The cranio-orbital foramen: a meta-analysis with a review of the literature

Abstract

Background: The goal of the present study was to provide accurate data on the prevalence and morphometrical aspects of the cranio-orbital foramen (COF), which can surely be of use by surgeons performing procedures on the lateral orbit. Furthermore, the embryology and the clinical significance of this osseous structure were thoroughly discussed.

Materials and methods: Major online medical databases such as PubMed, Scopus, Embase, Web of Science, and Google Scholar were searched to find all relevant studies regarding COF.

Results: Eventually, a total of 25 studies that matched the required criteria and contained complete and relevant data were included in this meta-analysis. The pooled prevalence of COF was found to be 48.37% (95% confidence interval [CI]: 41.67-55.10%). The occurrence of the COF unilaterally was set to be 71.92% (95% CI: 41.87-96.97%). The occurrence of the COF bilaterally was set at 26.08% (95% CI: 3.03-58.13%).

Conclusions: In conclusion, we believe that this is the most accurate and up-to- -date study regarding the anatomy of the COF. The COF is prevalent in 48.37% of the cases, and it is most frequently unilateral (73.92%). Furthermore, the prevalence of accessory COFs was found to be 16.72%. The presence of these foramina may represent a source of haemorrhage that ophthalmic surgeons should be aware of when performing procedures in the lateral part of the orbit.

Keywords: cranio-orbital foramen; frontozygomatic suture; lateral orbit; whitnall tubercle.