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Evaluation and Classification of Supraorbital Nerve Emerging Patterns

  • Original Article
  • Facial Surgery
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Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Numerous significant variations in the supraorbital nerve (SON) pass through the notches and foramina. During endoscopic forehead lifting, the passage and the location of the nerve against the frontal bone render it susceptible to injury, resulting in diminished or absent sensation in the corresponding location. We attempted to obtain accurate knowledge of the SON emergence routes.

Methods

Data of patients who underwent an endoscopic forehead lift in a plastic surgery clinic between November 2015 and August 2021 were retrospectively analyzed. Deep and superficial branch pathways of SONs were identified and compared according to side and gender. We also classified the nerve patterns into six types.

Results

Altogether, 942 patients (1884 SON cases) were evaluated. Out of the patients, 86 patients were male, and 856 were female. The overall mean age was 48.6 (± 13.1) years. In the deep branches, 49% came from the notch, and 51% came from the foramen. In the superficial branches, 67% came from the notch, and 33% of superficial branches came from the foramen. Unlike the deep branch, superficial branches from the notch were significant. Deep and superficial branches of male patients were much more notched than those of female patients. Branches emerged together in 56% and separately in 44% of the cases.

Conclusion

The absolute number of SON notches was higher than that of SON foramina. This study with the largest number of SON cases will help surgeons understand the variation and course of SON.

Level of Evidence IV

This journal requires that authors 38 assign a level of evidence to each article. For a full 39 description of these Evidence-Based Medicine ratings, 40 please refer to the Table of Contents or the online 41 Instructions to Authors www.springer.com/00266.

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Armed Forces Capital Hospital, Seongnam, Gyeonggi-do, Republic of Korea

    Ryun Ha

  2. Department of Otolaryngology-Head and Neck Surgery, Gil Medical Center, Gachon University School of Medicine, Incheon, Republic of Korea

    Seon Tae Kim

  3. Department of Otolaryngology-Head and Neck Surgery, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea

    Junsun Ryu

  4. ENT Over Flower Clinic, Incheon, Republic of Korea

    Il Gyu Kang

  5. Department of Otolaryngology-Head and Neck Surgery, G Sam Hospital, Gunpo, Gyeonggi-do, Republic of Korea

    Jae Goo Kang

  6. Department of Anatomy, College of Medicine, Korea University, Seoul, Republic of Korea

    Chang-Sub Uhm & Im Joo Rhyu

  7. Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Yun Hee Choi

  8. Grande International Hospital, Kathmandu, Nepal

    Sarina Rajbhandari

  9. AONE Plastic and Aesthetic Surgery, 18-6, Ihyeon-ro 29 beon-gil, Giheung-gu, Yongin, Gyeonggi-do, 16931, Republic of Korea

    Taek Keun Kwon

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  1. Ryun Ha
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Corresponding author

Correspondence to Taek Keun Kwon.

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The authors declare that they have no other conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards (P01-202201-01-010).

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For this type of study, all the patients had signed the informed consent.

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Video 1. Identify the deep and superficial branch pathways of supraorbital nerves using the Dandy nerve-hook in right surgical field. Supplementary file1 (MP4 15246 KB)

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Ha, R., Kim, S.T., Ryu, J. et al. Evaluation and Classification of Supraorbital Nerve Emerging Patterns. Aesth Plast Surg 48, 304–311 (2024). https://doi.org/10.1007/s00266-022-03181-2

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  • DOI: https://doi.org/10.1007/s00266-022-03181-2

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