Clinical anatomy of the superior orbital fissure and the orbital apex

Summary Background There are discrepancies between authors as far as topography of superior ophthalmic vein in the orbital apex is concerned. Objectives The aim was to determine the location of the structures within the posterior part of the orbit and in the superior orbital fissure. Material One hundred preparations of orbits were derived from the corpses sectioned in Forensic Medicine Department, University Medical School in Warsaw, Poland. Study design Anatomical preparation was performed with use of standard set of microsurgical equipment and operating microscope. Results Nine various morphological types of the superior orbital fissure were distinguished. Among those were two main categories: type “a” characterised by a clear narrowing within the fissure and type “b” which lacked such narrowing. The type “a” and “b” fissures were also different in length whereby type “b” fissure was significantly shorter. A diversity of positioning of the soft structures within those types was successfully noted. In type “a” the superior ophthalmic vein was located typically, however in type “b” fissures it was significantly more often the lowest structure in the posterior part of the orbital apex (except for muscles and orbital fat). A short case report of patient with superior orbital syndrome was added. Conclusion Position of soft tissue structures in superior orbital fissure depended on its morphological type.