Research Article
Morphometric Analysis of the Infraorbital Foramen:
The Clinical Relevance
Deepthi Nanayakkara,
1
Roshan Peiris,
1
Navini Mannapperuma,
1
and Amal Vadysinghe
2
1
Division of Anatomy, Department of Basic Sciences, Faculty of Dental Sciences, University of Peradeniya,
20400 Peradeniya, Sri Lanka
2
Department of Forensic Medicine, Faculty of Medicine, University of Peradeniya, 20400 Peradeniya, Sri Lanka
Correspondence should be addressed to Deepthi Nanayakkara; deepthinanayakkara@yahoo.com
Received 25 September 2016; Revised 11 November 2016; Accepted 7 December 2016
Academic Editor: Iwao Sato
Copyright © 2016 Deepthi Nanayakkara et al. Tis is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Te present study was conducted to ascertain the shape, size, presence of accessory foramina, direction, and the precise position of
the infraorbital foramen (IOF) in relation to the inferior orbital margin (IOM), anterior nasal spine (ANS), nasion (Na), maxillary
teeth, and supraorbital foramen/notch (SOF/N) in adult skulls in a Sri Lankan population. Fify-four skulls (42 males and 12
females) were analyzed. Te IOF was oval in shape (38.6% and 36.3% on the right and lef side, resp.) in a majority of skulls. Te
direction of the IOF was mostly medially downward (48.6%). Accessory foramina were found in 7.4% of the skulls. Te infraorbital
foramina were located at a mean distance of 6.52 ± 2.03 mm and 7.30 ± 1.57 mm, vertically below the IOM on the right and lef side,
respectively; 33.81 ± 2.68 mm and 34.23 ± 2.56 mm from the ANS on the right and lef side, respectively; and 42.37 ± 3.52 mm and
42.52 ± 3.28 mm from the Na on the right and lef side, respectively. In relation to the upper teeth the majority of IOF (37.5% and
55.9% on the right and lef side, resp.) were located in the same vertical axis as the tip of the buccal cusp of the maxillary second
premolar tooth.
1. Introduction
Te infraorbital foramen (IOF) is located on the maxillary
bone about 1 cm inferior to the infraorbital margin [1]. Te
infraorbital nerve and vessels are transmitted through this
foramen. Te infraorbital nerve, the continuation of the
maxillary or second division of the trigeminal nerve, is solely
a sensory nerve. It traverses the inferior orbital fssure into the
inferior orbital canal and emerges onto the face at the IOF. It
divides into several branches that innervate the skin and the
mucous membrane of the midface, such as the lower eyelid,
cheek, lateral aspect of the nose, upper lip, and the labial gum
[1].
Te IOF is an important landmark in facilitating anaes-
thetic and surgical interventions of the midface region.
Te infraorbital nerve block is widely used to accomplish
regional anaesthesia during surgeries involving the midface
region and paranasal sinuses [2, 3]. Traumatic or iatrogenic
injury to the infraorbital neurovascular bundle may result in
bleeding and hypoesthesia or paraesthesia or anaesthesia in
the region of its supply [4]. Hence, detailed knowledge of
the precise anatomical location and the possible variations
of the IOF is fundamental to ensure safe and successful
regional anaesthesia and to avoid the risk of damaging the
neurovascular bundle during surgery in this region.
Multiple studies have demonstrated that the dimensions
and relative position of the IOF vary between the genders and
among diferent population groups [5–22]. To ascertain its
precise location various sof tissue and bony landmarks have
been utilized. Signifcant variations have been reported in the
literature with regard to the position of IOF in relation to the
infraorbital margin [3, 5, 6, 8, 14]. Moreover, the position of
IOF in relation to maxillary teeth has been shown to vary
among population groups [3, 13, 21].
Despite its clinical relevance, information available on the
dimensions and relative position of the IOF in the Sri Lankan
population is scarce. Hence, the present study was under-
taken to ascertain the shape, presence of accessory foramina,
direction, and the dimensions of the IOF and its position in
relation to clinically relevant anatomical landmarks.
Hindawi Publishing Corporation
Anatomy Research International
Volume 2016, Article ID 7917343, 8 pages
http://dx.doi.org/10.1155/2016/7917343