distance between the base of the superior
orbital fissure and Warwick's foramen.
Traumatic superior
orbital fissure syndrome: Review of literature and report of three cases.
THS is caused by a non-specific inflammatory process in the cavernous sinus or superior
orbital fissure (SOF).
Specific diagnostic criteria have been recommended by the International Headache Society which includes unilateral headache; granulomatous inflammation of the cavernous sinus and superior
orbital fissure or orbit seen on magnetic resonance imaging or biopsy; paresis of one or more of the ipsilateral third, fourth, and/or sixth cranial nerves; evidence of causation demonstrated by both headache preceded by oculomotor paresis by less than 2 weeks or developed with it and headache that is localized around the ipsilateral brow and eye; and symptoms not better accounted for by an alternative diagnosis [9].
OM may cause infections of cavernous sinus, but the infections of cavernous sinuses, superior
orbital fissure or orbital apex are usually originated from para-nasal sinuses.4 Time interval between the onset of OM and cranial nerve involvements is usually between 1 week to 2-3 months.5
The intracranial extension has been described through the three major openings in the posterior aspect of the orbit, which include the superior
orbital fissure, optic canal and the inferior
orbital fissure.
From the superior
orbital fissure, light could travel through the cerebrospinal fluid behind the lesser wing of the sphenoid andalong the edge of the sella turcica will go directly into the mesencephalon (Figure 4(a)).
It was directed outwards, whereas in the posterior part of the orbital floor (between the inferior
orbital fissure and the optic nerve canal) the area of relocation extended as far as 0.5 mm and was directed towards the inside of the orbit, "the recurring wave" (white arrow, Figure 3).
The lesion can involve any peripheral nerve but usually involves sensory nerves in the orbit or eyelid and can cause widening of the superior
orbital fissure as well as dysplasia of the greater sphenoid wing [63].
This formation separates optic canal from the medial portion of superior
orbital fissure. Position of the optic strut was determined based on relation between the length of anterior clinoid process and the distance measuring from the optic strut to the top of the anterior clinoid process.
Tolosa-Hunt syndrome (THS) is a rare disorder indicated by recurrent painful ophthalmoplegia caused by non-specific inflammation of the cavernous sinus or superior
orbital fissure (SOF).
Typically, a fracture line extends from the inferior
orbital fissure anteromedially along the orbital process of the maxilla, toward the infraorbital rim.