Müller kasları: Göz ve Orbitanın Üç Farklı Düz Kası

Yıl 2025, Cilt: 34 Sayı: 3, 229 - 236, 30.09.2025

Cansu Kibar Karagöz , Hatice Yenigül , Özge Coşkun Sağlam

https://doi.org/10.17827/aktd.1612117

Öz

Amaç: "Müller kası" eponimi, çeşitli ders kitaplarında ve akademik makalelerde üç farklı düz kası (m. orbitalis, m. tarsalis superior ve m. ciliaris'in dairesel lifleri) ifade etmek için kullanılmıştır. Bu derlemenin amacı, literatürde Müller kası eponiminin göz ve orbita ile ilişkili üç farklı kas için ortak bir isim olarak kullanılmasıyla oluşan terminolojik karışıklığa dikkat çekmektir.
Yöntem: "Müller kası" teriminin uygun kullanımını netleştirmek için PubMed, Google Akademik, Scopus ve Web of Science gibi akademik veri tabanlarında kapsamlı bir literatür taraması yapıldı. Ayrıca, önde gelen tıp fakültesi kaynakları, atlaslar ve ders kitaplarındaki bu kasların tanımları incelendi. Kasların ayrıntılı topografik konumları, anatomik ve morfolojik özellikleri, histolojik yapıları, innervasyon ve vaskülarizasyonu ve klinik sendromları karşılaştırmalı olarak sunuldu.
Sonuç: Çalışmamızın, gelecekte anatomi atlaslarında, klinik rehberlerde ve bilimsel çalışmalarda topluca ‘Müller kası’ olarak adlandırılan bu kaslara ilişkin isimlendirme karışıklığının önlenmesine katkıda bulunacağına inanıyoruz.

Anahtar Kelimeler

orbita , müller kası , anatomi , göz

Müller's Muscles: Three Different Smooth Muscles of the Eye and Orbit

Öz

Purpose: The eponym “Müller’s muscle” has been used in various textbooks and academic articles to refer collectively to three different smooth muscles: orbital muscle, superior tarsal muscle and the circular fibers of the ciliary muscle. The aim of this review is to highlight the terminological confusion created in the literature by the use of the Müller’s muscle eponym as a common name for three different muscles associated with the eye and orbit.
Methods: A comprehensive literature review was conducted in academic databases such as PubMed, Google Scholar, Scopus, and Web of Science to clarify clarify the appropriate usage of the term “Müller’s muscle”. Additionally, the descriptions of these muscles in leading medical school sources, atlases, and textbooks were examined. The detailed topographical locations, anatomical and morphological characteristics, histological structures, innervation and vascularisation, and clinical syndromes of the muscles were presented in a comparative manner.
Conclusion: We believe that our study will contribute to preventing naming confusion regarding these muscles, collectively referred to as ‘Müller's muscle,’ in future anatomy atlases, clinical guidebooks, and scientific studies.

Anahtar Kelimeler

orbit , müller , anatomy , eye

Etik Beyan

Since it is a compilation article, an ethics committee was not required.

Destekleyen Kurum

Authors declared no financial support

Teşekkür

The authors would like to thank architect Yiğit Kağan KARAGÖZ for modeling the visual of ciliary muscle.

