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Background: Accessory levator muscle slips may be associated with congenital eyelid retraction or blepharoptosis. Nevertheless, congenital retraction of the upper eyelid is a poorly defined entity about which little is known. Because of the clinical importance of the accessory levator muscle slip of the levator palpebrae superioris muscle, this study aimed to describe the morphological appearance of this variation in human adult orbits. Methods: This study was undertaken in 60 orbits of 30 embalmed adult human cadavers, 17 men and 13 women, between the ages of 38 and 87 years at death. All cadavers were embalmed in 4% formalin solution. Results: Three accessory levator muscle slips of the levator palpebrae superioris muscle were identified. One of these arose laterally from the origin of the levator palpebrae superioris muscle. At its anterior end, it divided into two parts, the main superior and a smaller inferior accessory. The second had an accessory levator fibromuscular slip. It arose medially from the origin of the levator palpebrae superioris and lost its muscular character after a short course. The third arose from the origin of the levator palpebrae superioris as a thin flat muscle. Conclusions: Although many variations of the levator palpebrae superioris muscle have been reported in fetuses, investigation and demonstration of these may be more important in children and adults for ophthalmic surgery. We believe that detailed knowledge regarding the morphological appearance of an accessory levator muscle slip of the levator palpebrae superioris muscle may be useful for successful outcomes in ophthalmic surgery. [ABSTRACT FROM AUTHOR]

In this study, we aimed to investigate some features of the central retinal artery (CRA), which supplies the internal aspect of the retina. The CRA is the main vessel supplying blood to the retina. The origin, course and penetration point of the optic nerve by the CRA were studied in 30 human orbits. We compared the right sides to the left sides on the basis of gender in order to statistically analyse the relation between them. The CRA arose directly from the ophthalmic artery in 28 specimens. In two specimens, however, it arose in common with the medial posterior ciliary artery. When we observed the penetration point (site) of the CRA into the optic nerve, in 28 of 30 (93.3%) cases, the artery entered the nerve from the lower medial aspect and in two (6.7%) cases from the upper lateral aspect. The CRA penetrated the optic nerve between 6.4 and 15.2 mm behind the eyeball and reached the eyeball through the centre of the optic nerve. Because of the small diameter of the artery, it has a high risk of getting damaged during a surgical approach to the orbit. Therefore the anatomical relationships of this artery must be well known. [ABSTRACT FROM AUTHOR]

Background: Although in the past few authors stated that the nerve penetrated the ligament of Berry, many new authors have not confirmed this assertion. Because of the clinical importance and indefiniteness of this subject, we aimed to present an anatomical study concerning the course of the inferior laryngeal nerve. Method: In 60 specimens, 102 sides were examined for this project, including 41 male and 19 female cadavers between the ages of 40 and 89 years at death. Results: In two sides (one on the right and the other on the left), we found that the anterior (motor) laryngeal branch of the inferior laryngeal nerve penetrated the ligament unilaterally. The branch entered the ligament 5.6, 7.2 mm above its lower border and 3.3, 1.9 mm below its upper border. Distances from the entrance point of the branch to the trachea and thyroid were 9.5, 8.2 mm and 3.1, 2.2 mm, respectively. Conclusion: We found two anterior laryngeal branches penetrating the ligament of Berry. This subject is very important during the thyroid surgery, particularly during the division of the ligament for total lobectomy. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to an article on extralaryngeal bifurcation of the recurrent laryngeal nerve by T. Beneragama and J. W. Serpell, published in a previous issue of this periodical.