摘要
目的通过对视神经管及其相关结构的研究,为经颅视神经管减压术提供解剖学依据。方法随机选取10个外观无异常的经甲醛固定的成人尸头及5个成人干颅骨标本,在显微镜下进行视神经管及其相关结构的观察和测量。结果1视神经管颅口、中部及眶口的横截面积分别为(19.22±4.58)、(18.26±4.33)、(21.08±3.96)mm2;视神经管颅口与眉间及翼点的距离分别是(63.88±4.63)、(51.97±2.98)mm;2前床突全长为(9.52±0.38)mm,根宽为(11.45±0.67)mm。前床突气化率为20%。前床突与颅神经及颈内动脉关系密切。3本组20侧中12侧可见镰状韧带锐利的后缘压迫视神经;镰状韧带、视神经鞘膜、总腱环均比较坚韧结实;这些膜性结构与视神经之间无明显间隙。4本组有3侧(15%)滑车神经由于筛后动脉的牵拉,致使其紧贴上直肌腱。5眼动脉均在视神经下方的硬膜鞘内走行。结论 1视神经管减压应全程切开;2正确磨除前床突可减少脑神经及颈内动脉损伤概率;3在视神经上方纵行切开镰状韧带、鞘膜,在近眶口处贴近内侧切开总腱环,可使管内视神经有效减压,并可减少滑车神经的损伤概率,避免眼动脉损伤。
Objective To study the optic canal and its associated structures to provide anatomical basis for the transcranial decompression of optic nerve. Methods 10 well-reserved adult cadaveric heads fixed by formalin as well as 5 adult dry skull specimens were randomly selected to observe and measure their optic canals and the related structures under a microscope. Results ① The transverse areas in cranial orifice, middle part, orbital orifice of the optic cana were （ 19.22 ± 4.58）, （ 18.26 _± 4. 33 ）, （21.08 ± 3.96） mm^2, respectively ; the distance from en- docranial opening of optic canal to glabella was （63.88 ± 4.63 ） mm, and the range from endocranial opening to pterion was （51.97 ±2.98） ram. ② The total length of the anterior clinoid process was （9. 52 ±0. 38） ram, width of its root was （ 11.45 ± 0. 67 ） mam. The percentage of anterior clinoid gasification was 20%. Anterior clinoid process was close to cranial nerve and internal carotid artery. ③ Falciform ligament, annular tendon and the region dura were relatively tough and firm, and no significant space was between them and the optic nerve. ④ Three trochlear nerves （15%） in this group were pulled by posterior ethmoidal arteries, causing them to be close to supe- rior rectus tendons. ⑤ The ophthalmic artery went beneath the optic nerve when it was in the optic canal. Conclu- sion ① Optic canal should be full cut. ② It can reduce the chance of damage to cranial nerve and internal carot- id artery by grinding anterior clinoid process correctly. ③ The method to incise falciform ligament and the dura ver- tically on the optic nerve, and to slit annular tendon close to the inside when near the orbital orifice, can depressur- ize optic nerve effectively, and it also can reduce the chance of damage to the trochlear nerve and avoid the ophthalmic artery.
出处
《安徽医科大学学报》
CAS
北大核心
2016年第1期90-93,共4页
Acta Universitatis Medicinalis Anhui
基金
安徽省科技攻关项目(编号:12010402113)
关键词
视神经管
视神经
视神经管减压术
应用解剖
optic canal
optic nerve
transcranial decompression of optic canal
applied anatomy damage to
