The evidence regarding the anatomy of the infraorbital foramen in the Indian population is limited. It mainly focuses on its shape, size, and incidence in the Indian population. The current study aimed to evaluate morphometric parameters of infraorbital foramen that can help clinicians during surgery and procedures around it. MethodsWe evaluated 90 dry adult human hemi-skulls. The morphological parameters studied included the assessment of the shape of the infraorbital foramen, its horizontal and vertical diameters, and its relation to the teeth of the upper jaw. In addition, we measured the distance of the infraorbital foramen from the anterior nasal spine, nasion, infraorbital margin, and the lower extent of the alveolar margin. The length of the infraorbital canal till the inferior orbital fissure and the infraorbital groove and the infraorbital canal orientation angles in different planes were also measured. The measurement values were compared between the right and left side hemi-skulls. ResultsThe oval-shaped infraorbital foramen was most commonly noticed. The mean vertical and transverse diameters were 3.8 mm and 2.6 mm, respectively, on the right side. The left side's mean vertical and transverse diameters were 3.9 mm and 2.5 mm, respectively. The most common location of infraorbital foramen was in line with the maxillary second premolar tooth. The distances of infraorbital foramen from the alveolar margin were 29.6 mm and 29 mm on the right and left sides, respectively. The distances of the infraorbital foramen from the anterior nasal spine were 34.3 mm and 34.2 mm on the right and left sides, respectively. The distances of infraorbital foramen from the nasion were 42.3 mm and 42.2 mm on the right and left sides, respectively. The distances of infraorbital foramen from the inferior orbital margin were 5.8 mm and 6.2 mm on the right and left sides, respectively. The distances between the inferior orbital margin and infraorbital groove were 12.7 mm and 12.7 mm on the right and left sides, respectively. The distances between the inferior orbital margin and inferior orbital fissure were 27.5 mm and 27.1 mm on the right and left sides, respectively. The orientation angles of infraorbital foramen were 48.31° in the horizontal plane, 34.07° in the Frankfurt plane, and 14.4° in the parasagittal plane. ConclusionOur findings suggest that the location of the infraorbital foramen is difficult to standardize, considering the wide interindividual variations in the foramen relations. Further research should be performed to investigate the parameters related to the distance and orientation of the infraorbital foramen in relation to nearby bony landmarks that are least affected by individual variations in skull morphology.
Introduction: The median nerve is usually formed by two roots contributed from the medial and lateral cords of the brachial plexus. Morphological variations of the median nerve can have clinical implications from the anesthetic and surgical points of view. In this cadaveric observation study, we report the variations of median nerve formation in the North Indian population. Methods: We observed the formation of the median nerve in 40 human cadaveric upper limb specimens. The specimens belonged to 20 right and 20 left upper limbs. Variations in the formation of the median nerve were noted.Results: Of the 40 dissected specimens, six (15%) had triple roots including a supernumerary root contributing to the medial nerve formation. The supernumerary root was a branch of the lateral cord in five cases, and it had an additional contribution from the medial cord in one case. The median nerve formation and continuation were located anterior or laterally in 39 specimens (97.5%) and medial in one (2.5%) in relation to the axillary artery. Conclusion:We observed supernumerary roots of varying morphology contributing to the median nerve formation. These variations should be considered during the administration of regional anesthesia and during the management of brachial plexus injuries. Further large multi-region studies will help in a better understanding of these variations.
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