Superior Orbital Fissure - Structures Passing Through

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)
  • trochlear nerve (IV)
  • lacrimal, frontal and nasociliary branches of ophthalmic (V1).
  • abducens nerve (VI)
  • superior and inferior divisions of ophthalmic vein. Inferior division also passes through the inferior orbital fissure.
  • sympathetic fibers from cavernous plexus

These include nonvisual sensory messages, such as pain, or motor nerves. They also serve as vascular connections.

The nerves passing through the fissure can be remembered with the mnemonic, "Live Frankly To See Absolutely No Insult" - for Lacrimal, Frontal, Trochlear, Superior Division of Oculomotor, Abducens, Nasociliary and Inferior Division of Oculomotor nerve.

It is divided into 3 parts from lateral to medial: Lateral Part transmits: lacrimal nerve, frontal nerve, trochlear nerve, meningeal branch of lacrimal artery, anastomotic branch of middle meningeal artery which anastomoses with recurrent branch of the lacrimal artery Middle Part transmits: Upper and lower divisions of the oculomotor nerve, nasociliary nerve between the two divisions of oculomotor nerve and abducent nerve Medial Part transmits: Superior ophthalmic vein and sympathetic nerves from the plexus around internal carotid artery

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