibrous tissue comprising the orbital smooth muscle network and the posterior thin fibrous capsule of the orbital fat.
Clinical and Experimental Ophthalmology 12/2011; 40(6):611-6. · 1.98 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To examine the positional relationship between the ethmoidal foramina and the frontoethmoidal suture.
Eighty-four orbits of 42 Japanese cadavers (24 male and 18 female cadavers; average age at death, 81.0 years; range, 61-101 years), fixed in 10% buffered formalin, were used for investigation. The most anterior or posterior ethmoidal foramen was defined as the anterior or posterior ethmoidal foramen, respectively. All the intermediate foramina were determined as the accessory foramina. The vertical distances from the frontoethmoidal suture to the anterior, posterior, and accessory ethmoidal foramina were examined.
Seventeen anterior ethmoidal foramina (20.2%) were situated above the frontoethmoidal suture (mean distance, 1.8 mm), and 2 posterior ethmoidal foramina (2.3%) were situated at 1.0 mm and 1.5 mm above the suture. Although accessory ethmoidal foramina were detected in 32 orbits (38.1%), one accessory foramen (middle ethmoidal foramen) was identified in 30 orbits, and 2 foramina (additional deep-middle ethmoidal foramina), in 2 orbits. One middle ethmoidal foramen (3.1%) and 1 deep-middle ethmoidal foramen (50.0%) were located at 1.5 mm above the suture. In total, 2 of the 34 accessory ethmoidal foramina (5.9%) exhibited the extrasutural location.
Several ethmoidal foramina were situated above the frontoethmoidal suture. The anterior ethmoidal foramen most frequently showed the situation, followed by the accessory and posterior foramina, in order. Our findings help predict the anatomical variations in the location of the ethmoidal foramina in relation to the frontoethmoidal suture, thereby enhancing safety for medial orbital wall surgery.
Ophthalmic plastic and reconstructive surgery 07/2011; 27(6):457-9. · 0.69 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To characterize the macroscopic anatomy of the vertical lacrimal canaliculus and the lacrimal punctum in relation to the tarsal plate.
Twenty-eight eyelids of 7 cadavers (mean age at death, 79.1 years; range, 65-93 years) were used for the investigation. The harvested eyelids were incised vertically around the central part of the upper and lower eyelids. The whole superior border of the upper tarsal plate and the whole inferior border of the lower tarsal plate were exposed by removing the soft tissues adjacent to them. We first examined whether these tarsal plates contained a lacrimal punctum. If the lacrimal punctum was found, we inserted a lacrimal probe to the punctum and measured the length covered by the tarsal plate using a millimeter ruler.
All the tarsal plates contained the lacrimal punctum, and the mean length of the canaliculi covered by the tarsal plates was 2.82 mm (range, 2.3-3.0 mm) in the upper eyelid and 2.39 mm (range, 2.3-2.5 mm) in the lower eyelid.
Since the length of the vertical lacrimal canaliculus including the lacrimal punctum is generally 2 mm, they are considered as tarsal components in both the upper and lower eyelids.
Ophthalmic plastic and reconstructive surgery 05/2011; 27(5):384-6. · 0.69 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To examine Müller's muscle's horizontal extensions in relation to the peribulbar smooth muscle network.
Observational anatomic study.
Twenty postmortem orbits (10 right, 10 left) of 15 Asians (8 males, 7 females; age range at death, 61-93 years; mean age, 78.4 years) fixed in 10% buffered formalin.
After performing a full-thickness 360° incision of the periosteum around the circumference of the orbit, the periosteum was elevated and finally detached near to the orbital apex. Nerves, blood vessels, and the nasolacrimal duct arising from the orbital wall were cut. The lateral orbital wall then was removed at approximately 3 cm posterior to the orbital rim and the retrobulbar content was incised with a sharp scalpel in a coronal plane. The removed orbital content was incised at a plane passing from a point located 15 mm superior to the upper eyelid margin and the globe equator at 3- and 9-o'clock areas. The sliced specimens were dehydrated and embedded in paraffin, cut into 7-μm thickness sections, and then stained with Masson trichrome.
The medial and lateral extensions of Müller's muscle in relation to the peribulbar smooth muscle network.
In all specimens, Müller's muscle extended medially and laterally. The medial extension reached the medial rectus muscle pulley, which is rich in smooth muscle fibers. The lateral extension reached the lateral rectus muscle pulley by passing through the lacrimal gland fascia of the palpebral lobe, in which 12 specimens also showed a direct extension to the lateral rectus muscle pulley in the posterior part.
Müller's muscle has a medial and a lateral extension to the peribulbar smooth muscle network. These new findings indicated that Müller's muscle is not an independent structure in the upper eyelid, but rather a component of the peribulbar smooth muscle network.
