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The Sihler staining study of the infraorbital nerve and its clinical complication

 Hun Mu Yang  ;  Sung Yoon Won  ;  Young Il Lee  ;  Hee Jin Kim  ;  Kyung Seok Hu 
 JOURNAL OF CRANIOFACIAL SURGERY, Vol.25(6) : 2209-2213, 2014 
Journal Title
Issue Date
Acetic Acid/chemistry ; Aged ; Anatomic Landmarks/anatomy & histology ; Cadaver ; Chloral Hydrate/chemistry ; Coloring Agents ; Dissection ; Eyelids/innervation ; Face/innervation ; Facial Nerve/anatomy & histology ; Female ; Glycerol/chemistry ; Hematoxylin ; Humans ; Lip/innervation ; Male ; Mandibular Nerve/anatomy & histology ; Maxillary Nerve/anatomy & histology ; Nose/innervation ; Orbit/innervation* ; Staining and Labeling ; Trigeminal Nerve/anatomy & histology
Infraorbital nerve ; facial nerve ; trigeminal nerve ; nervous communication ; Sihler staining
The infraorbital nerve (ION) is a cardinal cutaneous nerve that provides general sensation to the mid face. Its twigs are vulnerable to iatrogenic damage during medical and dental manipulations. The aims of this study were to elucidate the distribution pattern of the ION and thus help to prevent nerve damage during medical procedures and to enable accurate prognostic evaluation where complications do occur. This was achieved by treating 7 human hemifaces with the Sihler modified staining protocol, which enables clear visualization of the course and distribution of nerves without the accidental displacement of these structures that can occur during classic dissection. The twigs of the ION can be classified into the usual 5 groups: inferior palpebral, innervating the lower eyelid in a fan-shaped area; external and internal nasal, reaching the nosewing and philtrum including the septal area between the nostrils, respectively; as well as medial and lateral superior labial, supplying the superior labial area from the midline to the mouth corner. Of particular note, the superior labial twigs fully innervated the infraorbital triangle formed by the infraorbital foramen, the most lateral point of the nosewing, and the mouth corner. In the superior 3-quarter area, the ION twigs made anastomoses with the buccal branches of the facial nerve, forming an infraorbital nervous plexus. The infraorbital triangle may be considered a dangerous zone with respect to the risk for iatrogenic complications associated with the various medical interventions such as implant placement.
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2. College of Dentistry (치과대학) > Dept. of Oral Biology (구강생물학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hee Jin(김희진) ORCID logo https://orcid.org/0000-0002-1139-6261
Hu, Kyung Seok(허경석) ORCID logo https://orcid.org/0000-0002-9048-3805
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