Jr. Lukas et al., 2 FIBROMUSCULAR TRANSVERSE LIGAMENTS RELATED TO THE LEVATOR PALPEBRAESUPERIORIS - WHITNALLS-LIGAMENT AND AN INTERMUSCULAR TRANSVERSE LIGAMENT, The Anatomical record, 246(3), 1996, pp. 415-422
Background: This study was performed to reinvestigate the detailed ana
tomy of the connective tissues related to the levator palpebrae superi
oris (LPS). Materials and Methods: One hundred and twenty human orbits
were prepared macroscopically or with the help of an operational micr
oscope. Connective tissues related to the LPS were measured, removed,
and prepared for histology, Different staining procedures including im
munohistochemistry for alpha-smooth muscle actin were applied to analy
ze the quality of these tissues. Results: Preparation consistently rev
ealed two definite fibromuscular transverse ligaments related to the L
PS, i.e., Whitnall's ligament (WL) and a definite intermuscular transv
erse Ligament (ITL) underlying the LPS, The ITL exhibited a greater an
terio-posterior extension than WL, In sagittal section, the ITL was ob
served slightly more posterior in the orbit than WL, Histologically, b
oth ligaments consisted of collagenous fibers, elastic fibers, and smo
oth muscle fibers. WL was connected with the LPS by sagittal fibroelas
tic connecting strands. Conclusions: Two transverse ligaments of fibro
muscular tissue, WL and the ITL, form a sleeve superior and inferior t
o the LPS, This sling is supposed to assist the LPS in its action and
should be preserved at ptosis surgery. (C) 1996 Wiley-Liss, Inc.