Abstract
Background
There is no information about muscle growth in eyelids with infrequent blinking in fetuses.
Methods
To examine the muscle and nerve morphology, we morphometrically and immunohistochemically examined sagittal sections of unilateral upper eyelids obtained from 21 term fetuses (approximately 30–42 weeks of gestation) and, for the comparison, those from 10 midterm fetuses (12–15 weeks).
Results
The approximation margin of the upper eyelid always corresponded to the entire free margin in midterm fetuses, whereas it was often (18/21) restricted in the posterior part in term fetuses. Thus, in the latter, the thickness at the approximation site to the lower lid often ranged from 0.8 to 1.6 mm and corresponded to 18–56% of the nearly maximum thickness of the lid. In the lower part of the upper eyelid, a layer of the orbicularis oculi muscles often (14/21) provided posterior flexion at 90–120° to extend posteriorly. Nerve fibers running along the mediolateral axis were rich along the approximation surface at term, but they might not be reported in the upper eyelid of adults.
Conclusion
Being different from adult morphologies, the term eyelid was much thicker than the approximation surface and it carried a flexed muscle layer and transversely-running nerve. The infrequent blinking in fetuses seemed to provide a specific condition for the muscle-nerve growth. Plastic and pediatric surgeons should pay attention to a fact that infants’ upper eyelid was unlikely to be a mini-version of the adult morphology.
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Funding
This study was supported by Wonkwang University in 2023.
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KC: planning; data acquisition; writing; KH: planning; data analysis; critical appraisal; JK: data acquisition; data analysis; GM: conceptualization; data acquisition; writing; JV: supervision; critical appraisal; HA: supervision; critical appraisal.
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This study was approved by the ethics committee of Complutense University (B08/374) and by the Akita University Ethics Committee (no. 1428).
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Cho, K.H., Homma, Ki., Kim, J.H. et al. Growth of muscles and nerves in the upper eyelid: a morphometrical and immunohistochemical study using term human fetuses. Surg Radiol Anat 46, 317–326 (2024). https://doi.org/10.1007/s00276-024-03308-x
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DOI: https://doi.org/10.1007/s00276-024-03308-x