摘要
目的 为临床眶内手术避免眼外肌运动神经损伤提供解剖学资料。方法 采用显微解剖学技术对 6 0侧成人动眼神经、滑车神经和外展神经的位置、走行、毗邻进行解剖学观察。结果 (1)滑车神经多在上斜肌后 1/ 3段的眶面入肌 ,在滑车神经与上睑提肌交叉处 ,额神经紧邻滑车神经外侧 ;(2 )外展神经入肌点有动脉伴行者占 86 .6 7% ,上下 3等分外直肌的肌腹 ,入肌点在肌的中 1/ 3份者 6 6 .6 7% ;(3)动眼神经上干出总腱环后行于上直肌与视神经之间 ,并分支入上直肌和上睑提肌。动眼神经下干分出内直肌支、下直肌支和下斜肌支。内直肌支经视神经下方向内前斜行至内直肌。下直肌支有 2～ 5条分支 ,入肌点多在肌的后 1/ 3部。下斜肌支沿下直肌的外上方前行入下斜肌 ,是动眼神经分支中行程最长的一支。结论 经颅开眶 ,在上斜肌与上睑提肌、上直肌之间的间隙入路手术时应注意保护滑车神经。肌锥内后部手术在保护好视神经、眼动脉及其分支等结构的同时 ,还应注意保护动眼神经和外展神经。
Objective To provide anatomic data for avoiding damage the extraocular muscular nerves during the intraorbital operation.Methods Microanatomic method was used to observe the location, course and syntopy of the oculomotor, trochlear and abducent nerves on 30 adult cadaveric heads (60 sides of orbits). Results (1)The trochlear nerve entered into the orbital side of one third of superior oblique muscle, it was neighboring frontal nerve when it crossed superior levator muscle; (2)There were arteries where the abducent nerves went into lateral rectus muscles (86.67%). If the belly of lateral rectus muscle was divided into three superior-inferior parts, nerve entered into middle one third commonly;(3)Superior division of oculomotor nerve coursed between optic nerve and superior rectus muscle after it left zinn ring, its branches entered into the superior rectus muscle and levator muscle. Inferior division of oculomotor nerve branched into medial rectus, superior rectus and superior oblique muscles. The branches which entered medial rectus muscle went under the optic nerve. There were 2~5 branches which entered inferior rectus muscle. Entering muscle point was on middle and posterior one third of muscle. Inferior oblique musclar branches were located at superior-lateral inferior rectus muscle. Conclusions The trochlear nerve should be protected through the space between superior oblique and the superior levator, rectus muscles into the optic and orbital apex. The oculomotor and abducent nerves should be protected during the operation of orbital apex.
出处
《眼科新进展》
CAS
2001年第6期413-414,共2页
Recent Advances in Ophthalmology
