The 'superior orbital fissure' is a
foramen in the skull, although strictly it is more of a cleft, lying between the
lesser and
greater wings of the
sphenoid bone.
Structures passing through
A number of important
anatomical structures pass through the fissure, and these can be damaged in
orbital trauma, particularly
blowout fractures through the floor of the orbit into the
maxillary sinus. These structures are:
★ superior and inferior divisions of
oculomotor nerve (III)
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trochlear nerve (IV)
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lacrimal,
frontal and
nasociliary branches of
ophthalmic nerve (
V1)
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abducens nerve (VI)
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superior ophthalmic vein
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sympathetic fibers from
cavernous plexus
Perhaps inevitably, a ribald
mnemonic has been dreamt up by medical students:
[1]
"Lazy French Tarts Sit Naked In Anticipation Of Sex" - for Lacrimal, Frontal, Trochlear,
Superior Division of Oculomotor, Nasociliary, Inferior Division of Oculomotor, Abducens nerves, Ophthalmic vein, Sympathetic nerves.
Pathology
The abducens nerve is most likely to show
signs of damage first, with the most common complaints retro-orbital
pain and the involvement of cranial nerves III, IV, V1, and VI without other neurological signs or symptoms. This presentation indicates either compression of structures in the superior orbital fissure or the
cavernous sinus.
Superior orbital fissure syndrome
'Superior orbital fissure syndrome', also known as 'Rochon-Duvigneaud's syndrome', is a neurological disorder that results if the superior orbital fissure is
fractured. Involvement of the cranial nerves that pass through the superior orbital fissure may lead to
diplopia,
paralysis of extraocular motions,
exophthalmos, and
ptosis.
Blindness or loss of vision indicates involvement of the orbital apex, which is more serious, requiring urgent surgical intervention.
See also
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Foramina of skull
Additional images
References
1.
External links
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