Tansatit Tanvaa, Apinuntrum Prawit, Phetudom Thavorn
The Chula Soft Cadaver Surgical Training Center and Department of Anatomy, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, 1873 Rama 4 Road, Pathumwan, Bangkok, 10330, Thailand.
Aesthetic Plast Surg. 2017 Jun;41(3):678-688. doi: 10.1007/s00266-016-0762-2. Epub 2016 Dec 28.
Filler injections for sunken upper eyelid correction and glabellar augmentation at the orbitoglabellar region need to be performed correctly. Precise knowledge of the emerging sites of all terminal branches of the ophthalmic artery is essential for these procedures to be conducted safely.
The terminal branches of the ophthalmic artery were studied in both periorbital and intraorbital dissections. The aim of this study was to verify the critical positions of the emerging sites at the orbital septum that may act as potential retrograde channels for filler emboli.
In the 40 eyes examined, the branches of the ophthalmic artery were found to emerge from four different sites. Two substantial emerging sites were situated on both sides of the trochlea of the superior oblique muscle. These sites were located at the superior part of the medial orbital rim (SMOR) and are alternatively named as the epitrochlear and the subtrochlear emerging sites. The other two sites can be regarded as accessory emerging sites due to the comparably smaller artery. Dissection of the intraorbital region revealed small periosteal branches of the infraorbital artery which coursed anteriorly on the orbital floor to form anastomoses with the lacrimal artery. In other areas of the orbital floor, no branches extended from the infraorbital artery. In front of the lacrimal gland, very minute branches descended and coursed along both margins of the superior tarsus but did not course outside the lateral orbital rim.
A danger zone was located at the SMOR, where the ophthalmic branches emerge to form anastomotic channels. Compression at the trochlea guarantees safe injection of filler, reducing the risk of complication.
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在上睑凹陷矫正及眶眉间区域眉间填充注射时，需要正确操作。精确了解眼动脉所有终末分支的发出部位对于安全进行这些操作至关重要。
在眶周和眶内解剖中研究眼动脉的终末分支。本研究的目的是确定在眶隔处发出部位的关键位置，这些位置可能成为填充剂栓子的潜在逆行通道。
在检查的40只眼中，发现眼动脉分支从四个不同部位发出。两个主要发出部位位于上斜肌滑车两侧。这些部位位于眶内侧缘上部（SMOR），也可分别称为滑车上方和滑车下方发出部位。另外两个部位由于动脉相对较细，可视为附属发出部位。眶内区域解剖显示眶下动脉的小骨膜分支，这些分支在眶底向前走行，与泪腺动脉形成吻合。在眶底的其他区域，没有分支从眶下动脉延伸出来。在泪腺前方，非常细小的分支下降并沿上睑板两侧走行，但未超出眶外侧缘。
危险区域位于SMOR，此处眼动脉分支发出形成吻合通道。在滑车处压迫可确保安全注射填充剂，降低并发症风险。
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