Summary
This investigation was designed to extend our present knowledge of the supraorbital n. (SO n.) distal to the supraorbital notch. It is based on 40 dissected hemi-faces and the position of the notch and the periosteal and frontalis cutaneous branches of the SO n. were studied. The notch was 33.05 mm from the midline on the right side and 30,70 mm on the left. The periosteal branch arises from the lateral frontalis cutaneous branch. Its ascends in an oblique direction laterally and ends in two terminal branches. The frontalis cutaneous branch, after a very short trunk, divides into two branches, medial and lateral. The medial or deep branch enters the corrugator supercilii m. between its fibers. Most frequently, it passes under the inferior fasciculus and superficial to the middle and superior ones. Leaving the corrugator m., it ascends medially into the frontalis m., supplying the median cutaneous frontalis region. The lateral or superficial branch crosses superficial to the corrugator supercilii m. to penetrate the frontalis m. in an ascending and lateral direction, supplying the lateral frontalis region. The two branches enter the frontalis m., displaying a zigzag pattern in order to adapt its length during expressive movements. They cross the frontalis region together with the SO a. and two veins supplying the nerve and the frontalis m. These anatomic data may explain some of the complications after surgery for ptosis and blepharospasm.
Résumé
Le but de ce travail est de mieux connaître le trajet du nerf supraorbitaire (n. SO) après sa sortie de l'échancrure supra-orbitaire. Nous avons disséqué 40 hemi-faces en déterminant pour chacune la position de l'échancrure, le trajet des branches périostée et cutanée frontale du nerf SO. La branche périostée provient le plus souvent de la branche cutanée frontale latérale. Sa direction est ascendante en haut et latéralement et se termine par deux branches terminales. La branche cutanée frontale, après un tronc commun court, se divise en deux branches, une médiale et une latérale. La branche médiale ou profonde chemine dans le muscle corrugator. La distribution la plus fréquente se fait en profondeur du faisceau inférieur et superficiellement par rapport aux faisceaux moyen et supérieur. Elle sort au bord supérieur du muscle corrugator et chemine dans le muscle frontal. Sa direction est ascendante médialement. Elle innerve la partie médiale du front. La branche latérale ou superficielle passe superficiellement au muscle corrugateur pour pénétrer dans le muscle frontal. Sa direction est ascendante latéralement et il innerve la partie latérale du front. Ces deux branches cheminent entre les fibres musculaires du muscle frontal et ont un aspect en accordéon pour suivre les mouvements musculaires au cours de la mimique. Elles sont accompagnées par une artère et deux veines provenant du pédicule supra-orbitaire. L'artère donne des collatérales destinées au nerf SO et au muscle frontal. Ces données anatomiques permettent d'expliquer certaines complications survenant dans la chirurgie du ptôsis et du blépharospasme.
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Malet, T., Braun, M., Fyad, J.P. et al. Anatomic study of the distal supraorbital nerve. Surg Radiol Anat 19, 377–384 (1997). https://doi.org/10.1007/BF01628505
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DOI: https://doi.org/10.1007/BF01628505