Cutaneous Depth of the Supraorbital Nerve: A Cadaveric Anatomic Study With Clinical Applications to Dermatology

• Published in: Dermatologic surgery 2014-12, Vol.40 (12), p.1342-1348
• Main Authors: Christensen, Kevin N, Lachman, Nirusha, Pawlina, Wojciech, Baum, Christian L
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Cadaver; Facial Muscles - anatomy & histology; Facial Muscles - innervation; Female; Forehead - anatomy & histology; Forehead - innervation; Humans; Male; Trigeminal Nerve - anatomy & histology
• ISSN: 1076-0512; 1524-4725
• DOI: 10.1097/DSS.0000000000000174

BACKGROUNDCommon dermatologic procedures performed on the forehead may injure the supraorbital nerve (SON) leading to adverse outcomes. OBJECTIVETo describe SON anatomic course and cutaneous depth. MATERIALS AND METHODSSixteen cadaver specimens were dissected. RESULTSThe supraorbital nerve originated 2.63 ± 0.27 (range, 2.1–3.5) cm from the midline and 0.25 ± 0.16 (range, 0–0.5) cm above the orbital rim. Supraorbital nerve emerged as 1 root dividing into superficial (SON-S) and deep (SON-D) branches. The supraorbital nerve deep branch remained deep to the aponeurosis of the corrugator supercilii and frontalis muscles and coursed laterally toward the scalp. Supraorbital nerve superficial branch emerged nearly perpendicular to the orbital rim and traveled under the corrugator supercilii with an average depth of 0.75 ± 0.16 (range, 0.5–1.1) cm. Supraorbital nerve superficial branches entered the subfrontalis plane at a mean distance of 1.29 ± 0.20 (range, 1.0–1.8) cm above the orbital rim with an average depth of 0.45 ± 0.13 (range, 0.3–0.8) cm. These branches entered the subcutaneous plane by piercing through the frontalis muscle at a mean distance of 2.60 ± 0.32 (range, 1.9–3.2) cm above the orbital rim with an average depth of 0.30 ± 0.10 (range, 0.2–0.6) cm. CONCLUSIONThe supraorbital nerve depth and course are relevant when performing procedures on the forehead. A thorough understanding of the anatomy and depth of SON-S is critical to help minimize nerve damage and optimize patient counseling.