An: 2019, Nr.3, Articol Nr. 1

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      ORBITAL SEPTUM AS AN ANATOMICAL LANDMARK OF MAJOR IMPORTANCE IN REGIONAL INTERVENTIONS (Abstract): The orbital septum is an anatomical landmark that separates two important regions: the face and the orbit. The continuity of the septum with the surrounding fibrous connective structures integrates this element into the anatomy of the face. The various pathological processes that can appear in these regions, the huge surgical implications (e.g. in Ophthalmology, Plastic Surgery and Neurosurgery) and the presence of the subcutaneous risk elements has determined us to start a meticulous dissection. We performed a layered dissection, highlighting the vital structures from superficial to deep. The skin of the eyelid is thin and easily mobilized, having its insertion base at the level of the free margin of the eyelid. After the removal of the skin, we can observe a layer of loose connective tissue, whose presence justifies the mobility of the eyelids. In the subcutaneous tissue, we then identified, in the internal angle of the orbit, on the fascia of the nose, and even on the orbital septum, the insertions of the elevator muscle of the nose wing. From a surgical point of view, the risk elements are represented by the angular artery and vein and by the supratrochlear veins, which perforate the orbital septum. It is significant to note that the supratrochlear vessels establish both an arterial and a venous anastomosis between the intra- and extraorbital circulation. The orbital septum appears as a dense and well-structured fibrous connective curtain, which is particularly resistant and closes the orbit towards anterior. After resecting the septum, we observed, inside the orbit, in the superior external angle, the lacrimal gland and its central depression, through which passes the lateral tendon of the elevator muscle of the superior eyelid. Due to the presence of all the described elements, this region is an area of risk in both surgery and periorbital injections. Their injuries may cause large regional hematomas, but for every surgery there are techniques which can avoid these complications.

Key words: ORBITAL SEPTUM, TEAR TROUGH, OPHTHALMOLOGY, PLASTIC SURGERY