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Regional Anatomy of the Superior Orbital Fissure and Orbit

Surgical Correlation


Regional Anatomy of the Superior Orbital Fissure and Orbit. A, Lateral view of the right SOF. The lesser wing of sphenoid bone and lateral wall orbit have been removed to expose the structures passing through the SOF. The frontal nerve has been retracted inferolaterally. The lateral sector transmits the trochlear, frontal, and lacrimal nerves, all of which pass through the fissure outside the annular tendon. B, Superior view of the right orbital apex. The optic nerve has been retracted medially to expose the ciliary ganglion. The ciliary ganglion receives parasympathetic motor root from the inferior oculomotor nerve, sensory root from the nasociliary nerve, and sympathetic fibers from the plexus around ophthalmic artery. C, Enlarged view of the SOF. The lateral margin of the SOF in A has been removed. The oculomotor foramen is the portion of the opening in the annular tendon lateral to the optic foramen through which the superior and inferior divisions of the oculomotor nerve and the nasociliary nerve and abducens nerve pass. The nasociliary nerve is situated above and lateral to the abducens nerve in the anterior part of the cavernous sinus. D, The annular tendon has been divided between the origin of the superior and lateral rectus muscles. The nasociliary nerve separates from the oculomotor and abducens nerves by fibrous septum within the oculomotor foramen. E, The levator and superior rectus muscles have been reflected medially and lateral rectus muscle has been reflected laterally to expose the right optic nerve (removed) and short ciliary nerve arising from the ciliary ganglion. F, Anterior view of the right orbit and extraocular muscles after removing the eye globe and optic nerve. The lacrimal nerve courses along the superior margin of the lateral rectus muscle. The nasociliary nerve gives rise to long ciliary nerves that enter the sclera around the optic nerve with the short ciliary nerves arising from the ciliary ganglion. (Images courtesy of AL Rhoton, Jr.)