ANTHROPOMETRIC MEASUREMENTS OF INFRAORBITAL FORAMEN AND ITS ANATOMIC VARIATIONS IN DRIED HUMAN SKULLS

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Int J Anat Res 2015, 3(4):1487-90. ISSN 2321-4287 1487

Original Research Article

AN THROPOM ETRIC M EASU REM EN TS OF I N FRAORBI TAL

FORAM EN AND ITS ANATOM IC VARIATIONS IN DRIED HUM AN

SKULLS

Shikha Sharma *

1

_{, Anil Sharma}

2

_{, Chetna Thakur}

3

_{, Bhaw ani Shankar M odi}

4

_.

ABSTRACT

Address for Correspondence: Dr. Shikha Sharma, FH M edical College, Anat omy Depart ment , Near Et madpur, Railway over Bridge, NH-2, Tundla Dist ., Firozabad, Uttar Pradesh 283201, India.

E-M ail: anilsharma4160@gmail.com

Aim: This st udy w as t o det erm ine t he dist ance bet w een IOF and IOM , IOF and pyriform apert ure,t he presence of accessor y foram inae, orient at ion and locat ion in relat ion w it h t eet h on bot h t he sides.

M aterials and M ethods: Fift y dried hum an skulls (100 sides) irrespect ive of age and sex w ere used for t his st udy. The distance bet w een t he IOF and IOM and t he dist ance bet w een t he IOF and pyriform apert ure w ere m easured by using m anual vernier calliper. The orientat ion, locat ion in relat ion w it h t eet h and presence of accessor y foram ina w ere observed m acroscopically.

Observations and Discussion: Accessory foramina m ay give com plicat ions during anaest het izat ion of t his region. The m ean dist ance bet w een t he IOF and infraor bit al m argin w as 22.6m m and 15.2m m on t he left and right side respect ively. M ean distance bet w een I.O.F and pyriform apert ure w as 26.2m m and 25.8m m on t he left and right side respect ively. In 30% skulls t he IOF w ere direct ed vert ically dow nw ard on t he r ight side and in 38% on t he lef t side. In 66% dow nw ard m edially on t he right side and 56% on t he left side and in4% skulls m edially on t he right side and 6% on t he left side. The m ajor it y of IOF w er e orient ed t o second prem olar t eet h on t he right side and bet w een second prem olar and first m olar on t he left side.Accessory foram inae w ere found in 6% of skulls. The result s of our st udy m ay be helpful during sur gical procedur es in t he m axillar y region in reduct ion of Lef ort fract ur e, and giving regional nerve block.

KEY W ORDS: Infraor bital foram en,Infraorbital m argin, Pyrifor m apert ure, M anual vernier calliper.

INTRODUCTION

Int ernat ional Journal of Anatomy and Research, Int J Anat Res 2015, Vol 3(4):1487-90. ISSN 2321- 4287 DOI: ht t p:/ / dx.doi.org/10.16965/ ijar.2015.272

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Received: 16 Sep 2015 Accept ed: 02 Oct 2015 Peer Review : 16 Sep 2015 Published (O): 31 Oct 2015 Revised: None Published (P): 31 Dec 2015

Int ernat ional Journal of Anat omy and Research ISSN 2321-4287

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DOI: 10.16965/ ijar.2015.272

*1_{Associate Professor, Depart ment of Anat omy, FH M edical College, Tundla, Uttar Pradesh, India.}

2_{Associate Professor, Depart ment of M edicine, FH M edical College, Tundla, Uttar Pradesh, India.}

3_{Assistant Professor, Depart ment of Anat omy, FH M edical College, Tundla, Uttar Pradesh, India.}

4_{Tut or, Depart ment of Anat omy, FH M edical College, Tundla, Uttar Pradesh, India.}

i nf r aor b i t al f o r am en an d gi v e sen so r y innervat ions t o low er eyelid,side of nose and upper lip t hr ough it s palpeber al, nasal and l ab ial b r anch es [ 3,4] . Th e po sit io n o f t h e infraorbit al foramen varies from 4-12mm [5,6]. The knowledge about t he posit ion of the infraor-bit al foramen provides import ant dat a in giving Infraorbit al m argin is form ed lat erally by t he

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Shikha Shar ma et al. ANTHROPOM ETRIC M EASUREM ENTS OF INFRAORBITAL FORAM EN AND ITS ANATOM IC VARIATIONS IN DRIED HUM AN SKULLS.

M ATERIALS AND M ETHODS

local anest hesia in m axillof acial and plast ic sur ger ies [ 7-10] . The know ledge about t he presence of supernumerary foraminae help in performing surgeries in relat ion t o t he infraor-bit al foramen and giving regional nerve block.

Fift y dried skulls of unknow n age and sex w ere selected from t he depart ment of CM CH BHOPAL and FHM C TUNDLA f or t his st u dy and t he follow ing measurement s and observat ions w ere recorded.

1. The dist ance of IOF from t he infraorbit al margin at t he zygomat icomaxillary sut ure w it h t he help of manual vernier calliper w it h least count of 0.1mm.

2. Transverse measurement s w ere taken from t h e IOF t o t he m ed ial m ar gin of pyr if o r m aperture.

3. Orient at ion of t he IOF w it h t he upper t eet h.

4. Direct ion of t he IOF w as not ed as vert ically dow nward, dow nward medially and medially.

5. The presence of accessory foraminae.

OBSERVATIONS

Fift y human dried skulls (bot h t he sides) w ere exam ined. The m ean v alue of t he v er t ical dist ance of IOF from t he infraorbit al margin w as found t o be 22.6mm on t he left side and15.2 mm on t he right side. The maximum dist ance recorded w as21mm and t he minimum dist ance w as 9mm on t he left side.

