The noe complex is located at the junction of the upper and middle thirds of the face. It is composed of four paired bones arranged at different angles to provide structural support and compensate for underlying sinus spaces. The medial aspects of the upper and lower eyelids converge at the medial canthus to form the origin of the orbicularis oculi muscle, which divides into anterior and posterior bands that attach to nearby bones. Restoring the attachment of the anterior band is essential for successful reconstruction of the noe complex after injury. Together, the lacrimal punctum, canaliculi, sac, and duct are responsible for draining tears from the eye into the nose.
The noe complex is located at the junction of the upper and middle thirds of the face. It is composed of four paired bones arranged at different angles to provide structural support and compensate for underlying sinus spaces. The medial aspects of the upper and lower eyelids converge at the medial canthus to form the origin of the orbicularis oculi muscle, which divides into anterior and posterior bands that attach to nearby bones. Restoring the attachment of the anterior band is essential for successful reconstruction of the noe complex after injury. Together, the lacrimal punctum, canaliculi, sac, and duct are responsible for draining tears from the eye into the nose.
The noe complex is located at the junction of the upper and middle thirds of the face. It is composed of four paired bones arranged at different angles to provide structural support and compensate for underlying sinus spaces. The medial aspects of the upper and lower eyelids converge at the medial canthus to form the origin of the orbicularis oculi muscle, which divides into anterior and posterior bands that attach to nearby bones. Restoring the attachment of the anterior band is essential for successful reconstruction of the noe complex after injury. Together, the lacrimal punctum, canaliculi, sac, and duct are responsible for draining tears from the eye into the nose.
The noe complex is located at the junction of the upper and middle thirds of the face. It is composed of four paired bones arranged at different angles to provide structural support and compensate for underlying sinus spaces. The medial aspects of the upper and lower eyelids converge at the medial canthus to form the origin of the orbicularis oculi muscle, which divides into anterior and posterior bands that attach to nearby bones. Restoring the attachment of the anterior band is essential for successful reconstruction of the noe complex after injury. Together, the lacrimal punctum, canaliculi, sac, and duct are responsible for draining tears from the eye into the nose.
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Anatomy of the noe complex.
Bony anatomy the NOE complex is vulnerable to injury because of its
prominent position at the junction of the upper and middle thirds of the face. Like the midface, it is a ed!e"shaped structure oriented so that the narro portion faces anteriorly and the broader base lies posteriorly beteen the to orbits. #his arran!ement compensates for the inherent eakness created by lar!e underlyin! sinus spaces $the ethmoidal sinuses%. Additional stren!th is provided by the or!ani&ation of the complex into a lattice ith individual bones oriented at different an!les to one another. #he NOE complex is composed of our paired bones' the lateral nasal bones, the frontal processes of the maxilla, the lamina papyraceae of the ethmoid bone, and the lacrimal bones. #he perpendicular and cribirform plates of the ethmoid bone, the nasal process of the frontal bone, and the sphenoid bone complete the bony skeleton in the midline. #he area beteen the to medial orbital alls and belo the anterior cranial fossa is sometimes referred to as the interorbital space. (ithin the upper portion of the nasal cavity lie the superior and middle turbinates, but these structures do not contribute to the structural support of the complex. )edial *anthal Anatomy. #he medial aspects of the upper and loer eyelids conver!e into an acute an!le and form the medial canthus. +ere, deep and superficial extensions of the preseptal and pretarsal orbicularis oculi conver!e into a common tendon. #he tendon, hich functions as the ori!in of the orbicularis oculi muscle, divides into anterior and posterior bands before attachin! to the bone. #he anterior limb is the lar!er and more si!nificant of the to. ,t inserts broadly into the frontal process of the maxilla, the anterior lacrimal crest $part of the maxillary bone%, and the lateralmost aspect of the nasal bone. ,f disrupted by injury, restoration of this attachment is essential to the successful reconstruction of the NOE complex. #he smaller posterior limb of the medial canthal tendon is poorly defined and inserts into the posterior lacrimal crest, hich is part of the lacrima l bone. ,t is composed of the deep head of the pretarsal orbicularis oculi $horner-s muscle% and is !enerally i!nored durin! reconstruction. Beteen the anterior and posterior canthal limbs lie the lacrimal punctum, superior and inferior canaliculi, and superior one third of the lacrimal sac, hich projects . to /mm above the level of the tendon. #he superior and inferior canaliculi travel for a shaort distance vertically $approximately /mm% before assumin! a more hori&ontal orientation $approximately /mm% before assumin! a more hori&ontal orientation $approximately .0mm%. #hey convera!e and form a common canaliculus that enters the nasolacrimal sac at its posteroinferior third. #he nasolacrimal duct, hich is approximately /0mm in len!th, travels vertically ithin the maxilla to open into the inferior meatus of the nose at the anteriorly located lacrimal fold. #o!ether, these structures are responsible for the collelction and draina!e of tears from the conjunctival fornices into the inferior meatus of the nose. 1ama!e to any portion of the system may lead to excessive tearin! from the eye, a condition knon as epiphora.