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The normal and variant clinical anatomy of the sensory supply of the orbit.
Clin Anat. 2014 Mar; 27(2):169-75.CA

Abstract

Orbital and retro-orbital pain are relatively common clinical conditions that are associated with such disorders as trigeminal, lacrimal, and ciliary neuralgia, cluster headaches, paroxysmal hemicrania, inflammatory orbital pseudotumor, trochleitis, and herpetic neuralgia ophthalmicus, thus making the nerves supplying the orbit of great clinical importance. Surprisingly, how pain from this region reaches conscious levels is enigmatic. Classically, it has been assumed that pain reaches the ophthalmic division of the trigeminal nerve (V1) and travels to the descending spinal trigeminal nucleus. However, exactly where the receptors for orbital pain are located and how impulses reach V1 is speculative. In this project, we reviewed all of the reported connections between the orbital nerves and V1 in order to understand how pain from this region is transmitted to the brain. We found reported neural connections to exist between cranial nerve (CN) V1 and CNs III, IV, and VI within the orbit, as well as direct neural branches to extra-ocular muscles from the nasociliary, frontal, and supraorbital nerves. We also found reported neural connections to exist between the presumed carotid plexus and CN VI and CN V1 , CN VI and CN V1 and V2 , and between CN V1 and CN III, all within the cavernous sinus. Whether or not these connections are sympathetic or sensory or some combination of both connections remains unclear. An understanding of the variability and frequency of these neural connections could lead to safer surgical procedures of the orbit and effective treatments for patients with orbital pain.

Authors+Show Affiliations

Department of Anatomy and Cell Biology, Indiana University School of Medicine, Fort Wayne, IN.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

24430947

Citation

Voirol, Jenna R., and Joel A. Vilensky. "The Normal and Variant Clinical Anatomy of the Sensory Supply of the Orbit." Clinical Anatomy (New York, N.Y.), vol. 27, no. 2, 2014, pp. 169-75.
Voirol JR, Vilensky JA. The normal and variant clinical anatomy of the sensory supply of the orbit. Clin Anat. 2014;27(2):169-75.
Voirol, J. R., & Vilensky, J. A. (2014). The normal and variant clinical anatomy of the sensory supply of the orbit. Clinical Anatomy (New York, N.Y.), 27(2), 169-75. https://doi.org/10.1002/ca.22328
Voirol JR, Vilensky JA. The Normal and Variant Clinical Anatomy of the Sensory Supply of the Orbit. Clin Anat. 2014;27(2):169-75. PubMed PMID: 24430947.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The normal and variant clinical anatomy of the sensory supply of the orbit. AU - Voirol,Jenna R, AU - Vilensky,Joel A, Y1 - 2014/01/16/ PY - 2013/08/12/received PY - 2013/09/04/revised PY - 2013/09/04/accepted PY - 2014/1/17/entrez PY - 2014/1/17/pubmed PY - 2014/10/1/medline KW - abducens nerve KW - oculomotor nerve KW - ophthalmic nerve KW - orbital pain KW - trigeminal nerve KW - trochlear nerve SP - 169 EP - 75 JF - Clinical anatomy (New York, N.Y.) JO - Clin Anat VL - 27 IS - 2 N2 - Orbital and retro-orbital pain are relatively common clinical conditions that are associated with such disorders as trigeminal, lacrimal, and ciliary neuralgia, cluster headaches, paroxysmal hemicrania, inflammatory orbital pseudotumor, trochleitis, and herpetic neuralgia ophthalmicus, thus making the nerves supplying the orbit of great clinical importance. Surprisingly, how pain from this region reaches conscious levels is enigmatic. Classically, it has been assumed that pain reaches the ophthalmic division of the trigeminal nerve (V1) and travels to the descending spinal trigeminal nucleus. However, exactly where the receptors for orbital pain are located and how impulses reach V1 is speculative. In this project, we reviewed all of the reported connections between the orbital nerves and V1 in order to understand how pain from this region is transmitted to the brain. We found reported neural connections to exist between cranial nerve (CN) V1 and CNs III, IV, and VI within the orbit, as well as direct neural branches to extra-ocular muscles from the nasociliary, frontal, and supraorbital nerves. We also found reported neural connections to exist between the presumed carotid plexus and CN VI and CN V1 , CN VI and CN V1 and V2 , and between CN V1 and CN III, all within the cavernous sinus. Whether or not these connections are sympathetic or sensory or some combination of both connections remains unclear. An understanding of the variability and frequency of these neural connections could lead to safer surgical procedures of the orbit and effective treatments for patients with orbital pain. SN - 1098-2353 UR - https://www.unboundmedicine.com/medline/citation/24430947/The_normal_and_variant_clinical_anatomy_of_the_sensory_supply_of_the_orbit_ L2 - https://doi.org/10.1002/ca.22328 DB - PRIME DP - Unbound Medicine ER -