title: Can Sonography Distinguish a Supraorbital Notch From a Foramen?
abstract: Diagnostic tools for evaluating the supraorbital rim in preparation for nerve decompression surgery in patients with chronic headaches are currently limited. We evaluated the use of sonography to diagnose the presence of a supraorbital notch or foramen in 11 cadaver orbits. Sonographic findings were assessed by dissecting cadaver orbits to determine whether a notch or foramen was present. Sonography correctly diagnosed the presence of a supraorbital notch in 7 of 7 cases and correctly diagnosed a supraorbital foramen in 4 of 4 cases. We found that sonography had 100% sensitivity in diagnosing a supraorbital notch and foramen. This tool may therefore be helpful in characterizing the supraorbital rim preoperatively and may influence the decision to use a transpalpebral or endoscopic approach for supraorbital nerve decompression as well as the decision to use local or general anesthesia.
authors.affiliation: Department of Surgery, Division of Plastic and Reconstructive Surgery (R.K.G., A.M.A.), Department of Radiology, Section of Musculoskeletal Radiology (K.S.L., S.C.K.), and Department of Neurological Surgery (M.K.B.), University of Wisconsin, Madison, Wisconsin USA; and Division of Plastic Surgery, Cairo University, Cairo, Egypt (A.M.A.).
authors.forename: Ravi K
authors.initials: RK
authors.lastname: Garg
authors.affiliation: Department of Surgery, Division of Plastic and Reconstructive Surgery (R.K.G., A.M.A.), Department of Radiology, Section of Musculoskeletal Radiology (K.S.L., S.C.K.), and Department of Neurological Surgery (M.K.B.), University of Wisconsin, Madison, Wisconsin USA; and Division of Plastic Surgery, Cairo University, Cairo, Egypt (A.M.A.).
authors.forename: Kenneth S
authors.initials: KS
authors.lastname: Lee
authors.affiliation: Department of Surgery, Division of Plastic and Reconstructive Surgery (R.K.G., A.M.A.), Department of Radiology, Section of Musculoskeletal Radiology (K.S.L., S.C.K.), and Department of Neurological Surgery (M.K.B.), University of Wisconsin, Madison, Wisconsin USA; and Division of Plastic Surgery, Cairo University, Cairo, Egypt (A.M.A.).
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Kohn
authors.affiliation: Department of Surgery, Division of Plastic and Reconstructive Surgery (R.K.G., A.M.A.), Department of Radiology, Section of Musculoskeletal Radiology (K.S.L., S.C.K.), and Department of Neurological Surgery (M.K.B.), University of Wisconsin, Madison, Wisconsin USA; and Division of Plastic Surgery, Cairo University, Cairo, Egypt (A.M.A.).
authors.forename: Mustafa K
authors.initials: MK
authors.lastname: Baskaya
authors.affiliation: Department of Surgery, Division of Plastic and Reconstructive Surgery (R.K.G., A.M.A.), Department of Radiology, Section of Musculoskeletal Radiology (K.S.L., S.C.K.), and Department of Neurological Surgery (M.K.B.), University of Wisconsin, Madison, Wisconsin USA; and Division of Plastic Surgery, Cairo University, Cairo, Egypt (A.M.A.) afifi@surgery.wisc.edu.
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Afifi
mesh_terms: D059925:Anatomic Landmarks / Q000000981:diagnostic imaging*; D002102:Cadaver; D003937:Diagnosis, Differential; D005260:Female; D005624:Frontal Bone / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D015588:Observer Variation; D009882:Ophthalmic Nerve / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*
keywords: head and neck ultrasound; headache surgery; musculoskeletal ultrasound; supraorbital foramen; supraorbital notch; supraorbital rim