158 ● Oculofacial Plastic and Orbital Surgery Park KH, Kim YK, Woo SJ, et al; Korean Retina Society. Iatrogenic occlusion of the ophthalmic artery after cosmetic facial filler injections: a national survey by the Korean Retina Society. JAMA Ophthalmol. 2014;132(6):714–723. Supraorbital Supratrochlear Lacrimal Infratrochlear External nasal Buccal Mental Posterior rami Anterior rami Zygomaticotemporal Infraorbital Zygomaticofacial Greater occipital (C2) Third occipital (C3) Lesser occipital (C2,C3) Great auricular (C2,C3) Auriculotemporal CN V 1 CN V 2 CN V 3 Trigeminal nerve (CN V) S p i n a l n e r v e s Lateral view Supraorbital Supratrochlear Lacrimal Infratrochlear External nasal CN V 1 Zygomaticotemporal Infraorbital Zygomaticofacial CN V 2 Great auricular (C2,C3) Buccal Mental Auriculotemporal CN V 3 Anterior view Figure 9-8 The face receives its sensory innervation from the 3 branches of CN V: V 1 , ophthal- mic; V 2 , maxillary; and V 3 , mandibular. (Modified with permission from Moore KL, Dalley AF, Agur AMR. Clinically Oriented Anatomy. 7th ed. Baltimore: Lippincott Williams & Wilkins; 2013:851.)
Transcript
158 ● Oculofacial Plastic and Orbital Surgery
Park KH, Kim YK, Woo SJ, et al; Korean Ret ina Society. Iatrogenic occlusion of the ophthalmic artery after cosmetic facial filler injections: a national survey by the Korean Ret ina Society. JAMA Ophthalmol. 2014;132(6):714–723.
Supraorbital
Supratrochlear
Lacrimal
Infratrochlear
External nasal
Buccal
Mental
Posteriorrami Anterior
rami
Zygomaticotemporal
Infraorbital
Zygomaticofacial
Greater occipital (C2)
Third occipital (C3)
Lesser occipital (C2,C3)
Great auricular (C2,C3)Auriculotemporal
CN V1
CN V2
CN V3
Trigeminal nerve (CN V)
Spin
al n
erv
es
Lateral view
Supraorbital
Supratrochlear
Lacrimal
Infratrochlear
External nasal
CN V1
Zygomaticotemporal
Infraorbital
ZygomaticofacialCN V
2
Great auricular (C2,C3)
Buccal
Mental
Auriculotemporal
CN V3
Anterior view
Figure 9-8 The face receives its sensory innervation from the 3 branches of CN V: V1, ophthal-mic; V2, maxillary; and V3, mandibular. (Modified with permission from Moore KL, Dalley AF, Agur AMR. Clinically Oriented Anatomy. 7th ed. Baltimore: Lippincott Williams & Wilkins; 2013:851.)
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CHAPTER 9: Facial and Eyelid Anatomy ● 159
Eyelids
The eyelids can be divided into the following 7 structural layers:• skin and subcutaneous connective tissue• muscles of protraction• orbital septum• orbital fat• muscles of retraction• tarsus• conjunctiva
Figure 9-10 details the anatomy of the eyelids; Activity 9-2 is an online interactive tool for self- testing knowledge of eyelid anatomy. See also BCSC Section 2, Fundamentals and Princi ples of Ophthalmology, for additional discussion and numerous illustrations.
ACTIVITY 9-2 Upper and lower eyelid anatomy.Illustration modified from Stewart WB. Surgery of the Eyelid, Orbit,
and Lacrimal System. Ophthalmology Monograph 8, vol 2. San Francisco: American Acad emy of Ophthalmology; 1994:23, 85. Illustration by Cyndie C. H. Wooley.
Skin and Subcutaneous Connective Tissue
Eyelid skin is the thinnest skin of the body and is unique in having no subcutaneous fat layer. Because the thin skin of the eyelids is subjected to constant movement with each blink, the
Figure 9-9 Arterial danger zones of the face. Shading denotes areas to inject with caution. (Illustra-tion courtesy of Mark Miller, based on a sketch by Cat N. Burkat, MD.)
Supraorbital a.
Infraorbital a.
Ophthalmic a.chlear a.SupratrocS
.Angular a.A
Facial a.
Internalcarotid a.
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