Kaynakça

• REFERENCES 1. Cornelius CP, Mayer P, Ehrenfeld M, Metzger MC. The Orbits— Anatomical features in view of innovative surgical methods. Facial Plast Surg. 2014;30:487–508.
• 2. Cho KH, Lee HS, Katori Y, Rodríguez-Vázquez JF, Murakami G, Abe S. Deep fat of the face revisited. Clin. Anat. 2013; 26:347–356.
• 3. Wilden A, Feiser J, Wöhler A, Isik Z, Bendella H, Angelov DN. Anatomy of the human orbital muscle (OM): Features of its detailed topography, syntopy and morphology. Ann Anat. 2017;211:39-45.
• 4. De Battista JC, Zimmer LA, Theodosopoulos PV, Froelich SC, Keller JT. Anatomy of the inferior orbital fissure: implications for endoscopic cranial base surgery. J. Neurol. Surg. B: Skull Base. 2012;73:132–138.
• 5. Rodríguez-Vázquez JF, Mérida-Velasco JR, Arráez-Aybar LA, Jiménez-Collado J. Anatomic relationships of the orbital muscle of Müller in human fetuses. Surgical and Radiologic Anatomy. 1999;20:341-344.
• 6. Von Lanz T, Wachsmuth W. Praktische Anatomie. Kopf. Springer-Verlag, Berlin, 1979:481–482.
• 7. Standring S. Gray's Anatomy. 41st ed. Edinburgh: Elsevier Churchill Livingstone, 2016.
• 8. De Haan AB, Willekens B, Klooster J, Los AA, van Zwietwn J, Botha CP, et al.. The prenatal development of the humanorbit. Strabismus. 2006;14:51–56.
• 9. Osanai H, Abe SI, Rodríguez-Vázquez J, Verdugo-López S, Murakami G, Ohguro H. Human orbital muscle: a new point of view from the fetal development of extraocular connective tissues. Investigative Ophthalmology & Visual Science. 2011;52(3): 1501-1506.
• 10. Arifoğlu Y. Her Yönüyle Anatomi. 3. Baskı. İstanbul, İstanbul Tıp Kitabevi, 2021.
• 11. Finsterer J. Ptosis: Causes, Presentation, and Management . Aesth. Plast. Surg. 2003;27:193–204.
• 12. Beard C. Müller's superior tarsal muscle: anatomy, physiology, and clinical significance. Ann Plast Surg. 1985;14(4):324-33.
• 13. Esperidião-Antonio V, Conceição-Silva F, De-Ary-Pires B, Pires-Neto MA, de Ary-Pires R. The human superior tarsal muscle (Müller's muscle): a morphological classification with surgical correlations. Anat Sci Int. 2010;85(1):1-7.
• 14. Bang YH, Park SH, Kim JH, Cho JH, Lee CJ, Roh TS. The role of Müller's muscle reconsidered. Plast Reconstr Surg. 1998;101(5):1200-4.
• 15. Stewart JM, Carter SR. Anatomy and examination of the eyelids. Int Ophthalmol Clin. 2002;42(2):1.
• 16. Baldwin HC, Bhagey J, Khooshabeh R. Open sky Muller muscle-conjunctival resection in phenylephrine test-negative blepharoptosis patients. Ophthal Plast Reconstr Surg. 2005;21:276–280.
• 17. Moore KL, Dalley AF, Agur AMR. Clinically Oriented Anatomy.7th ed. Philadelphia, PA: Lippincott Williams & Wilkins, 2014.
• 18. Yuzuriha S, Matsuo K, Hirasawa C, Moriizumi T: Refined distribution of myelinated trigeminal proprioceptive nerve fibres in Mueller's muscle as the mechanoreceptors to induce involuntary reflexive contraction of the levator and frontalis muscles. J Plast Reconstr Aesthet Surg. 2009; 62:1403-10.
• 19. Landau-Prat D, Mayer C, Gomel N, Arazi M, Zloto O, Dori A, & Simon GJB. Müller's Muscle as a Sensory Proprioceptive Organ: Histological and Histochemical Analysis. Investigative Ophthalmology & Visual Science. 2023;64(5):18-18.
• 20. Ban R, Matsuo K, Osada Y, Ban M, & Yuzuriha S. Reflexive contraction of the levator palpebrae superioris muscle to involuntarily sustain the effective eyelid retraction through the transverse trigeminal proprioceptive nerve on the proximal Mueller's muscle: verification with evoked electromyography. Journal of plastic, reconstructive & aesthetic surgery. 2010;63(1):59-64.
• 21. Matsuo K, & Kaneko A. Stretching of Mechanoreceptors in Superior Tarsal Muscle Reflexively Contracts Slow-Twitch Fibers in Facial Expression Muscles: A Case Series. Cureus. 2024;16(7):e64438.
• 22. Murchison AP, Bilyk JR, Savino PJ. Ptosis in neurologic disease. Smith and Nesi’s Ophthalmic Plastic and Reconstructive Surgery. 2021;243-278.
• 23. Leshno A, Smadar L, Kapelushnik N, Serlin T, Prat D, Priel A, & Sagiv O. New insight into the physiologic function of Müller's muscle. Experimental Eye Research. 2021;202, 108336.
• 24. Ben Simon GJ, Lee S, Schwarcz RM et al. Muller's muscle-conjunctival resection for correction of upper eyelid ptosis: relationship between phenylephrine testing and the amount of tissue resected with final eyelid position. Arch Facial Plast Surg. 2007;9:413-417.
• 25. Forrester JV, Dick AD, McMenamin PG, Roberts F, Pearlman E. The Eye: Basic Sciences in Practice. 5th ed. UK, Saunders/Elsevier, 2021.
• 26. Remington LA, & Goodwin D. Clinical Anatomy and Physiology of the Visual System. 4th ed. Elsevier Health Sciences, 2022.
• 27. Mao Y, Bai HX, Li B, Xu XL, Gao F, Zhang ZB, Jonas J. B. Dimensions of the ciliary muscles of Brücke, Müller and Iwanoff and their associations with axial length and glaucoma. Graefe's Archive for Clinical and Experimental Ophthalmology. 2018;256: 2165-2171.
• 28. Park CY, Lee JK, Kahook MY, Schultz JS, Zhang C, Chuck RS. Revisiting ciliary muscle tendons and their connections with the trabecular meshwork by two photon excitation microscopic imaging. Invest Ophthalmol Vis Sci. 2016;57:1096–1105.
• 29. Flügel-Koch CM, Tektas OY, Kaufman PL, et al. Morphological alterations within the peripheral fixation of the iris dilator muscle in eyes with pigmentary glaucoma. Invest Ophthalmol Vis Sci. 2014;55(7):4541–4551
• 30. Warjri GB, & Senthil S. Imaging of the Ciliary Body: A Major Review. Seminars in Ophthalmology, 2022;37(6):711–723.
• 31. Strenk SA, Strenk LM, Guo S. Magnetic resonance imaging of aging, accommodating, phakic, and pseudophakic ciliary muscle diameters. J Cataract Refract Surg. 2006;32:1792–1798.