The Localization of the Supraorbital Notch or Foramen is Crucial for Headache and Supraorbital Neuralgia Avoiding and Treatment

Abstract

The aim of this study was to provide the morphological and morphometric data of the supraorbital foramina or notches related to sex, side, and the climatic conditions where the population lived. It was hypothesized that the distribution of the occurrence and location of these openings depends on climatic conditions in which the population lived. Orbits from 866 dried skulls obtained from three climatic regions: warm, temperate, and cold were examined. The examination concentrated on the configuration (notch/foramen) and on the distances to the reference points: nasion, frontomalare orbitale, infraorbital foramen and the superior orbital rim. In 14.3% of cases a smooth supraorbital rim was observed while different variants of the structures were observed in 85.7% of the cases. In cold climatic conditions, supraorbital foramina were found in the highest frequency (35.4%). In warm and temperate climates, the observed frequencies of supraorbital foramen were the lowest (18.8% and 19.9%, respectively). Frequency of supraorbital notches was the lowest of those skulls from a cold climate (44.0%) and the highest in those from a warm climate (59.0%). These results support the hypothesis that the occurrence of the supraorbital notches is greater in populations from warm compared with cold regions. This would provide a greater exit route for the neurovascular bundle and this may be related to the thermoregulatory processes in the supraorbital region. Furthermore, knowledge of precise locations of supraorbital structures is important when a supraorbital nerve block is given, for example, in the treatment of migraine headaches. Anat Rec, 2012. © 2012 Wiley Periodicals, Inc.

Anatomical Variations of the Supraorbital and Supratrochlear Nerves: Their Intraorbital Course and Relation to the Supraorbital Margin

“…In our study, the distance to the midline ranged from 12.9 mm to 34.9 mm for all types of passages located on the supraorbital margin (Table 3). According to Tomaszewska et al [26], extra care should be taken during surgical procedures in the supraorbital region because population variations regarding passages on supraorbital notch have been described.…”

Pediatric regional anesthesia: A review of the relevance of surface anatomy and landmarks used for peripheral nerve blockades in infants and children

“…The direct external landmarks used for identifying these nerves are the supraorbital and infraorbital foramina (or notches). A recent adult cadaveric study (Tomaszewska et al, ), however, observed the location of supraorbital foramen in 866 dried skulls ( n = 1,732 orbits), and found varying locations of supraorbital structures relative to their openings depending on different climatic conditions. This suggested that palpating the foramen alone may not be sufficient for successful nerve blockades in certain patients, hence the need for additional anatomical landmarks.…”

<p>Treatment of Supraorbital Neuralgia Using Ultrasound-Guided Radiofrequency Thermocoagulation of the Supraorbital Nerve: A Retrospective Study</p>

“…37 Although the supraorbital nerve is well positioned by the supraorbital notch in most cases, some patients may have anatomical variations in the supraorbital structures. 38 Therefore, the detection of possible anatomical variations by ultrasound is of great significance to improve the therapeutic efficiency of radiofrequency thermocoagulation.…”