3차원 전산화단층촬영을 이용한 안와위패임과 안와위구멍의 해부학적 위치와 모양 분포
Anatomical Location and Distribution of Supraorbital Notch and Foramen Evaluations Using Facial 3D Computed Tomography
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목적: 성인 안와 3차원 전산화단층촬영을 분석해 안와위패임과 안와위구멍의 해부학적 위치와 모양 분포를 확인하여 임상에 적용하고자 했다. 대상과 방법: 안와 3차원 전산화단층촬영을 한 사람 중 수술 및 외상 기왕력, 안과기저질환이 없는 남자 45명, 여자 42명을 대상으로수직정중선은 양쪽 안와위뼈둘레 윗 끝점의 중점, 비근점, 상악골 양끝의 중점을 이용해 정의하였고, 이 선으로부터 수평거리를 측정하였다. 안와위구멍은 안와위뼈둘레의 윗 선으로부터 수직거리와 각도를 측정하였고 좌우, 성별, 모양 간 수평거리 분포, 대칭성에대해서 확인하였다. 결과: 평균 나이 45.44 ± 8.34세였고, 안와위구멍은 66안, 안와위패임은 108안이었다. 양안 간 수평거리나 모양은 유의한 차이가없었으며, 남자 3안과 여자 1안에서 부속 안와위구멍이 있었다. 전체 수평길이는 평균 23.95 ± 3.93 mm이었다. 남자 평균수평거리25.18 ± 4.16 mm로 여자 22.63 ± 3.19 mm보다 길었고, 안와위패임은 평균 22.59 ± 3.18 mm로 안와위구멍 26.18 ± 4.04 mm보다짧았다(p＜0.001, 독립변수 T 검정). 안와위구멍 평균 수직거리는 3.02 ± 1.119 mm, 각도는 6.81 ± 2.31도이었다. 결론: 정상 성인에서 안와위패임과 안와위구멍의 위치 및 분포를 확인하여, 임상에서 수술 중 의인성 손상을 피하고, 추후 선택적신경차단을 하는 데에 도움이 될 것이다.
Abstract
Purpose: To evaluate anatomical locations and distributions of supraorbital notch and foramen using facial 3D computed tomographyin the Korean adult population. Methods: The study sample was composed of 87 adult patients with no history of trauma or ocular disease. The horizontal positionof the supraorbital foramen or notch was recorded in relation to a vertical line defined by a reproducible hypothetical point,such as the nasion and mid-maxilla and the midpoint of the horizontal supraorbital plane. The distance and angle for each supraorbitalforamen and notch were calculated from the defined vertical line. Furthermore, vertical distance from supraorbital plane,which was established using the highest points of both supraorbital rims, was obtained from the supraorbital foramen. Results: The mean age of the 87 patients was 45.44 ± 8.34 years (range, 30-59 years). There were 66 eyes in the supraorbitalnotch and 108 eyes in the supraorbital foramen. There were no distributional differences between the 2 sides. The mean horizontaldistance of both types was 23.95 ± 3.93 mm (range, 16.41-38.94 mm). The horizontal distance of male patients was longerthan the female patients (25.18 ± 4.16 mm vs. 22.63 ± 3.19 mm, p < 0.001, based on independent t-test) and the horizontaldistance of supraorbital notch was shorter than the supraorbital foramen (22.59 ± 3.18 mm vs. 26.18 ± 4.04 mm, respectively, p< 0.001, based on independent t-test). The mean vertical distance and mean angles of the supraorbital foramen were 3.02 ±1.119 mm and 6.81 ± 2.31 degrees (°), respectively. Conclusions: The present study described the anatomical location of each supraorbital opening type in Korean adults. Accordingto horizontal distance, a surgeon can avoid iatrogenic injury of the supraorbital neurovascular complex, especially during browsurgery. In addition, the anatomy can aid in targeting supraorbital neurovascular complex in cases of nerve block.
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