论文部分内容阅读
目的:研究视神经和后组鼻窦以及眼动脉的关系,寻找可靠的解剖标志,为经鼻视神经减压手术中视神经定位和有效避免损伤眼动脉提供内镜解剖学基础。方法:选用8例成人头颅标本,采用messerklinger手术方法开放后组筛窦和蝶窦。在内镜下辨认视神经-颈动脉隐窝和视神经管,观察视神经和后组鼻窦的关系,去除骨性管壁,充分开放视神经的颅口和眶口,切开视神经管硬膜层,观察视神经和眼动脉的关系。结果:本组发现在所有标本中均可以观察到颈内动脉-视神经隐窝,视神经隆起出现率仅为62%;视神经和蝶窦以及后组筛窦存在3种毗邻关系,8侧(50%)前部为后筛窦,后部为蝶窦,5侧(31%)全为蝶窦,3侧(19%)全为筛窦;视神经管颅口部眼动脉位于视神经内下方9例(56%)、下方4例(25%)和外下方3例(19%),眼动脉在视神经下方向外侧行走,至视神经管眶口部,眼动脉位于视神经下方3例(19%)和外下方13例(81%)。结论:视神经-颈内动脉隐窝恒定出现,同时由于内镜的成像特点,该隐窝比视神经管隆起的辨认更加可靠,可以作为视神经减压手术中的首选解剖标志;眼动脉发起的位置位于视神经的下内侧,发出后向下外侧行走,行程中存在交叉关系,手术中应注意该因素,避免损伤眼动脉。
OBJECTIVE: To study the relationship between the optic nerve and the posterior group of the sinuses and the ophthalmic arteries and to find reliable anatomical landmarks for the purpose of providing endoscopic anatomy for the localization of the optic nerve in nasal optic nerve decompression surgery and effective avoidance of damage to the ophthalmic artery. Methods: Eight adult skull specimens were selected and the posterior ethmoid sinus and sphenoid sinus were opened by messerklinger operation. The optic nerve-carotid arteries and optic canal were identified by endoscopy. The relationship between the optic nerve and the posterior group was observed. The bony wall was removed and the cranial and orbital orbital orifice of the optic nerve was fully opened. The optic nerve canal was excised and the optic nerve And the relationship between the eye artery. Results: The carotid artery - optic nerve recess was found in all the specimens. The incidence of optic nerve bulge was only 62%. There were three kinds of adjacent relationship between the optic nerve, the sphenoid sinus and the posterior ethmoid sinus. The eight sides (50% ) Of the posterior ethmoid sinus, posterior for the sphenoid sinus, 5 sides (31%) were all sphenoid sinus, 3 sides (19%) were all ethmoid sinus; optic canal of the cranial and cranial nerves located in the lower part of the optic nerve in 9 cases 56%), the lower 4 cases (25%) and the lower 3 cases (19%). The ophthalmic artery walked under the optic nerve to the lateral orbit of the optic canal. The ophthalmic artery was located under the optic nerve in 3 cases (19% The bottom 13 cases (81%). CONCLUSIONS: The crypts of the optic nerve-internal carotid artery are invariably present. Because of the imaging characteristics of the endoscope, this crypt is more reliable than the optic canal uplift and can be used as the anatomical landmark of optic nerve decompression surgery. The location of the ophthalmic artery is The lower medial optic nerve, issued after the downward lateral walking, there is a cross-stroke relationship, surgery should pay attention to this factor, to avoid damage to the ophthalmic artery.