open access

Vol 79, No 3 (2020)
Original article
Submitted: 2019-09-20
Accepted: 2019-10-12
Published online: 2019-10-16
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Morphometric study of the ciliary ganglion and its pertinent intraorbital procedure

L. Tesapirat1, S. Jariyakosol23, V. Chentanez1
·
Pubmed: 31621056
·
Folia Morphol 2020;79(3):438-444.
Affiliations
  1. Department of Anatomy, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  2. Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  3. Ophthalmology Department, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand

open access

Vol 79, No 3 (2020)
ORIGINAL ARTICLES
Submitted: 2019-09-20
Accepted: 2019-10-12
Published online: 2019-10-16

Abstract

Background: Ciliary ganglion (CG) can be easily injured without notice in many intraorbital procedures. Surgical procedures approaching the lateral side of the orbit are at risk of CG injury which results in transient mydriasis and tonic pupil. This study aims to focus on the morphometric study of the CG which is pertinent to intraoperative procedure.

Materials and methods: Forty embalmed cadaveric globes were dissected to observe the location, shape and size of CG, characteristics and number of roots reaching CG, number of short ciliary nerve in the orbit. Distances from CG to posterior end of globe, optic nerve, lateral rectus muscle and its scleral insertion were measured.

Results: Ciliary ganglion was located between optic nerve and lateral rectus in every case. Its shape could be oval, round and irregular. Mean width of CG was 2.24 mm and mean length was 3.50 mm. Concerning the roots, all 3 roots were present in 29 (72.5%) cases. Absence of motor root was found in 7 (17.5%) cases. Absence of sympathetic root was found in 4 (5%) cases. The number of motor root could be 1, 2 and also 3 roots. Three motor roots were found in 1 case which originated from nerve to inferior oblique muscle. Only one sensory root was found in every specimen. One sympathetic root could be observed in most of the specimens and 6–14 short ciliary nerves were found. Mean distances from CG to posterior end of globe, optic nerve, lateral rectus muscle and its scleral insertion were 16.04 mm, 1.47 mm, 2.88 mm, and 31.53 mm, respectively.

Conclusions: This study described the characteristic of CG, number of its nerve root and some measurements relevant to intraorbital procedures in Asian population. Moreover, a new parameter was the distance between CG and scleral insertion of the lateral rectus muscle. This parameter should be considered when performing operation involved the lateral rectus muscle and BTX-A injection to lateral rectus muscle to reduce CG injury.

Abstract

Background: Ciliary ganglion (CG) can be easily injured without notice in many intraorbital procedures. Surgical procedures approaching the lateral side of the orbit are at risk of CG injury which results in transient mydriasis and tonic pupil. This study aims to focus on the morphometric study of the CG which is pertinent to intraoperative procedure.

Materials and methods: Forty embalmed cadaveric globes were dissected to observe the location, shape and size of CG, characteristics and number of roots reaching CG, number of short ciliary nerve in the orbit. Distances from CG to posterior end of globe, optic nerve, lateral rectus muscle and its scleral insertion were measured.

Results: Ciliary ganglion was located between optic nerve and lateral rectus in every case. Its shape could be oval, round and irregular. Mean width of CG was 2.24 mm and mean length was 3.50 mm. Concerning the roots, all 3 roots were present in 29 (72.5%) cases. Absence of motor root was found in 7 (17.5%) cases. Absence of sympathetic root was found in 4 (5%) cases. The number of motor root could be 1, 2 and also 3 roots. Three motor roots were found in 1 case which originated from nerve to inferior oblique muscle. Only one sensory root was found in every specimen. One sympathetic root could be observed in most of the specimens and 6–14 short ciliary nerves were found. Mean distances from CG to posterior end of globe, optic nerve, lateral rectus muscle and its scleral insertion were 16.04 mm, 1.47 mm, 2.88 mm, and 31.53 mm, respectively.

Conclusions: This study described the characteristic of CG, number of its nerve root and some measurements relevant to intraorbital procedures in Asian population. Moreover, a new parameter was the distance between CG and scleral insertion of the lateral rectus muscle. This parameter should be considered when performing operation involved the lateral rectus muscle and BTX-A injection to lateral rectus muscle to reduce CG injury.

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Keywords

ciliary ganglion; mydriasis; tonic pupil

About this article
Title

Morphometric study of the ciliary ganglion and its pertinent intraorbital procedure

Journal

Folia Morphologica

Issue

Vol 79, No 3 (2020)

Article type

Original article

Pages

438-444

Published online

2019-10-16

Page views

993

Article views/downloads

830

DOI

10.5603/FM.a2019.0112

Pubmed

31621056

Bibliographic record

Folia Morphol 2020;79(3):438-444.

Keywords

ciliary ganglion
mydriasis
tonic pupil

Authors

L. Tesapirat
S. Jariyakosol
V. Chentanez

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