An anatomical study of the medial canthus using a three-dimensional model

Opinions on the direction and insertion of the muscle and tendon of the medial canthus not only differ depending on the reporter, but, to date, have lacked objectivity. The direction and insertion of the muscle and tendon of the medial canthus have, therefore, not been clear to surgeons operating on the medial canthus. In order to fully grasp the anatomy of this construct three-dimensionality, we constructed a 3D model of successive sections of the medial canthus in a frontal direction using five cadavers, and then studied this model. The pretarsal part of the orbicularis oculi muscle is formed from a single muscle bundle of both the upper and lower eyelids, and runs into the medial palpebral tendon. This muscle bundle further branches off along the outside of the lacrimal sac, internally. It surrounds the back of the lacrimal sac without entering it. The preseptal part of the orbicularis oculi muscle consists of a single muscle bundle for both the upper and lower eyelids. The muscle fibers on the side of the skin run into the medial palpebral tendon. The muscle fibers posterior to this muscle bundle run into tendinous fibers, and, in all of the upper eyelids examined, they stop at the lacrimal fornix. In three out of the five lower eyelids examined the muscle fibers stop at the anterior surface of the lacrimal sac, while in the remaining cases they run into the medial palpebral tendon, as with the muscle fibers on the side of the skin. The medial palpebral tendon traverses the anterior surface of the lacrimal sac in an internal direction without branching off anteroposteriorly.