distance between the superior aspect of the superior orbital fissure
(peak point of the superior orbital fissure
) and the base of the metoptic canal,
The term superior orbital fissure
syndrome (SOFS) or Rochon-Duvigneaud syndrome is applied to lesions located immediately anterior to the orbital apex, associated with impaired function of the cranial nerves (III, IV, V, and VI) that enter the orbit through the SOF.,, An orbital apex syndrome (OAS) is a syndrome involving the same cranial nerves as in SOFS, but there is associated optic nerve dysfunction.,
Clinical anatomy of the superior orbital fissure
and the orbital apex.
The optic strut represents a bony formation that connects the body of sphenoid bone and its lesser wing and separates optic canal from the medial part of the superior orbital fissure
. Surgical procedures on cavernous sinus and suprasellar region demand total removal of the optic strut, which if not removed can lead to damage of optic nerve or internal carotid artery.
Head CT scan revealed a low density 4 cm long foreign body extending from the left orbit to superior orbital fissure
and posteriorly to the left temporal lobe (Figures 1(a)-1(c)).
The most likely path was thought to be through the medial aspect of the orbit through the superior orbital fissure
, then through the cavernous sinus, lateral/tangential to the internal carotid artery, and then traversing the pons in an anteroposterior fashion (Figure 2 right).
THS is caused by a non-specific inflammatory process in the cavernous sinus or superior orbital fissure
Specific diagnostic criteria have been recommended by the International Headache Society which includes unilateral headache; granulomatous inflammation of the cavernous sinus and superior orbital fissure
or orbit seen on magnetic resonance imaging or biopsy; paresis of one or more of the ipsilateral third, fourth, and/or sixth cranial nerves; evidence of causation demonstrated by both headache preceded by oculomotor paresis by less than 2 weeks or developed with it and headache that is localized around the ipsilateral brow and eye; and symptoms not better accounted for by an alternative diagnosis .
Orbital canal, superior orbital fissure
and cavernous sinuses are located in the retroorbital area and anatomically related to each other.
The mass was extending into the right cavernous sinus through the superior orbital fissure
and into the sella, displacing the pituitary gland.
Through the retroorbital tissue, light could then reach the large superior orbital fissure
, as shown in the MRI scan in Figure 4(b), gaining access to the internal cavity of the skull.
Wysocki, "Clinical anatomy of the superior orbital fissure
and the orbital apex," Journal of Cranio-Maxillofacial Surgery, vol.