[Arterial vascularization of the levator muscle of the upper eyelid]

The arterial vascularization of the levator to the anterior half of the nasal edge and the posterior half of the inferior face come from the supra orbital artery or from a branch of the ophthalmic artery. The posterior third receives its arterial supply from the posterior ethmoïdal artery. The anterior portion and the lateral and medial horns get their blood supply from the lacrimal artery but the presumed supply from the palpebrae arteries has not been shown in this study. The radio-anatomic study of the muscle defines three of different arterial supplies: the lacrimal artery in the anterior part; the supra orbital or ophthalmic artery in the middle and the posterior ethmoïdal artery, posteriorly. Some arterioles traverse the entire muscle from single pedicle (supra orbital) but in a third of cases the lateral arteriole arises from the posterior ethmoïdal artery. They anastomose in the anterior portion of the muscle with the arterioles arising from the lacrimal artery through the lacrimal gland. The radio-anatomic pictures emphasize the great supply from that origin. The major practical implication of this study is the importance of better hemostasis in anterior levator surgery particularly during ptosis surgery.