Anat Cell Biol.  2019 Sep;52(3):242-249. 10.5115/acb.19.101.

Position and size of the sphenoid door jamb in the lateral orbital wall for the orbital decompression

• Shin KJ
• Lee SH
• Ha TJ
• Shin HJ
• Koh KS
• Song WC
• Paik DJ

• KMID: 2459538
• DOI: http://doi.org/10.5115/acb.19.101

Abstract

The aim of this study was to identify the three-dimensional topography of the sphenoid door jamb (SDJ) in the lateral orbital wall and to propose navigational guidelines for safe deep lateral decompression using surgical landmarks. The 120 orbits and SDJs of 60 subjects were three-dimensionally reconstructed using Mimics software. The mean volumes of the orbit and SDJ were 24.3 mm³ and 2.0 mm³, respectively. The mean distances from the lateral orbital margin (LOM) to the anterior and posterior margins of the SDJ were 13.2 and 36.3 mm, respectively. The mean distances from the superior orbital fissure to the LOM and to the posterior margin of the SDJ were 40.2 mm and 4.6 mm, respectively. The mean distances from the inferior orbital fissure (IOF) to the anterior and posterior margins of the SDJ were 3.8 mm and 20.5 mm, respectively. In the superior approach of the orbit, it can be predicted that the area up to 3 cm posterior from the LOM is safe, while 1 cm posterior from the safe zone could be a dangerous zone. In the inferior approach of the orbit, the safe area will be about 1 cm posterior from the anterior tip of the IOF, and the area up to 1 cm posterior from the safe zone should be approached with extreme care.

Keyword

Sphenoid doorjamb; Orbit; Orbital decompression; Graves disease

MeSH Terms

Decompression*
Graves Disease
Orbit*

Figure

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  Fig. 1 Transverse plane of the sphenoid door jamb (SDJ). CS, the cranial surface of the SDJ; MCF, the middle cranial fossa; OS, the orbital surface of the SDJ; T, the temporalis muscle; TS, the temporal surface of the SDJ.

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  Fig. 2 Segmentation and 3D volume rendering of the orbit and sphenoid door jamb (SDJ). (A) the outlines of the orbit and SDJ by manual segmentation. (B) The superior view of reconstructed orbit and SDJ. (C) Frontal view reconstructed orbit and SDJ. O, orbit.

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  Fig. 3 (A–C) Mean distances of the sphenoid door jamb (SDJ ) at the intermediated level (mm). CS, the cranial surface; LOM, the lateral orbital margin; MCF, the middle cranial fossa; OC, the optic canal; OS, the orbital surface; TS, the temporal surface.

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  Fig. 4 Mean distances of the sphenoid door jamb at the superior orbital fissure (SOF) and inferior orbital fissure (IOF) level (mm). LOM, lateral orbital margin.

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  Fig. 5 The navigational guidelines for the effective and safe deep lateral orbital decompression. IOF, inferior orbital fissure; LOM, lateral orbital margin; SOF, superior orbital fissure.

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