The maximum dist ance on t he right side w as 21 mm and minimum w as 11mm. The maximum dist ance bet ween t he IOF and pyriform apert ure w as 31mm and minimum w as 19mm on t he left side w hile on t he r ight side t he m axim um dist ance w as 30 mm and minimum distance w as 19mm. The mean of t he t ranseverse dist ance w as 26.2 mm on t he left side and 25.8 mm on the right side. Accessory foraminae were present in t hree skulls of w hich it w as unilat eral in t w o skulls and bilat eral in one skull as show n in fig. 1 and 2.

Fig. 1:Show ing presence of accessory foram inae.

Fig. 2:Ver t ical and Transverse M easurem ent s.

A

C B

B

Table 1:M orphom et ric M easurem ent M ean Values.

Plane of

m easure m e nt Left side Right side

Ve rt ical 22.6mm 15.2mm

Transverse 26.2mm 25.8mm

Table 2: M orphom et r ic M easurem ent s of Accessor y Foramen.

1 4mm 11mm 17mm 19mm

2 3mm 9mm 11mm 14mm

3 - 8mm 7mm

-Right Side S.No

Vert ical m easurement Transverse measurement

Right Side Left side Left Side

Table 3:Orientat ion of IOF w it h t he Teet h.

Teet h Right side no and % Left side no and %

1st M O 6(12%) 8(16%)

2NDPM / ISTM O 6(12%) 10(20%)

1stPM / 2NDPM 5(10%) 6(12%)

2NDPM 14(28%) 6(12%)

2NDM O 2(4%) 2(4%)

1stM O/ 2NDM O 2(4%) 1(2%)

Edant ulous 15(30%) 17(34%)

Table 4:Show ing t he direct ion of IOF.

Direct ion Right side no and % Left side no and %

DM 33(66%) 28(56%)

VD 15(30%) 19(38%)

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Int J Anat Res 2015, 3(4):1487-90. ISSN 2321-4287 1489 DISCUSSION

Table 5:Com par ision of Present St udy w it h Previous Study.

St udy No of

sam ples

M ean Dist ance of IOF from IOM mm

Accessory foramen %

Aziz et al 2000 [7] 47 8.3±1.9 15

Cut right et al 80 6.4±0.3

-Elias et al 2004 [19] 210 6.71±1.70 15.23

Bhoopat i et al 2010 [17] 80 6.57±1.7 16.25

Present st udy 50 15.2(rt),22.6mm(l t) 15

The know ledge of anat omical feat ures of IOF is essent ial for t he surgeons dealing wit h maxillary region like surgeries for fractures of zygoma [11], int ra or ext ra-oral anaest hesia [12,13]. The di st an ce bet w een IOF and IOM had been report ed t o lie bet w een 4-10mm [7,14,15]. The mean distance in between IOF and IOM our st udy w as 22.6mm and 15.2mm on t he left and right side respect ively, w hich was on t he higher side as com pared w it h t he previous st udy. The know ledge of locat ion of IOF is mandat ory t o avoid injuries of eye during nerve block and dur ing sur ger ies of com m inut e f r act ur e of m axilla or inf er ior or bit al w all. Gr uber [ 16] r ep o r t ed f i r st t h e p r esen ce o f accessor y infraorbit al foramen. Bhoopat i et al [17] report ed accessory foramen in 16.25% of skulls in sout h Indians.In present st udy. The incidence of AF was low er t han t he pr evious st udies.Regar ding double AF, present st udy coincide w it h t he findings of Kadnoff [18] M ost of t he IOF w ere direct ed dow nw ard and medially as revealed by Ellias [19]. In our st udy 38% IOF w ere direct ed vert ically downward and in 6% directed medially. It is necessary t o know t he direction of IOF while passing needle t o block t he nerve and t o direct t he p r o b e i n r ad i of r equ en cy n eu r o t o m y procedures. Our st udy show ed t hat in t he 10% t he t oot h most commonly not ed in t he same vert ical line w as bet w een second premolar and first molar on t he left side and in 14% cases t he t oot h in t he same vert ical plane w as second premolar on t he right side.

CONCLUSION

The know ledge of t he locat ion of IOF, presence o f accessor y f or am in a an d m or ph om et r i c m easurem ent is very useful t o m axillofacial surgeons as in reduct ion of Lefort ’s fract ure, for anaest het ist w hile giving regional nerve block

f o r t h e b et t er o u t co m e of d iagn ost i c o r t herapeutic procedures.

ACKNOW LEDGEM ENTS

I am t hankful t o M r. Ramesh and M r. M ukesh w ho helped me in t aking phot ographs. I am also t hankful to M s.Shilpi w ho helped me in t he draft -ing of t he t ext .

ABBREVIATIONS

IOF- Infra Orbit al Foramen, IOM - Infra Orbit al M argin, PM - Premolar,

M O- M olar,

DM - Directed medially, VD- Vert ically directed M - M edially

AF- Accessory Foramen.

Conflicts of Interests: None

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ANTHROPOMETRIC MEASUREMENTS OF INFRAORBITAL FORAMEN AND ITS ANATOMIC VARIATIONS IN DRIED HUMAN SKULLS