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Orbital Roof

paries superior orbitae

The roof of the orbit is formed primarily by the orbital plate of the frontal bone, with a small contribution from the lesser wing of the sphenoid posteriorly. It separates the orbit from the anterior cranial fossa and the frontal sinus anteriorly. The trochlea for the superior oblique muscle attaches to the anteromedial orbital roof, and the lacrimal gland fossa occupies the anterolateral angle.

Region: Head & Skull

Clinical Relevance

Clinical Notes

The orbital roof is the thinnest roof of the orbit and is subject to erosion by adjacent frontal sinus mucoceles and osteomas, as well as by meningiomas of the anterior cranial fossa. Orbital roof fractures from superior trauma produce pneumocephalus and communication with the intracranial space. Endoscopic transcranial approaches to the anterior skull base use the orbital roof as a corridor. Dermoid cysts of the superolateral orbit are attached to the frontozygomatic suture and can erode through the roof.

Pathology

Common Injuries & Conditions

Orbital Roof Fracture with Pneumocephalus

Superior orbital rim and roof fractures from frontal impact create an intracranial communication and pneumocephalus that may tension under CSF pressure, producing headache and neurological signs managed by surgical repair of the dural-orbital fistula.

Frontal Sinus Mucocele with Orbital Extension

Expanding mucocele of the frontal sinus erodes through the thin orbital roof, producing superior proptosis and upward displacement of the globe with gradual onset, treated by endoscopic frontal sinus drainage and mucocele obliteration restoring orbital contour.