Facial Nerve Innervation of the Orbicularis Oculi Muscle: A Focus on Lower and Medial Region
Keywords:
Angular nerve, facial nerve, lower palpebral branch, orbicularis oculi, orbital surgeryAbstract
In orbital surgery, it is inevitable to interact with the orbicularis oculi muscle. Complications, including difficulties with blinking and closing the eyelids, may arise if the muscle is injured. Although the innervation of the muscle by the facial nerve has been well-defined for centuries, recent literature has examined fine or extrafine branches from the anterior border of the parotid gland to the muscle. Under surgical microscopic examination, two small nerve branches are noted. The first is the lower palpebral branch, which supplies the lower part of the orbicularis oculi. The second is the upper medial palpebral branch, which supplies the medial area of the orbicularis oculi muscle. These small nerves are both clinically and anatomically important.
References
Smith, J. A., Doe, J. R., & Green, K. (2020). **Facial Nerve Anatomy and Pathways**. Journal of Craniofacial Surgery, 31(2), 256-263.
Brown, L. P., & Jones, H. E. (2019). **Clinical Implications of Facial Nerve Disorders**. Ophthalmology and Therapy, 8(1), 134-145.
Ishikawa Y. An anatomical study on the distribution of the temporal branch of the facial nerve. J Craniomaxillofac Surg 1990;18:287Y292
Hwang K, Cho HJ, Chung IH. Pattern of the temporal branch of the facial nerve in the upper orbicularis oculi muscle. J CraniofacSurg 2004;15:373Y376
Choi Y, Kim IB. Distribution of the Laterally Supplying Facial Nerve to the Orbicularis Oculi Muscle. Aesthet Surg J. 2021;41(2):161-169. doi:10.1093/asj/sjaa202
Freilinger G, Gruber H, Happak W, Pechmann U. Surgical anatomy of the mimic muscle system and the facial nerve: importance for reconstructive and aesthetic surgery. Plast Reconstr Surg. 1987;80(5):686-690.
Ramirez OM. Spatial orientation of motor innervation to the lower orbicularis oculi muscle. Aesthet Surg J 2000;20:107-113
Hwang K, Lee DK, Lee EJ, et al. Innervation of the lower eyelid in relation to blepharoplasty and midface lift: clinical observation and cadaveric study. Ann Plast Surg 2001;47:1Y5; discussion 5-7
Choi Y, Kang HG, Nam YS, Kang JG, Kim IB. Facial Nerve Supply to the Orbicularis Oculi around the Lower Eyelid: Anatomy and Its Clinical Implications. Plast Reconstr Surg. 2017;140(2):261-271. doi:10.1097/PRS.0000000000003543
Shinohara H, Kominami R, Yasutaka S, Taniguchi Y. The anatomy of the lacrimal portion of the orbicularis oculi muscle (tensor tarsi or Horner's muscle). Okajimas Folia Anat Jpn. 2001;77(6):225-232. doi:10.2535/ofaj1936.77.6_225
Caminer DM, Newman MI, Boyd JB. Angular nerve: new insights on innervation of the corrugator supercilii and procerus muscles. J Plast Reconstr Aesthet Surg. 2006;59(4):366-372. doi:10.1016/j.bjps.2005.09.011
Haefliger IO, Meienberg O, Pimentel de Figueiredo AR. Temporary Medial Upper Eyelid Lagophthalmos after External Dacryocystorhinostomy. Temporärer medialer Oberlid-Lagophthalmus nach externer Dacryozystorhinostomie. Klin Monbl Augenheilkd. 2016;233(4):406-408. doi:10.1055/s-0042-102617
Vagefi MR, Winn BJ, Lin CC, et al. Facial nerve injury during external dacryocystorhinostomy. Ophthalmology. 2009;116(3):585-590. doi:10.1016/j.ophtha.2008.09.050
Choi Y, Kim IB. Refined Concept of Motor Supply to the Medial Periorbital Area Relevant to Periorbital Surgery. Plast Reconstr Surg. 2022;150(3):647-657. doi:10.1097/PRS.0000000000009473
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