Medial palpebral ligament

The anterior attachment of the medial palpebral ligament is to the frontal process of the maxilla in front of the lacrimal groove (near the nasal bone and the frontal bone),{{cite journal |last1=Shinohara |first1=Harumichi |last2=Kominami |first2=Rieko |last3=Yasutaka |first3=Satoru |last4=Taniguchi |first4=Yutaka |title=The Anatomy of the Lacrimal Portion of the Orbicularis Oculi Muscle (Tensor Tarsi or Horner's Muscle) |journal=Okajimas Folia Anatomica Japonica |date=2001 |volume=77 |issue=6 |pages=225–232 |doi=10.2535/ofaj1936.77.6_225 |pmid=11392011 |doi-access=free }} and its posterior attachment is the lacrimal bone. Crossing the lacrimal sac, it divides into two parts, upper and lower, each attached to the medial end of the corresponding tarsus of each eyelid.{{cite journal |last1=Hwang |first1=Kun |last2=Huan |first2=Fan |last3=Nam |first3=Yong Seok |last4=Han |first4=Seung Ho |last5=Kim |first5=Dae Joong |title=Location and Tension of the Medial Palpebral Ligament |journal=Journal of Craniofacial Surgery |date=November 2013 |volume=24 |issue=6 |pages=2119–2123 |doi=10.1097/SCS.0b013e31827c7c3e |pmid=24220420 }}

As the ligament crosses the lacrimal sac, a strong aponeurotic lamina is given off from its posterior surface; this expands over the sac, and is attached to the posterior lacrimal crest.

The medial palpebral ligament consists of a superficial (anterior) and a deep (posterior) layer.{{cite journal |last1=Ritleng |first1=P. |last2=Bourgeon |first2=A. |last3=Richelme |first3=H. |title=New concepts of the anatomy of the lacrimal apparatus |journal=Anatomia Clinica |date=March 1983 |volume=5 |issue=1 |pages=29–34 |doi=10.1007/BF01798870 }} The superficial layer has a length of around 9.6 mm, a width of around 2.4 mm, and a thickness of around 4.5 mm. The deep layer has a length of around 3.7, a width of around 2.9, and a thickness of around 0.3 mm. Together, these have a strength of around 17 newtons, with most of this strength from the superficial layer.

The superior branch of the medial palpebral artery runs directly behind the medial palpebral ligament.{{cite journal |last1=Erdogmus |first1=Senem |last2=Govsa |first2=Figen |title=The arterial anatomy of the eyelid: importance for reconstructive and aesthetic surgery |journal=Journal of Plastic, Reconstructive & Aesthetic Surgery |date=March 2007 |volume=60 |issue=3 |pages=241–245 |doi=10.1016/j.bjps.2006.01.056 |pmid=17293279 }} Branches of the facial nerve, particularly the buccal branches, pass upwards over the medial palpebral ligament to reach the nose.{{cite journal |last1=Nemoto |first1=Y |last2=Sekino |first2=Y |last3=Kaneko |first3=H |title=Facial Nerve Anatomy in Eyelids and Periorbit |journal=Japanese Journal of Ophthalmology |date=October 2001 |volume=45 |issue=5 |pages=445–452 |doi=10.1016/s0021-5155(01)00381-1 |pmid=11583664 }}

The medial palpebral ligament connects the medial canthus of each eyelid to the medial part of the orbit.

The medial palpebral ligament can be used as a point of fixation during eyelid reconstructive surgery, allowing for normal blinking.{{cite journal |last1=Ueda |first1=K. |last2=Oba |first2=S. |last3=Okada |first3=M. |last4=Hara |first4=M. |last5=Zen |first5=N. |title=Eyelid reconstruction with a composite radial forearm palmaris longus tendon flap |journal=Journal of Plastic, Reconstructive & Aesthetic Surgery |date=March 2007 |volume=60 |issue=3 |pages=256–259 |doi=10.1016/j.bjps.2006.03.058 |pmid=17293282 }}{{cite journal |last1=Srivastava |first1=Kuldeep Kumar |last2=Sundaresh |first2=Kannan |last3=Vijayalakshmi |first3=Perumalsamy |title=A new surgical technique for ocular fixation in congenital third nerve palsy |journal=Journal of American Association for Pediatric Ophthalmology and Strabismus |date=August 2004 |volume=8 |issue=4 |pages=371–377 |doi=10.1016/j.jaapos.2004.01.015 |pmid=15314600 }}

The medial palpebral ligament has also been known as the medial canthal tendon. Some consider it to be a tendon of the lacrimal part of the orbicularis oculi muscle.

• Orbicularis oculi muscle

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{{Accessory organs of the eye}}

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Category:Human eye anatomy

Category:Ligaments of the head and neck