An anatomical study of the junction of the orbital septum and the levator aponeurosis in Orientals

The anatomical relationships of the orbital septum and levator aponeurosis has been studied in 40 eyelids subjected to blepharoplasty and corrective p tosis surgery by dissection in 10 cadavers and in histological sections. Th e orbital septum originates from the arcus marginalis of the frontal bone a nd consists of two layers. The whitish outer (superficial) layer, containin g vertically running vessels, descends just inside the orbicularis oculi mu scle to interdigitate with the levator aponeurosis with loose connective ti ssue, then disperses inferiorly. The inner (deep) layer follows the superfi cial one initially, then reflects at the levator aponeurosis and continues posteriorly with the levator sheath. We reconfirmed Whitnall's original des cription that the levator sheath thickens to form the superior transverse l igament runs continuously inferiorly anterior to the levator aponeurosis an d forms the inner layer of the orbital septum. This detailed anatomical ana lysis should assist in performing upper eyelid surgery such as the Oriental double fold operation or levator resection.