Emerging Points of the Supraorbital and Supratrochlear Nerves in the Supraorbital Margin With Reference to the Lacrimal Caruncle: Implications for Regional Nerve Block in Upper Eyelid and Dermatologic Surgery
Emerging Points of the Supraorbital and Supratrochlear Nerves in the Supraorbital Margin With Reference to the Lacrimal Caruncle: Implications for Regional Nerve Block in Upper Eyelid and Dermatologic Surgery
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DOI：
10.1097/dss.0000000000000818
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发表时间：
2016-08
影响因子：
2.4
通讯作者：
K. Shin;H. Shin;Shin-Hyo Lee;W. Song;K. Koh;Y. Gil
中科院分区：
文献类型：
--
作者：
K. Shin;H. Shin;Shin-Hyo Lee;W. Song;K. Koh;Y. Gil
背景通过在手术部位远端注射麻醉剂来阻断眶上神经（SON）和肌上神经（OPN）在上眼睑手术中具有避免模糊手术标志和损害提肌功能的优点。目的以泪阜为参照点，确定泪上腺和泪下腺在眶上缘的出露点。方法对27具朝鲜族尸体的49个眼眶进行解剖。以泪阜和面部中线为标志。在眶上缘确定SON和SON的出露点。结果SON和SON的出射点分别位于沿着眶上缘泪阜顶点垂线外侧3.0 mm和内侧3.3 mm处。从面部中线到SON和STN出现点的水平距离分别为22.8和15.2 mm。结论SON阻滞的最佳位置为泪阜顶点沿眶上缘沿着垂直线外侧3mm，泪阜顶点沿眶上缘垂直线内侧3mm。这些知识将帮助外科医生实现一个简单而准确的方法进行区域神经阻滞。
BACKGROUND Blocking the supraorbital nerve (SON) and supratrochlear nerve (STN) by injecting anesthetic distal to the surgical site has the advantage in upper eyelid surgery that avoids obscuring the surgical landmarks and compromising the levator function. OBJECTIVE To identify the emerging points of the SON and STN in the supraorbital margin with reference to the lacrimal caruncle. METHODS Forty-nine orbits from 27 embalmed Korean cadavers were dissected. The lacrimal caruncle and facial midline were used as landmarks. The emerging points of the SON and STN in the supraorbital margin were determined. RESULTS The emerging points of the SON and STN were, respectively, located at 3.0 mm lateral and 3.3 mm medial to the vertical line through the apex of the lacrimal caruncle along the supraorbital margin. The horizontal distances from the facial midline to the emerging points of the SON and STN were 22.8 and 15.2 mm, respectively. CONCLUSION The optimum sites for achieving SON and STN block are, respectively, located approximately 3 mm lateral and 3 mm medial to the vertical line through the apex of lacrimal caruncle along the supraorbital margin. This knowledge will help the surgeon achieve an easy and accurate approach for regional nerve block.