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Ophthalmology 11/2010; 117(11):2229-32. · 5.45 Impact Factor
-
Ophthalmology 03/2010; 117(3):644, 644.e1-4. · 5.45 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To examine the anatomic relationships between the preaponeurotic fat pad, orbital septum, and the distal end of the anterior layer of the levator aponeurosis (DEALLA) in relation to the superior tarsal plate border.
Prospective, clinical case series and experimental anatomic study.
Twenty-two upper eyelids in 11 Asian patients (average age, 76.5 years) and 10 postmortem upper eyelid specimens of 7 Asians (average age, 81 years).
The relationships between the orbital septum, DEALLA, preaponeurotic fat pad, and the superior tarsal plate border were examined in vivo, during upper blepharoplasty. In cadavers, the orbital septum was exposed and excised from the DEALLA, and the distance from the superior tarsal plate border to the DEALLA was measured at 3 points: the center of the palpebral width, and 2 points located 7 mm medial and lateral to the center.
The anatomic relationships of the orbital septum, DEALLA, and the preaponeurotic fat pad with the superior tarsal plate border.
In vivo, the DEALLA was always located above the superior tarsal plate border, and the lower margin of the preaponeurotic fat was always positioned below the DEALLA and around the superior tarsal plate border. The lateral preaponeurotic fat in 4 eyelids showed extension beyond the superior tarsal border. In cadavers, the average distance from the superior tarsal plate border to the DEALLA was 3.7 mm centrally, 3.0 mm medially, and 0.9 mm laterally. In 3 specimens, the confluent part of the orbital septum and the levator aponeurosis reached the tarsus in the lateral area.
Orbital septum attachment on the levator aponeurosis in Asians seems to be situated above the superior tarsal plate border in vivo, but the preaponeurotic fat extends beyond the DEALLA, sometimes reaching the tarsal plate. In some cadavers, the confluent part was found to be situated on the tarsus laterally.
Ophthalmology 08/2009; 116(10):2031-5. · 5.45 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Lysosome reactions were ultrastructurally analyzed using a cell-free system with inside-out cell membrane vesicles (IOVs) prepared from rat erythrocyte ghosts in an alkaline buffer and with wheat germ agglutinin-coated colloidal gold particles (WGA-CGs). The submembranous surface coat in the ghosts was depleted from the IOVs' outer surfaces. When lysosomes from rat liver were incubated with these IOVs, some of the trilaminar membranes of the lysosomes and IOVs came into close contact and formed a five-laminar structure without an intermembranous gap. In other reactions, the membranes of both structures formed one continuous trilaminar membrane along the margin of contact and ruffling five-laminar structures in other regions. Several lysosomes exhibited invaginating hollows or projections that entrapped or encircled the IOVs. Similar five-laminar structures were seen at a few points of contact between the IOVs and the hollowing or projecting membranes. In contrast, such reactions were much rarer when IOVs with reconstituted spectrins and actins on their outer surface were used. The formation of tubuliform pits with membrane-bound WGA-CGs was also observed after the incubation of lysosomes with WGA-CGs. These observations suggest that lysosomes fuse with cytoskeleton-depleted IOVs, wrap arm-like projections around them, enclose them by invagination or incorporate their membrane-bound macromolecules through the process of tubuliform invagination. Furthermore, the fusion and wrapping processes are not necessarily independent.
Okajimas Folia Anatomica Japonica 08/2009; 86(2):37-44.
-
[show abstract]
[hide abstract]
ABSTRACT: The nomenclature of each part of the lacrimal canaliculus, for example the vertical portion, does not always reflect the true course. Since we have sometimes observed findings suggesting the so called vertical portion of the lower lacrimal canaliculus inclined laterally, we re-examined the course of the vertical portion. Twenty-eight postmortem lower eyelids in 16 Japanese were examined and divided into 2 groups. The first group was 14 lower eyelids of 7 cadavers. Eyelids were incised sagittally from the lower lacrimal punctum. The second group was 14 lower eyelids of 9 cadavers; these were incised from the lower lacrimal punctum with 5 degrees lateral inclination to the sagittal plane. In the first group, 10 canaliculi of 7 cadavers were interrupted at the halfway point of the vertical portion. Four canaliculi of 4 cadavers included the whole length of the vertical portion. In the second group, all specimens included the whole length of the vertical portion. Most vertical portions of the lower lacrimal canaliculus demonstrated a laterally inclined course of approximately 5 degrees, although some took a completely vertical course.
Clinical ophthalmology (Auckland, N.Z.) 01/2009; 2(4):753-6.
